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"ABSTRAKAngka kejadian apendisitis di negara maju khususnya daerah perkotaan meningkat. Apendisitis dapat terjadi karena gaya hidup yang kurang baik dalam pola konsumsi makanan rendah serat masyarakat perkotaan. Komplikasi apendisitis antara lain perforasi sehingga menimbulkan efek, salah satunya adalah keluhan nyeri. Pemberian posisi semi fowler dan bantal di bagian bawah punggung adalah intervensi keperawatan yang efisien, sederhana dan mandiri. Karya ilmiah ini bertujuan untuk menggambarkan asuhan keperawatan anak post operasi laparotomi appendiktomi dengan pemberian posisi semi fowler dan bantal di bagian bawah punggung. Evaluasi dari pemberian posisi semi fowler terbukti memberikan rasa nyaman dan mengurangi nyeri pada anak dengan post operasi laparotomi appendiktomi. Intervensi keperawatan pemberian posisi semi fowler dan bantal di bagian bawah punggung dapat menjadi evidence based practice pada anak post laparotomi appendiktomiKata kunci: Appendiktomi, manajemen nyeri, pemberian posisi.

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ABSTRACT

The rate of appendicitis in developed countries especially in urban areas increased. Appendicitis could occur due to the lifestyle because of low fiber food consumption pattern of urban communities. One of the complications of appendicitis was perforations, so that generated pain. Semi fowler positioning and pillow in the bottom of the backbone was efficient, simple and eased independent nursing interventions. This paper aimed to describe nursing care of laparotomy appendectomy children in post surgery period with semi fowler positioning and pillow in the bottom of the backbone. The evaluation of semi fowler positioning proved to improve children rsquo s comfort and reduced the pain with post surgery laparotomy appendectomy. The intervention of care nursing of semi fowler positioning and pillow in the bottom of the backbone could be an evidence based practice to children in post laparotomy appendectomy period. Key words Appendectomy, pain management, positioning."

"Nyeri kronik pada sendi dapat menimbulkan dampak negatif bagi kehidupan lansia seperti mengganggu aktivitas keseharian dan mobilitas. Studi kasus ini bertujuan untuk menggambarkan hasil intervensi dari manajemen nyeri non farmakologi yaitu kompres hangat jahe yang dilakukan pada lansia dengan masalah nyeri kronik. Kompres hangat jahe dilakukan sebanyak delapan kali selama 20 menit dalam waktu 3 minggu. Hasil intervensi menunjukkan bahwa terjadi penurunan skala nyeri dengan menggunakan Visual Analog Scale (VAS) dari nyeri sedang (skala 5-6) menjadi ringan (1-2) pada ketiga keluarga kelolaan. Hal ini menunjukkan bahwa manajemen nyeri non farmakologi dengan penerapan kompres hangat jahe dapat menurunkan gejala nyeri. Studi ini menyarankan untuk pengaplikasian kompres hangat jahe bagi lansia dengan nyeri kronik di institusi perawatan jangka panjang.

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Chronic pain in joints can cause a negative impact for the elderly, such as disrupted daily activities and mobility. This case study aims to describe the results of interventions from non-pharmacological pain management, namely warm ginger compresses performed in the elderly with chronic pain problems. Ginger warm compress is done eight times for 20 minutes in 3 weeks.

The results of the intervention show that there is a decrease in pain scale by using the Visual Analog Scale (VAS) from moderate (5-6 pain scale) to mild pain (1-2 pain scale) in the three managed families. This shows that non-pharmacological pain management by applied warm ginger compresses can reduce pain symptoms. This study suggests the application of ginger warm compresses for the elderly with chronic pain in long-term care institutions."

