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"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"

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan.Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation.

Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Latar belakang Gagal tumbuh atau failure to thrive adalah kondisi keterlambatan pertumbuhan fisik pada anak, dimana terjadi kegagalan penambahan berat badan yang sesuai dengan grafik pertumbuhan normal, dibandingkan dengan tinggi badan. Beberapa kondisi menjadi faktor risiko terjadinya gangguan pertumbuhan terutama pada neonatus. Studi ini memberikan gambaran penerapan Model Adaptasi Roy dalam asuhan keperawatan pada lima kasus neonatus dengan risiko gangguan pertumbuhan. Presentasi kasus Kasus 1 neonatus laki-laki, dengan extremely preterm usia gestasi 27 minggu, berat badan lahir 870 gram, neonatus kurang bulan kecil masa kehamilan (NKB-KMK), RDS, TTN, septikemia, tersangka SNAD, neonatal jaundice, terpasang ventilator mode high frequency oscilation (HFO), terpasang orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 dengan GIR 4,7, kebutuhan kalori kurang dari target, interpretasi kurva Fenton dibawah persentil 50, berat badan menurun, usia enam hari 860 gram. Kasus 2 perempuan, extremely preterm usia gestasi 26 minggu, berat badan lahir 744 gram, NKB-KMK, RDS, tersangka SNAD, PDA, neonatal jaundice. Terpasang ventilator, sementara puasa, grafik Fenton berada dibawah persentil 50, kebutuhan kalori kurang dari target. Kasus 3 dan 4 neonatus berjenis kelamin perempuan, lahir dengan extremely preterm dan very preterm, terpasang ventilator, kebutuhan kalori kurang dari target, sementara dipuasakan karena kondisi belum stabil. Kasus 5 perempuan, usia gestasi 37 minggu, BBL 2610 gram, berat badan saat dikaji 2340 gram. Diagnosis medis gastroschizis post tutup defek hari ke 27, terpasang non invasif ventilasi, sementara puasa produksi OGT kehijauan, BB/PB berada di -3SD s/d <-2 SD (gizi kurang). Evaluasi respons adaptif dari kelima pasien didapatkan kebutuhan kalori terpenuhi sesuai target.Kesimpulan Hasil pengkajian perilaku dan stimulus mode fisiologis-fisik kelima kasus didapatkan empat kasus berisiko mengalami gangguan pertumbuhan dari kondisi neonatus lahir prematur, terpasang ventilator, penundaan pemberian makan karena kondisi klinis, risiko infeksi/sepsis serta kondisi medis lain yang mempengaruhi. Satu neonatus aterm gagal tumbuh karena gastroschizis post tutup defek, dengan produksi OGT kehijauan. Nutrisi optimal baik enteral maupun parenteral diperlukan pada kondisi neonatus tersebut untuk meningkatkan respons adaptif.

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Background Failure to thrive or failure to thrive is a condition of delayed physical growth in children, in which there is a failure to gain weight according to the normal growth chart, compared to height. Several conditions are risk factors for growth disorders, especially in neonates. This study provides an overview of the application of the Roy Adaptation Model in nursing care to five cases of neonates with a risk of growth retardation. Case presentation Case 1 male neonate, with extremely preterm gestational age 27 weeks, birth weight 870 gram, small preterm neonate for gestational age (NKB-KMK), RDS, TTN, septicemia, TSK SNAD, neonatal jaundice, put on ventilator mode high frequency oscillation (HFO), installed orogastric (OGT), diet ASI 12x1 ml, TPN PG 2 with GIR 4.7, caloric requirement less than target, interpretation of Fenton curve below 50th percentile, decreased body weight, age six days 860 gram. Cases of 2 women, extremely preterm, gestational age 26 weeks, birth weight 744 grams, NKB-KMK, RDS, suspected SNAD, PDA, neonatal jaundice. Installed on a ventilator, while fasting, the Fenton chart is below the 50th percentile, calorie needs are less than the target. Cases 3 and 4 female baby were born extremely preterm and very preterm, were attached to a ventilator, their caloric needs were less than the target, while they were fasted because their condition was not yet stable. Case 5 female, gestational age 37 weeks, BBL 2610 grams, body weight when studied 2340 grams. Medical diagnosis of gastroschizis post closed defect on day 27, installed non-invasive ventilation, while fasting green OGT production, BB/PB was in -3SD to <-2 SD (malnutrition). Evaluation of the adaptive response of the five patients found that the calorie needs were fulfilled according to the target.

Conclusion The results of the assessment of the behavior and stimulus of the physiological-physical mode of five cases found that four cases were at risk of experiencing growth retardation from the condition of the neonate born prematurely, being placed on a ventilator, delaying feeding due to clinical conditions, risk of infection/sepsis and other affecting medical conditions. One term neonate failed to thrive because of a closed post gastroschizis defect, with greenish OGT production. Optimal nutrition, both enteral and parenteral, is needed in these neonatal conditions to increase adaptive responses."

