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"Kehamilan merupakan bagian dari proses reproduksi, kehamilan akan berkualitas jika ibu maupun ayah dalam keadaan sehat, oleh sebab itu program spesialis keperawatan maternitas dibentuk bertujuan untuk memberikan pelayanan yang profesional. Laporan ini bertujuan untuk memberikan gambaran praktek residensi keperawatan maternitas selama satu tahun, meliputi asuhan keperawatan pada masa child bearing normal dan resiko tinggi, bayi baru lahir normal dan resiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi, yang dilaksanakan selama menjalankan praktek residensi baik pada tatanan klinik maupun di komunitas. Residen juga melakukan asuhan keperawatan pada kasus focus of interest dengan mengaplikasikan teori model keperawatan adaptasi Roy dan Health Belief Model dalam asuhan keperawatan ibu hamil HIV positif, membahas kesenjangan asuhan keperawatan ibu hamil HIV positif dibandingkan teori, menguraikan peran perawat, mengemukakan hambatan serta dukungan pada pelaksanaan praktek residensi. Hasil asuhan keperawatan di dapatkan, klien mampu memahami penatalaksanaan kehamilan dengan HIV positif, meningkatkan penerimaan terhadap kehamilan dan mendapatkan dukungan keluarga. Dalam mencapai tujuan tersebut dibutuhkan perawat profesional yang mampu menerapkan perannya secara komprehensif.

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Pregnancy is part of reproduction process. Healthy pregnancy can be achieved if mother and her spouse is in healthy condition. Therefore, maternity nursing specialist can provide professional nursing care to these couples. The purpose of this report is to have a documentation of comprehensive clinical practice in residency from nursing care of normal and high risk child bearing, normal and high risk newborn, women with reproduction and gynecological problem, from clinical to community setting. Implementation of nursing care concentrating on “focus of interest” concept with implementation of adaptation theory by Roy and Health Belief Model in HIV positive pregnant mother were also had been done in this practice. This report was documenting the gap of the implementation of nursing care in the clinic and the theory, describing the role of the nurses, obstacles and support during residency clinical practice. The result shows that the clients able to understand the management of HIV positive pregnancy, improving acceptance to the pregnancy, and had family support. In fulfilling this goal, nurse should be professional who able to apply all of her role comprehensively."

"Program residensi spesialis keperawatan maternitas dilakukan dalam rangka menerapkan peran dan fungsi perawat maternitas pada asuhan keperawatan secara profesional. Laporan ini bertujuan memberi gambaran pelaksanaan praktik residensi ners spesialis keperawatan maternitas, meliputi asuhan keperawatan sistem reproduksi perempuan normal dan resiko tinggi di klinik dan komunitas. Adapun kasus focus of interest yang dikelola selama melakukan praktik residensi adalah penerapan teori model keperawatan self care dan comfort pada ibu post partum dengan payudara bengkak, dengan tujuan kenyamanan disertai kemampuan merawat diri. Dengan demikian, penerapan teori model self care dan comfort merupakan pendekatan tepat untuk kenyamanan dan memandirikan klien. Residen membahas kesenjangan asuhan keperawatan dibandingkan teori, menguraikan peran dan fungsi perawat, mengemukakan hambatan serta dukungan pelaksanaan praktek residensi.

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Specialist maternity nursing residency program conducted in order to implement the roles and functions of nurses in the maternity nursing care in a professional manner. This report aims to illustrate the implementation of specialist nursing practice residency for nurses in maternity nursing specialist namely the nursing care for normal and high risk female reproductive system in clinic and community. The focus of interest case administered during a residency practice is the application of the theory of self care and comfort model of nursing in postpartum mothers with breast engorgement, with the goal of comfort with selfcare skills. Thus, the application of theoretical models of self care and comfort is the right approach to client’s convenience and self help. Resident discusses the gaps in nursing care compared to the theory, outlines the roles and functions of nurses, and exposes the barriers and support in the implementation of residency practice."

