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"Karya ilmiah akhir ini disusun sebagai laporan dari praktik residensi spesialis keperawatan Matemitas yang berfokus pada penerapan teori keperawatan Need for Help Wiedenbach dan unpleasant symptoms pada kasus kehamilan ektopik terganggu. Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktik Spesialis Keperawatan Matemitas 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 heap Wiedenbach dan unpleasant symptoms efektif dilakukan pada lima kasus ibu dengan kehamilan ektopik terganggu. Aplikasi teori tersebut berhasil membantu menyelesaikan masalah keperawatan difase akut maupun pemulihan. Setelah melaksanakan praktik residensi spesialis keperawatan matemitas, penulis mampu mencapai target kompetensi dengan baik.

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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 Unpllleasant Symptoms theory in the nursing care to clients ruptured ectopic pregnancy. 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 unpleasant symptoms theory in the nursing care was effective to resolve client’s ruptured ectopic pregnancy in acute and recovery phase. After finishing residential practice of maternity nursing specialist, the competencies was achieved with a good result."

"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 "

"Kematian ibu yang terjadi selama kehamilan sebagian besar disebabkan oleh perdarahan, hipertensi dalam kehamilan, infeksi, partus lama/macet dan abortus. Fenomena tersebut mendorong profesi keperawatan untuk terus mengembangkan ilmu sejalan dengan tuntutan masyarakat terhadap pelayanan kesehatan yang berkualitas. Laporan ini bertujuan menggambarkan pelaksanaan praktek residensi keperawatan maternitas selama satu tahun meliputi asuhan keperawatan pada masa childbearing normal dan resiko tinggi, bayi baru lahir normal dan resiko tinggi, perempuan yang mengalami masalah reproduksi dan ginekologi ditatanan klinik maupun di komunitas. Residen juga melakukan asuhan keperawatan pada kasus dengan focus of interest yaitu abortus inkomplit dengan mengaplikasikan teori need for help yang dikombinasikan dengan teori unpleasant symtomps. Selain itu, laporan ini juga memaparkan tentang kegiatan pencapaian kompetensi perawat spesialis maternitas melalui penerapan peran sebagai pemberi perawatan, pendidik, konselor, koordinator, komunikator, advokat serta agen perubahan dan peneliti.

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Maternal deaths that occur during pregnancy are mostly caused by bleeding, hypertension in pregnancy, infection, old / stuck particles and abortion. This phenomenon encourages the nursing profession to continue to develop knowledge in line with the demands of society to quality health services. This report aims to describe the implementation of a one-year maternity nursing residency practice covering normal and high-risk childbearing nursing care, normal and high-risk newborns, women with reproductive and gynecological problems in clinical and community settings. The resident also performs nursing care in a case with a focus of interest ie an incomplete abortus by applying the need for help theory in combination with the unpleasant symtomps theory. In addition, this report also describes the activities of the achievement of nursing specialist maternity competence through the application of roles as carers, educators, counselors, coordinators, communicators, advocates and agents of change and researchers."

"[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 retensio plasenta. Tujuan penulisan laporan ini untuk memberikan gambaran aplikasi teori Wiedenbach dan Kolcaba pada kasus retensio plasenta serta 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 lima ibu dengan retensio plasenta. Teori keperawatan Need for Help dari Wiedenbach menjadi pilihan untuk kasus retensio plasenta diruang gawat darurat. Penekanan teori ini berdasarkan kebutuhan ibu harus segera dipenuhi yang sifatnya gawat darurat. Labor is a holistic event and Comfort is a holistic phenomenon. Kenyamanan adalah fenomena holistik dan kebutuhan dasar manusia. Oleh karena itu perawat berupaya mengatasi kelemahan teori need for help Wiedenbach dengan menggabungkannya dengan Theory of Comfort Kolcaba. Teori keperawatan ini untuk mengatasi ketidaknyamanan dari aspek fisik, psikospiritual, sosial dan lingkungan sehingga asuhan keperawatan secara komprehensif dapat diberikan. Theory of Comfort Kolkaba terintegrasi dalam penerapan teori need for help Wiedenbach pada asuhan keperawatan ibu dengan retensio plasenta., 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 retained placenta. The purpose of this report to provide an overview of the application and Kolcaba Wiedenbach theory in the case of retained placenta and describe the implementation of maternity nursing specialist practices in their role as care giver, educator, counselor, advocate, collaborator, communicator, coordinator, innovators and researchers. Application of nursing theory need for help Wiedenbach and theory of Comfort Kolcaba effectively done in five women with retained placenta. Nursing theory Need for Help from Wiedenbach be an option for retained placenta cases in emergency ward. The emphasis of this theory is based on the needs of the mother must be met emergency nature. Labor is a holistic event and Comfort is a holistic phenomenon. Comfort is a holistic phenomenon and basic human needs. Therefore, the nurse tried to address the weaknesses of the theory of the need for help Wiedenbach combine with theory of Comfort Kolcaba. This nursing theory to address the discomfort of physical aspects, phsycospiritual, social and environment so comprehensively nursing care can be given. Theory of Comfort Kolcaba integrated in the application of the theory of the need for help Wiedenbach nursing mothers with retained placenta .]"