"Hipospadia adalah kelainan kongenital yang menyebabkan anatomi pembukaan saluran kemih berada pada bagian ventral penis. Salah satu faktor risiko hipospadia adalah faktor gaya hidup yang tidak baik ataupun polusi udara yang dapat ditemukan pada masyarakat perkotaan. Penatalaksaan medis hipospadia adalah dengan operasi uretroplasti yang dapat menimbulkan masalah keperawatan berupa nyeri akut. Tujuan penulisan karya ilmiah ini adalah menguraikan asuhan keperawatan pada anak dengan hipospadia. Salah satu intervensi yang diimplementasikan adalah teknik distraksi dengan menonton video kartun animasi. Hasil evaluasi dari tindakan keperawatan yang berupa manajemen nyeri farmakologis dan non farmakologis selama tiga hari adalah skala nyeri anak turun dari skala nyeri 3/10 menjadi 0/10 atau tidak nyeri, anak tampak tenang dan dapat tertawa saat ada adengan lucu pada video kartun. Penulis menyarankan rumah sakit menyediakan fasilitas untuk melakukan distraksi pada anak berupa radio atau tape recorder untuk memutar musik, televisi untuk memutar video animasi ataupun mainan yang dapat mendistraksi anak. Sehingga distraksi dapat dilakukan sesuai dengan karakteristik nyeri dan usia anak.

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Hypospadias is a congenital aberration that causes the anatomy of the opening of the urinary tract to be in the ventral part of the penis. One of the risk factors for hypospadias is a factor of poor lifestyle or air pollution that can be found in urban communities. Hypospadias can be treated through urethroplasty surgery. Post surgical pain will occur in a child. The steps to be taken to deal with this issue is to manage the pain in the child. The purpose of this paper is to describe nursing care in children with hypospadias. One of the interventions implemented is the distraction technique by playing animated cartoon videos as pain management for the child. The usage of distraction technique and pharmacological techniques for three days period decreased the pain rating scale from the 3 10 to 0 10, and the observation showed that the child also seemed to be calmed and laugh when there is a funny scene on an animated cartoon video. The authors suggest that hospitals provide facilities to perform distractions in children such as radio or tape recorders to play music, televisions to play animated videos or toys that can distract children, so that distractions can be performed according to the characteristics of pain and age of the child."

"[Kehamilan dengan Lupus Eritematosus Sistemik (LES) merupakan kondisi yang beresiko tinggi. Karya ilmiah ini bertujuan untuk menganalisis pemberian asuhan keperawatan pada penderita LES di perkotaan dalam periode perinatal. Asuhan keperawatan pada klien dilakukan sesuai dengan proses keperawatan. Tiga masalah keperawatan utama pada klien adalah nyeri, resiko cedera dan ansietas. Intervensi yang diberikan antara lain manajemen nyeri, pemantauan kesehatan kehamilan serta active listening untuk mengatasi ansietas. Pada evaluasi asuhan keperawatan ditemukan masalah nyeri teratasi, cedera tidak terjadi dan ansietas teratasi sebagian. Karya ilmiah ini diharapkan menjadi gambaran dalam pemberian asuhan keperawatan bagi penderita LES pada periode perinatal.;regnancy with Systemic Lupus Erythematosus is a high-risk condition. This paper aims to analyze the provision of nursing care to client with SLE during the perinatal period in urban area. Nursing care to client conducted in accordance with the nursing process. Three major nursing problems that appear on the client were pain, risk of injury and anxiety. Interventions performed for client were pain management, control of pregnancy and active listening to reduce anxiety. Evaluation of nursing intervention revealed that the pain has been managed successfully, there was no injury and reduced anxiety. This paper expected be an example to describe the provision of nursing care for client with SLE.;regnancy with Systemic Lupus Erythematosus is a high-risk condition. This paper aims to analyze the provision of nursing care to client with SLE during the perinatal period in urban area. Nursing care to client conducted in accordance with the nursing process. Three major nursing problems that appear on the client were pain, risk of injury and anxiety. Interventions performed for client were pain management, control of pregnancy and active listening to reduce anxiety. Evaluation of nursing intervention revealed that the pain has been managed successfully, there was no injury and reduced anxiety. This paper expected be an example to describe the provision of nursing care for client with SLE., regnancy with Systemic Lupus Erythematosus is a high-risk condition. This paper aims to analyze the provision of nursing care to client with SLE during the perinatal period in urban area. Nursing care to client conducted in accordance with the nursing process. Three major nursing problems that appear on the client were pain, risk of injury and anxiety. Interventions performed for client were pain management, control of pregnancy and active listening to reduce anxiety. Evaluation of nursing intervention revealed that the pain has been managed successfully, there was no injury and reduced anxiety. This paper expected be an example to describe the provision of nursing care for client with SLE.]"