"[ABSTRAKPelayanan keperawatan merupakan bagian integral dari pelayanan kesehatan dan masalah kesehatan reproduksi perempuan menjadi bagian yang tak terpisahkan dari sistim pelayanan kesehatan secara keseluruhan. Residen keperawatan maternitas dalam melaksanakan perannya dituntut mampu memberikan asuhan keperawatan sesuai dengan kebutuhan masyarakat di berbagai tatanan pelayanan kesehatan. Dalam upaya memberikan asuhan keperawatan, residen mengelola tujuh pasien dengan kista ovarium di dua rumah sakit yang berbeda dengan menggunakan pendekatan teori Adaptasi Roy. Dari ketujuh kasus tersebut, lima kasus jenis kista coklat dengan karakteristik munculnya keluhan dipengaruhi oleh siklus menstruasi dan dua kasus lain berjenis kista denoma. Dengan adanya berbagai perubahan dalam diri penderita kista ovarium, maka teori keperawatan Adaptasi Roy dianggap tepat diterapkan pada pasien dengan kista ovarium. Laporan akhir residensi juga memapartkan capaian 100% untuk target kompetensi pada tiga lahan praktek dan berusaha memodifikasi setiap hambatan yang ada selama pelaksanaan praktik residensi.

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ABSTRACTNursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice., Nursing service is an integral part of healthcare services and women's reproductive health problems become an integral part of the overall healthcare system. Maternity nursing resident in performing its role is demanded to provide nursing care in accordance with the needs of the community in a variety of healthcare structures. In providing nursing care, resident managed seven patients with ovarian cysts at two different hospitals using Roy Adaptation Theory approach. Of the seven cases, five cases were chocolate cyst type characterized by the emergence of complaints influenced by menstrual cycle and two other cases were denoma cyst. Since ovarian cysts patients experienced various changes, Roy Adaptation Nursing Theory was considered appropriate to be applied on patients with ovarian cysts. The final report also described the achievement of 100% of the target competencies in the three fields of practice and try to modify any existing obstacles during the residency practice.]"

"Laporan ini merupakan rangkuman kegiatan praktek residensi ners spesialis keperawatan maternitas selama satu tahun untuk menerapkan peran dan fungsi perawat maternitas dengan mengambil contoh penerapan teori model keperawatan Self Care Orem dan Transkultural Nursing Leininger pada pasien dengan anemia selama hamil. Penerapan teori Self care Orem pada kelima kasus yang sudah dilakukan residen mencakup universal self care, developmental self care, health deviation dan conditioning factor. Kekuatan teori Self Care Orem pada klien dengan anemia selama hamil dapat membantu mengatasi klien untuk mencapai kemandirian baik dalam kondisi anemia ringan, sedang dan berat. Kelemahan teori Orem pada klien dengan anemia kurang dapat mendapatkan hasil pengkajian nutrisi. Disamping itu dilaporkan tentang kegiatan pencapaian kompetensi perawat spesialis keperawatan maternitas sebagai pemberi asuhan, konselor, pendidik, advokad, kolaborator, peneliti dan change agent serta proyek inovasi yang dilakukan di lahan praktek.

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This report is a summary of the activities of specialist nursing practice residency maternity nurses for a year to implement the roles and functions of maternity care by taking the example of the application of theoretical models of nursing Orem Self Care and Leininger Transcultural Nursing in patients with anemia during pregnancy. Application of Orem's theory of self-care in the five cases that have been made resident includes universal self care, developmental self care, health deviation and conditioning factor. Strength theory of Orem Self Care on the client with anemia during pregnancy can help to overcome the client to achieve independence either in a mild anemia, moderate and severe. Weaknesses of the theory of Orem on the client with anemia are less able to get the nutrition assessment. Besides, it was reported on activities of achievement of competencies as a maternity nurse specialist nursing care providers, counselors, educators, Advocates, collaborator, researcher and change agent and innovation projects undertaken in the field of practice."

"Integrasi teori model need for help Wiedenbach dengan self care Orem pada asuhan keperawatan klien dengan abortus inkomplet menjadi kerangka kerja praktik residensi keperawatan maternitas selama setahun. Laporan ini bertujuan untuk memberikan gambaran asuhan keperawatan pada child bearing normal dan 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 kedua model tersebut efektif dan efisien dalam membantu mengatasi permasalahan lima klien dan keluarga dengan abortus inkomplet. Pencapaian kompetensi perawat spesialis maternitas dilakukan melalui penerapan peran perawat secara komprehensif.

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Integration of theoretical model Wiedenbach "need for help" with Orem "self care" in nursing care to clients with incomplete abortion 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 newborns and high risk, women who experience reproductive problems and gynecology, which conducted at the clinical and community setting. It showed that both models were effective and efficient to five clients and family in solving their problems. The nurse specialist maternity competencies were achieved through applying nurse roles comprehensively."