"[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.]"

"Kesehatan reproduksi merupakan masalah penting untuk diperhatikan dalam rangka meningkatkan derajat kesehatan perempuan. Sebagai salah satu usaha untuk mencapai tujuan tersebut, dilaksanakanlah program ners spesialis keperawatan maternitas. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktek residensi ners spesialis keperawatan maternitas dengan fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan pada asuhan keperawatan klien dengan retensio plasenta. Masalah keperawatan pada tahap akut yaitu kekurangan volume cairan, gangguan integritas jaringan, dan kecemasan, sementara pada tahap pemeliharaan adalah gangguan pemenuhan kebutuhan sehari-hari, ketidakefektifan proses menyusui, dan risiko infeksi. Tindakan yang dilakukan meliputi resusitasi cairan, pengeluaran plasenta, perbaikan kontraksi uterus, dan pendidikan kesehatan tentang perawatan pada ibu dan bayi. Evaluasi pada fase akut yaitu perdarahan berkurang, kontraksi uterus kuat, dan pada fase pemeliharaan yaitu peningkatan kemandirian klien.

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Reproductive health is a critical problem that needs attentions in order to increase the female health level. As an attempt to reach this goal, a maternity nursing specialist program is performed. This final scientific work aimed to describe the residential practice of maternity nursing specialist which focused on the application of Wiedenbach's concept of need for help during the acute phase and Orem's self care model during the maintenance phase in the nursing care to a client with placenta retention.

Nursing problems in the acute stage were fluid volume deficit, impaired tissue integrity, and anxiety, while in the maintenance stage were daily needs fulfillment, ineffective breastfeeding, and risk of infection. The nursing intervention included fluid resuscitation, placenta delivery, uterine contraction improvement, and health education related to mother and baby care. The evaluation in the acute phase included reduced bleeding and good uterine contraction, while in the maintenance phase included the enhancement of client's independency."

"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."

"[ABSTRAKPermasalahan kesehatan selama masa kehamilan membutuhkan perhatian dari petugas kesehatan sehingga proses kehamilan dan persalinan dapat berjalan selamat. Peran Ners spesialis keperawatan maternitas sangat diperlukan dalam upaya pencegahan dan penanggulangan masalah tersebut. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktik residensi ners spesialis keperawatan maternitas dan memberikan gambaran fokus penerapan model konsep need for help Wiedenbach pada fase akut dan self care Orem pada fase pemeliharaan. Evaluasi yang diharapkan pada fase akut adalah kontraksi berhenti, dan tidak adanya tanda-tanda kegawatan maternal dan janin. Evaluasi pada fase pemeliharaan yaitu peningkatan kemandirian klien. Penerapan model dan konsep keperawatan need for help dan self care terbukti bermanfaat mengatasi kontraksi dalam kehamilan sehingga bisa di aplikasikan dalam proses asuhan keperawatan kontraksi dalam kehamilan.

