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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: Sepsis merupakan disfungsi organ yang mengancam jiwa akibat disregulasi respon tubuh terhadap infeksi (Singer et al., 2016). Sepsis menyebabkan mikroganisme menghasilkan toksin atau zat beracun di dalam darah dan memunculkan manifestasi dari mikroganisme tersebut seperti demam, leukositosis, dan terganggunya sistem sirkulasi yang membutuhkan penanganan dengan segera (Singer, Deutschman, Seymour, 2016). Diabetes melitus adalah sekelompok penyakit metabolik yang ditandai dengan tingginya kadar gula (glukosa) dalam darah yang disebabkan kelainan dalam sekresi insulin,kerja insulin atau kedua-duanya (PERKENI, 2015). Pasien dengan diabetes melitus tipe 2 memiliki peningkatan resiko terjadi infeksi dan sepsis sekitar 20,1-22,7 % dari semua pasien sepsis. Penelitian ini bertujuan mengetahui hubungan diabetes melitus tipe 2 dan mortalitas sepsis di IGD RSUPN Dr. Cipto Mangunkusumo tahun 2017.Metode Penelitian: Desain penelitian ini adalah kohort retrospekstif menggunakan data rekam medis pasien sepsis. Sampel penelitian adalah pasien sepsis usia ≥ 18 tahun di IGD RSUPN Dr. Cipto Mangunkusumo tahun 2017 berdomisili di Jabodetabek, yaitu sebanyak 357 pasien.Hasil Penelitian: Hubungan antara DM tipe 2 dan mortalitas sepsis memiliki hubungan signifikan dengan RR sebesar 0,55 (95% CI: 0,35-0,87) sedangkan RR adjusted sebesar 0,75 setelah dianalisis multivariat tidak signifikan berbeda dengan RR crude pada analisis bivariate sebesar 0,55 yang berarti kedua analisis tersebut membuktikan bahwa hubungan DM tipe 2 dengan mortalitas bersifat protektif.

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Background: Sepsis is a life-threatening organ dysfunction due to dysregulation of the bodys response to infection (Singer et al. 2016). Sepsis causes microorganisms to produce toxins or toxic substances in the blood and give rise to manifestations of microorganisms such as fever, leukocytosis, and disruption of the circulatory system that requires immediate treatment (Singer, Deutschman, Seymour, 2016). Diabetes mellitus is a group of metabolic diseases characterized by high levels of sugar (glucose) in the blood caused by abnormalities in insulin secretion, insulin work or both (PERKENI 2015). Patients with type 2 diabetes mellitus have an increased risk of infection and sepsis in approximately 20.1-22.7% of all sepsis patients. This study aims to determine the relationship between type 2 diabetes mellitus and sepsis mortality in the emergency department of RSUPN Dr. Cipto Mangunkusumo in 2017.Methods: The design of this study is a retrospective cohort using medical records of septic patients. The study sample was septic patients aged ≥ 18 years in the emergency room at RSUPN Dr. Cipto Mangunkusumo in 2017 is domiciled in Jabodetabek, which is 357 patientsResult: The relationship between type 2 DM and sepsis mortality has a significant relationship with RR of 0.55 (95% CI: 0.35-0.87) while the adjusted RR is 0.75 aftermultivariate analysis was not significantly different from RR crude at bivariate analysis of 0.55 which means the two analyzes prove that the association of type 2 DM with mortality is protective."

"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."