"ABSTRAKLatar Belakang: Di Indonesia diperkirakan ada 100 pasien kanker baru per 100.000 penduduk setiap tahun dan nyeri menjadi salah satu masalah utama yang dihadapi pasien dengan kanker. Paint Management Index (PMI) adalah suatu instrumen untuk menilai tingkat kesesuaian terapi nyeri kanker yang dibuat berdasarkan panduan terapi nyeri kanker WHO dan Agency for Health Care Policy and Research (AHCPR). Kesesuaian terapi nyeri dinyatakan baik bila pemberian obat analgesik sesuai dengan kualitas nyeri yang dikeluhkan pasien.Tujuan: Mengetahui hubungan antara tingkat pendidikan dan latar belakang dokter PPDS dengan tingkat kesesuaian terapi nyeri pada pasien kanker berdasarkan PMI.Metode: Penelitian ini menggunakan desain potong lintang. Populasi penelitian adalah pasien kanker yang berobat rawat jalan maupun rawat inap di RSCM. Sampel diambil dengan metode consecutive. Data penelitian didapatkan melalui wawancara Subjek penelitian. Data dianalisis menggunakan uji chi-square dan nilai p yang dianggap bermakna apabila kurang dari 0,05.Hasil: Sampel sebanyak 98 pasien kanker dengan rerata usia 47,2 ± 13,4 tahun dan jenis kelamin terbanyak adalah perempuan (52%). Lokasi kanker tertinggi pada daerah genital (23,5%) dengan stadium kanker terbanyak pada stadium 3 (38,7%). Median intensitas nyeri sebelum dan sesudah terapi ada pada skala nyeri 4 (1-9) dan 1 (0-6). Latar belakang pendidikan dokter berasal dari 5 departemen dengan tahun pendidikan terbanyak pada tahun ketiga (54,1%). Proporsi kesesuaian terapi Antinyeri (Skor PMI ≥ 0) sebesar 54,1%. Hubungan antara kesesuaian terapi nyeri dengan latar belakang pendidikan dokter PPDS (p<0,001) dan tahun pendidikan (p=0,022).Simpulan: Proporsi kesesuaian terapi nyeri pada pasien kanker di RSCM sebesar 54,1% dan terdapat hubungan antara tingkat pendidikan dan latar belakang pendidikan dokter PPDS dalam kesesuaian terapi nyeri kanker.

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ABSTRACT

Background: In Indonesia, there are an estimated 100 new cancer patients per 100.000 populations every year and pain becomes one of the major problems faced by patients with cancer. Paint Management Index (PMI) is an instrument to assess the suitability of cancer pain therapy which is based on the WHO cancer pain treatment guidelines and Agency for Health Care Policy and Research (AHCPR). Suitability of pain therapy is considered good when giving analgesics according to the pain quality which complained by the patient.

Aim: To know the relationship between level of education and background of doctors who participate in specialist medical education program with the suitability of pain therapy in cancer patients based on PMI.

Method: This study used a cross-sectional design. The study population was outpatients or inpatients with cancer at the RSCM. Samples were taken with consecutive sampling. Data were obtained through interview with the subjects. Data were analyzed using chisquare test and p values were considered significant if lower than 0.05.

Result: There were 98 cancer patients with a mean age of 47.2 ± 13.4 years and most were female (52%). Highest location of cancers was in the genital area (23.5%) and cancer stage mostly in stage 3 (38.7%). Median of pain intensity before and after the therapy were 4 (1-9) and 1 (0-6) respectively. Doctors? educational background came from 5 different departments with the highest level of education was in the third year (54.1%). Suitability of anti-pain therapy (PMI Score ≥ 0) was 54.1%. The relationship between the suitability of pain therapy by doctors who participate in specialist medical education program (p <0.001) and level of education (p = 0.022).