"Karya Ilmiah Akhir ini bertujuan memberikan gambaran pemberian terapi spesialis ldquo Terapi Penerimaan Dan Komitmen rdquo pada klien harga diri rendah dan resiko perilaku kekerasan melalui pendekatan model adaptasi Roy dan interpersonal Peplau di Ruang Yudistira Rumah Sakit Dr H Marzoeki Mahdi Bogor ACT diberikan kepada 7 klien. Hasil yang ditemukan ACT sama sama efektif dalam menurunkan gejala dari harga diri rendah maupun resiko perilaku kekerasanyang ditunjukkan melalui respon kognitif afektif fisiologis perilaku dan sosial tetapi penurunan gejala lebih besar terlihat pada klien dengan resiko perilaku kekerasan ACT direkomendasikan sebagai terapi spesialis keperawatan pada klien harga diri rendah dan resiko perilaku kekerasan.

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This study described an overview specialist therapy Acceptance and Commitment Therapy to the patients with low self esteem and the risk of violent using Roy adaptation and Peplau interpersonal model approach at Yudistira Room Dr H Marzoeki Mahdi Hospital in Bogor ACT was provided to 7 clients.

The result found that ACT was equally effective in reduced the symptoms of low self esteem and the risk of violent was demonstrated by the response of cognitive affective physiological behavioral and social but a greater reduction in symptoms seen in clients with a risk of violent ACT was recommended as therapy of nursing specialists at the client with low self esteem and the risk of violent."

"Terapi penerimaan dan komitmen (TPK) sering digunakan untuk mengatasi masalah gangguan jiwa. TPK meningkatkan fleksibilitas psikologis individu agar mampu menerima pengalaman masalah lalu yang tidak menyenangkan dan membangun komitmen perilaku baru yang lebih baik. TPK dapat menjadi pilihan dalam mengatasi masalah harga diri rendah kronis (HDRK).Tujuan karya ilmiah ini adalah menjelaskan penerapan TPK pada klien HDRK di rumah sakit jiwa daerah Jawa Barat. Sebanyak 25 klien HDRK mendapatkan TPK dengan jumlah 4 sesi.Hasilnya menunjukkan bahwa tanda gejala kognitif turun 92,16%; tanda gejala afektif turun 85,31%; tanda gejala fisiologis turun 89,23%; tanda gejala perilaku turun 88,41%; tanda gejala sosial turun 85,96%; kemampuan menerimaan dan berkomitmen meningkat 66,00%.Penerapan TPK direkomendasikan sebagai terapi spesialis keperawatan untuk klien HDRK. TPK 4 sesi ini juga perlu diuji keefektifannya melalui riset dan pengaruhnya pada diagnosis keperawatan lain.

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Acceptance and commitment therapy (ACT) is often used to solve the mental health problem. ACT increasing the individual psychological flexibility to enable him to receive unpleasant experiences and problems and build commitment to new and better behaviors. ACT can be one of solutions to resolve chronic low self-esteem.

The purpose of this study was to explain the application of ACT in chronic low self-esteem to hospitalized clients at Mental Hospital in West Java. Twenty-five clients with chronic low self-esteem received 4 sessions of ACT.

The results were cognitive signs and symptoms decreased 92,16%; affective signs and symptoms decreased 85,31%; physiological signs and symptoms decreased 89,23%; behavior signs and symptoms decreased 88,41%; social signs and symptoms decreased 85,96%; and the patient?s ability to accept and commit increased up to 66,00%.

It is recommended that ACT is implemented as nursing specialized therapy to chronic low self-esteem clients. Four sessions of ACT also need to be tested for its effectiveness through research and its effect in other nursing diagnosis."

"Prakktik residensi merupakan bagiam dari pendidikan profesi yang bertujuan untuk memebentuk perawat spesialis. Beberapa kompensasi yang harus dicapai dalam praktik residensi keperawatan medikal ebdah adalah manajemen kasus   menggunakan teori model keperawatan, penerapan model keperawatan berbasis bukti, dan proyek inovasi. Model adaptasi Roy digunakan dalam asuhan keperawatan dengan pasien dengan gangguan system pernapasan. Pendekatan model adaptasi Roy bertujuan untuk mempertahankan integritas adaptasi manusia. Model adaptasi Roy berperan dalam membantu mengembangkan mekanisme koping yang adaptif terhadap stimulusdari lingkungan. Pada target kompetensi penerapan asuhan berbasis bukti dengan penerapan Aroma Hand Massage untuk mengurangi nyeri, tingkat kecemasan dan depresi pada pasien dengan kanker paru terminal.Hasil penerapan menunjukkan bahwa terapi aroma hand massage menurunkan skor nyeri dan depresi pada pasien dengan kanker paru terminal. Proyek inovasi adalah penerapan mobile phone application untuk pengkajian dan manajemen keperawatan mandiri pada pasien dengan kanker paru. Hasil penerapan aplikasi tersebut  menunjukkan bahwa kemanfaatan, mudah dalam penggunaan dan kepuasan responden dalam mengaplikasikannya.