"[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.]"

"ABSTRAK Tingginya angka kematian ibu saat ini salah satunya disebabkan oleh adanya komplikasi pada saat kehamilan dan persalinan Ners spesialis keperawatan maternitas mempunyai peran penting dalam mencegah kematian baik ibu maupun janin Laporan ini bertujuan untuk memberikan gambaran pelaksanaan praktik ners spesialis keperawatan maternitas meliputi asuhan keperawatan pada masa prenatal intranatal postnatal dan bayi baru lahir normal dan berisiko serta mengenai masalah kesehatan reproduksi perempuan Residen juga memberikan asuhan keperawatan dengan focus penerapan teori need for help dari Wiedenbach pada ibu dengan terminasi kehamilan karena preeklamsia berat Hasil menunjukkan bahwa penanganan segera dan terminasi kehamilan sesuai dengan indikasi dapat mencegah komplikasi dan kegawatan pada ibu dan bayi serta mencegah terjadinya Sindrom HELLP dan Eklamsia Penerapan teori model keperawatan Need For Help efektif untuk diaplikasikan pada kasus terminasi kehamilan karena preeklamsia berat Pencapaian kompetensi perawat spesialis keperawatan maternitas dilakukan dengan penerapan peran perawat secara komprehensif.ABSTRACT One of the causes of high maternal mortality rate is the complications of pregnancy and labor A maternity nursing specialist has an important role to prevent maternal and fetal death This report aimed to provide an overview of the implementation of maternity nursing specialist practice including nursing care of normal and high risk prenatal intranatal postnatal and newborn as well as women rsquo s health Resident also provided nursing care focused on the application of Wiedenbach Need for Help Theory on mothers with pregnancy termination due to severe preeclampsia Results showed that the immediate management and pregnancy termination as indicated could prevent complications and maternal and infant distress as well as prevent HELLP Syndrome and eclampsia The application of Wiedenbach Need for Help Model Theory was effective to be applied on cases of pregnancy termination due to severe preeclampsia The maternity nursing specialist competencies were achieved by applying a nurse rsquo s roles comprehensively."

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Retensi urin postpartum merupakan ketidakmampuan mengosongkan kandung kemih secara spontan setelah melahirkan dengan residu urin lebih dari 200 ml. Komplikasi yang dapat terjadi yaitu distensi kandung kemih, kontraksi uterus terhambat, perdarahan, otot detrusor melemah, kateterisasi intermiten dan disfungsi berkemih permanen. Penatalaksanaan keperawatan pada retensi urin postpartum dengan memberikan asuhan keperawatan secara holistik menggunakan studi kasus dan penerapan teori keperawatan. Penerapan teori self care Orem dan comfort Kolcaba pada lima kasus retensi urin postpartum dengan membahas permasalahan yang dialami dan menguraikan peran perawat pada kasus tersebut, dengan tujuan kebutuhan kenyamanan dan kemandirian pasien dapat terpenuhi. Kejadian retensi urin dapat diatasi dengan menerapkan evidence based nursing practice kegel excercise dan bladder training. Studi kasus yang dilakukan pada lima ibu postpartum yang mengalami retensi urin didapatkan bahwa kegel exercise dan bladder training mampu mengatasi retensi urin secara signifikan, menurunkan tingkat nyeri, dan meningkatkan self care.

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Postpartum urinary retention is the inability to empty the bladder spontaneously after giving birth with more than 200 ml urine residue. Complications that can occur are distention of the bladder, obstructed uterine contractions, bleeding, weak detrusor muscles, intermittent catheterization and permanent voiding dysfunction. Nursing management in postpartum urinary retention by providing nursing care holistically uses case studies and the application of nursing theory. Application of self care Orem and Comfort Kolcaba theory in five cases of postpartum urine retention by discussing the problems experienced and outlining the role of nurses in the case, with the aim of comfort and independence of patients can be fulfilled. Urinary retention can be overcome by applying evidence based nursing practice kegel excercise and bladder training. Case studies conducted on five postpartum mothers who experienced urinary retention found that kegel exercise and bladder training were able to overcome urinary retention significantly, reduce pain levels, and improve self care.

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"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."

"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 "