Conclusion: Suitability of anti-pain therapy in cancer patients in RSCM was 54,1% and there was association between the suitability of pain therapy by doctors who participate in specialist medical education program and level of education."

"ABSTRAKAngka kejadian kanker payudara di Indonesia tertinggi diantara jenis kanker padawanita dengan prevalensi nyeri diperkirakan 40-89%. Tujuan penelitian ini adalahmengembangkan model pengelolaan nyeri berbasis kenyamanan dengan strategicoaching dan mengidentifikasi pengaruhnya terhadap derajat nyeri, kenyamanan, dankualitas hidup pasien kanker payudara. Penelitian ini dilakukan melalui dua tahap,yaitu tahap 1 berupa penelitian deskriptif kualitatif dan pengembangan model, sertatahap 2 berupa penelitian kuasi eksperimen pre-post test control group design.Metode sampling tahap 1 digunakan purposive sampling dengan 11 partisipan. Tahap2 sampel dipilih secara consecutive sampling dengan jumlah 64 responden (32 pasienkelompok intervensi dan 32 pasien kelompok kontrol). Hasil penelitian tahap satuteridentifikasi 12 tema dan dihasilkan model pengelolaan nyeri berbasis kenyamananbeserta perangkatnya. Hasil penelitian tahap dua membuktikan bahwa ada pengaruhyang signifikan dari model pengelolaan nyeri berbasis kenyamanan dengan strategicoaching terhadap penurunan derajat nyeri, peningkatan kenyamanan, peningkatanstatus fungsional dan perbaikan status gejala pasien kanker payudara. Namun, tidakada pengaruh pada status kesehatan/kualitas hidup global. Rekomendasi penelitianhendaknya perawat menerapkan model pengelolaan nyeri berbasis kenyamanansebagai bentuk nyata pengelolaan nyeri kanker secara holistik dalam pelayanankeperawatan.

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ABSTRACTIncidence of breast cancer in Indonesia is still the highest among the other type ofcancer deseases on women with the prevalence of pain estimated from 40 ? 89per cent. The purpose of this research was to develop model of pain managementbased on comfort with coaching strategy and identify its effect on pain severity,comfort, and quality of life patient breast cancer. This study was conducted in twostages. The first stage was descriptive qualitative research and the development ofmodel. The second stage was quasi-experimental research with pre - post test controlgroup design. The sampling method that used to stage 1 was purposive samplingwith 11 partisipants. Sampling method on stage 2 this study was consecutivesampling with 64 breast cancer patients (32 respondents as intervention group and 32respondents as control group). The first stage of the study resulted 12 themes and hasresulted the model of pain management based on comfort and its devices. The secondstage of research proved that there were significance effects from the model of painmnagement based on comfort with coaching strategy toward decreasing painseverity, increasing comfort and functional status, and repairing symptom status forbreast cancer patients. However, there was no effect on global health status/quality oflife. This study recommends that nurse should apply the model of pain managementbased on comfort as a concrete holistic cancer pain management in setting practice ofnursing care."

"ABSTRAKAnalisis Praktik Residensi Keperawatan Medikal Bedah pada Kanker Lambung dengan Pendekatan Model Adaptasi Roy di Rumah Sakit Kanker Dharmais dan Cipto Mangunkusumo Jakarta Karya ilmiah ini bertujuan memberikan gambaran analisis praktik residensi Keperawatan Medikal Bedah selama 2 semester tentang penerapan teori model keperawatan dalam studi kasus, dan analisis hasil penerapan tindakan mandiri keperawatan berbasis pembuktian ilmiah (evidence based nursing practice), serta analisis hasil inovasi kelompok terhadap fenomena yang ditemui selama praktik residensi. Penerapan peran perawat profesional dalam proses asuhan keperawatan dengan menggunakan teori adaptasi Roy dilakukan pada kasus karsinoma nasofaring dan berbagai kasus keganasan lainnya terbukti bermanfaat membantu dan meningkatkan kemampuan adaptasi pasien terhadap stimulus internal dan esternal yang dialami. Kegiatan aplikasi tindakan mandiri keperawatan berdasarkan pembuktian ilmiah pelaksanaan guided imagery dan progressive muscle relaxation bukti bermanfaat untuk mengurangi nyeri dan meningkatkan kualitas hidup pasien. Pada proyek inovasi manajemen nyeri pada pasien kanker yang menjalani kemoterapi di ruang rawat inap dengan memfasilitasi pembuatan multi media video guided imagery dan progressive muscle relaxation perawat dalam manajemen nyeri. Peran perawat profesional dapat dijalankan dalam setiap tahap kegiatan praktik residensi keperawatan medikal bedah peminatan onkologi secara holistik dan komprehensif meliputi upaya promotif, reventif, kuratif, dan rehabilitatif. Kata kunci: Adaptasi Roy, kanker, guided imagery dan progressive muscle relaxation, Manajemen nyeri.