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The residency practice is a part of professional education to build specialist nurses. Some of the competencies must be achieved in residency practice of medical surgical are case management using nursing model theory, the application of  evidence-based nursing practice, and innovation projects. Roys adaptation mode is used in nursing care in patients with impaired respiratory function. Roys adaptation model aimed to develop adaptive coping mechanism from environment stimuli.

The implementation of evidence based nursing used Aroma Hand Massage was effective and useful significantly to reduce score pain and depression on patient with terminal lung cancer. Innovation project was the use of mobile phone application for assessment and management nursing intervention  on patient with lung cancer it was  useful, easy and fun to be applied."

"Klien gangguan jiwa cenderung tidak produktif dan berpenghasilan mempengaruhi stigma sehingga menyebabkan Harga Diri Rendah (HDR) dan isolasi sosial. Klien memerlukan pemulihan jangka panjang, yang dipersulit insight buruk. Tujuan: menjelaskan penerapan Acceptance and Commitment Therapy (ACT), Cognitive Behavior Social Skills Training (CBSST) menggunakan pendekatan Model Adaptasi Roy (MAR) dan Model Tidal. MAR sebagai kerangka utama dan Teori Model Tidal pada proses kontrol koping. Analisis dilakukan pada 32 klien ACT+CBSST, dan 22 klien CBSST. Hasil: ACT+CBSST memperbaiki insight dan meningkatkan keterampilan sosial, perilaku adaptif meningkatkan penurunan tanda gejala HDR kronis dan isolasi sosial. Saran: kombinasi ACT+CBSST pilihan pada awal program pemulihan.

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Clients of mental disorders tend to be non- productive and non-income that affect stigma the impact Low Self-Esteem (LSE) and social isolation. The client required a long-term recovery, which compounded a poor insight.

Objective: explained the application of Acceptance and Commitment Therapy (ACT), Cognitive Behavior Social Skills Training (CBSST) by using the approaches of Roy Adaptation Model (RAM) and the Tidal Model. RAM as the main framework and the Tidal Model Theory as coping control process. Analysis was performed on 32 ACT + CBSST clients, and 22 CBSST client.

Results: ACT improved insight and increased social skills, improved adaptive behavior and decreased in signs and symptoms of chronic LSE and social isolation.

Recomendation: the combination of ACT + CBSST choice at the beginning of the recovery program."

"Pelaksanaan praktek spesialis keperawatan merupakan bagian penting dalam meningkatkan kualitas pelayanan serta pendidikan berkelanjutan. Praktek spesialis keperawatan dilakukan dapat dikembangkan berdasarkan ilmu dan teknologi. Beberapa kompetensi yang harus dicapai oleh residen selama praktek spesialis keperawatan ini adalah mampu berperan sebagaipemberi asuhan keperawatan care provider manager, mampu menerapkan hasil penelitian berbasis hasil pembuktian ilmiah evidence based nursing practice, mampu melakukan inovasi Inovator. Dalam melakukan peran perawat sebagai pemberi asuhan keperawatan, residen melaksanakan asuhan keperawatan dengan menerapkan teori Model Adaptasi Roy pada pasien dengan gangguan sistem perkemihan sebanyak 30 pasien di Rumah Sakit Umum Pusat Fatmawati Jakarta dan RSPAD Gatot Soebroto Jakarta. Intervensi yang dilakukan untuk mengurangi pruritus yang dialami oleh pasien yaitu dengan melakukan terapi akupresur pada titik Li-11 berdasarkan hasil penelitian ilmiah pada 19 pasien hemodialisis di RSPAD Gatot Soebroto. Selain itu, residen bersama kelompok melakukan program inovasi keperawatan berupa edukasi mengenai intervensi untuk menangani komplikasi akut selama hemodialisis menggunakan video pada 30 orang pasien hemodialisis. Secara umum, penerapan Teori Model Adaptasi Roy dapat dilakukan oleh perawat dan diterapkan pada pasien dengan gangguan sistem perkemihan. Kualitas asuhan keperawatan yang baik, akan meningkatkan kualitas hidup pasien.

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Implementation of nursing specialist practice is the most important part to improve service program quality and sustainable education. Specialist nursing practice was developed based on science and technology. Several competencies has to be achieved and practiced during this residential practice are competencies to be care provider and manager, competencies to implement result of research which based on scientific evidence evidence based nursing practice and being innovative innovator. As. nursing care provider, practitioners implementing nursing care based on the implementation of Roy Adaptation Model on 30 patients with urinary disorder in Fatmawati Hospital and RSPAD Gatot Soebroto, Jakarta. Practitioners also do intervention to reduce pruritus in hemodialysis patient based on evidence based nursing The practitioners do acupressure in Li-11 accupoint based on result of scientific research on 19 patient with hemodialysis in Gatot Soebroto Hospital. Practitioners also create nursing innovation program related with the education about intervention for acute complication on 30 patient with hemodialysis in form of video. Generally, Roy Model of Adaptation theory is done by nurse and implemented on patient with urinary system problems. Good quality of nursing care will improve patient quality of life."