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ABSTRACTHealth problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction., Health problems during pregnancy require the attention of health professionals so that the process of pregnancy and childbirth can be safe. The role of maternity nursing specialist is indispensable in the prevention and control of the problem. This final scientific work aimed to provide an overview of the implementation of maternity nursing specialist residency practice and describe the application of Wiedenbach Need for Help Conceptual Model in the acute phase and Orem Self Care Conceptual Model in the maintenance phase. The expected evaluation in the acute phase was the contraction stopped, and there were no signs of maternal and fetal distress. The evaluation in the maintenance phase was the increase of the client independency. The application of Need for Help and Self Care Nursing Model and Concept has been proved beneficial to overcome the preterm contraction, so that these models can be applied in the nursing care process of preterm contraction.]"

"Karya ilmiah akhir disusun sebagai laporan praktik residensi ners spesialis keperawatan maternitas yang menggambarkan pencapaian kompetensi ners spesialis keperawatan maternitas dengan fokus pada aplikasi teori keperawatan need for help dan symptom management pada ibu hamil dengan preeklampsia berat. Kompetensi ners spesialis keperawatan maternitas diwujudkan dengan penerapan peran dan fungsi perawat sebagai pemberi pelayanan keperawatan, advokat. manajer, rehabilitator, komunikator, edukator, kolaborator, dan agen perubah. Aplikasi teori keperawatan need for help Wiedenbach dan symptom management Humphreys pada ibu hamil dengan preeklampsia berat dapat mengatasi masalah keperawatan selama fase akut dan pemeliharaan.

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This final report is created as a report of maternity nursing specialist residency practice which describes the achievement of maternity nursing specialist's competencies focused on the application of 'need for help' and 'symptom management' nursing theory to pregnant women with severe preeclampsia. The competencies of a maternity nursing specialist were actualized by the implementation of roles and functions as a nursing care provider, an advocate, a manager, a rehabilitator, a communicator, an educator, a collaborator, and a change agent The application of Wiedenbach's 'need for help' nursing theory and Humphreys theory of symptom management to pregnant w9men with severe preeclampsia could solve the nursing problems during acute and maintenance phase."

"Indikator capaian dari SDG’s salah satunya menurunkan angka kematian ibu dan bayi. Indonesia akan berusaha menurunkan angka kematian ibu menjadi kurang dari 70 kematian per 100.000 kelahiran hidup pada tahun 2030. Kematian ibu dan bayi disebabkan terjadinya persalinan prematur. Persalinan prematur dapat disebabkan adanya kontraksi uterus sehingga terjadi dilatasi serviks pada usia kehamilan 20-36 minggu. Ancaman persalinan prematur akan mengakibatkan gawat janin dan komplikasi pada bayi baru lahir. Study kasus pada lima ibu hamil yang mengalami kontraksi dini dengan fokus mengimplementasikan teori need for help pada keadaan emergency dan penerapan teori comfort Kolcaba pada tahap pemulihan. Ibu hamil akan mendapatkan intervensi tatalaksana tokolitik dan terapi relaksasi dengan self-hypnosis yang membantu ibu untuk mengontrol ketidaknyamanan dan menurunkan kecemasan selama di rumah sakit. Aplikasi tersebut berhasil membantu ibu hamil melalui tahap kegawatan dan meningkatkan kenyamanan serta mencegah kontraksi uterus berulang sehingga ibu dapat mempertahankan kehamilan sampai usia kehamilan aterm.

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The achievement indicators of SDG’s are one of them reducing maternal and infant mortality. Indonesia will try to reduce maternal mortality to less than 70 deaths per 100,000 live births by 2030. Maternal and neonatal deaths are caused by preterm labor. Premature labor can be caused by uterine contractions resulting in cervical dilatation at 20-36 weeks' gestation. The threat of preterm labor will result in fetal distress and complications in newborns. Case studies on five pregnant women who experienced premature contractions with a focus on implementing the need for help theory in an emergency and the application of the Kolcaba comfort theory in the recovery phase. Pregnant women will get a tocolytic management intervention and relaxation therapy with self-hypnosis that helps the mother to control discomfort and reduce anxiety during the hospital. The application is successful in helping pregnant women go through the emergency phase and increase comfort and prevent repeated uterine contractions so that the mother can maintain the pregnancy until the term gestational age."