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ABSTRACTractice Analysis of Medical Surgical Nursing Surgery on Stomach Cancer with Roy's Adaptation Model Approach at Dharmais Cancer Hospital and Cipto Mangunkusumo Jakarta This paper aims to provide an overview of residency medical Surgical Nursing residency analysis for 2 semesters on the application of nursing model theory in case study, and analysis of the results of the implementation of scientifically based nursing based action (evidence based nursing practice), and analysis of group innovation results on the phenomenon encountered during residency practice. The application of the role of professional nurses in the nursing care process using Roy's adaptation theory was done in cases of nasopharyngeal carcinoma and other malignant cases proved helpful in improving the patient's adaptability to internal and esternal stimuli. The activities of self-directed nursing action based on scientific proof of guided imagery and progressive muscle relaxation are useful to reduce pain and improve patient's quality of life. In the pain management innovation project in cancer patients undergoing chemotherapy in the inpatient room by facilitating the creation of multi media video guided imagery and progressive muscle relaxation nurses in pain management. The role of professional nurse can be carried out in every stage of medical residency practice of medical surgical treatment of oncology specialization holistically and comprehensively covering promotive, reventif, curative and rehabilitative efforts. Keywords: Roy's adaptation, cancer, guided imagery and progressive muscle relaxation, pain management"

"Nyeri merupakan keluhan yang paling banyak dirasakan oleh pasien kanker. Manajemen nyeri kanker perlu dilakukan secara efektif sehingga dampak dari nyeri yang mungkin timbul dapat diatasi dengan tepat. Penanganan nyeri yang tepat pada akhirnya dapat meningkatkan kepuasan pasien terhadap pelayanan khususnya manajemen nyeri. Penelitian ini bertujuan untuk mengetahui gambaran kepuasan pasien terhadap manajemen nyeri kanker. Data dianalisis dengan menggunkan proporsi. Besar sampel pada penelitian ini sebesar 107 responden. Penelitian ini menggunakan desain deskriptif Cross Sectional dari pasien rawat inap di Rumah Sakit Kanker Dharmais. Cara pengumpulan data dengan menggunakan kuesioner Pain Treatment Satisfactoin Scale. Hasil analisis data menunjukkan bahwa sebagian besar responden merasa puas dengan manajemen nyeri kanker secara keseluruhan dengan presentase sebesar 79,4%. Hasil ini merekomendasikan untuk mempertahankan dan meningkatkan kembali kualitas pelayanan manajemen nyeri, dan menjadwalkan rutin evaluasi terhadap manajemen nyeri untuk meningkatan kepuasan pasien dan menjaga kualitas pelayanan.

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Pain is one of the symptom that is most felt by cancer patients. Cancer pain needs to be manage effectively so that the cancer pain can be controlled. Adequate cancer pain management can increase the satisfaction of patient in nursing service. This study aimed to describe the patients satisfaction with cancer pain management. This study used a descriptive design, with 107 respondents from inpatients at the Dharmais Cancer Hospital. The questionnaire was used was Pain Treatment Satisfaction Scele. The result showed that most respondents were satisfied with the overall management of cancer pain by percentage 79,4%. This result recommends to maintain and to improve the quality of pain management services, and scheduling routine evaluations of pain management to improve patient satisfaction and maintain service quality."