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"ABSTRAKKebutuhan pasien di akhir kehidupan untuk mendapatkan kenyamanan seringkali tidak dapat terpenuhi. Kenyamanan anak di akhir kehidupan dipengaruhi oleh pemahaman perawat akan makna kenyamanan yang sebenarnya dimaksud oleh anak. Penelitian ini bertujuan untuk menggali pemahaman akan esensi dan makna kenyamanan anak di akhir kehidupan bagi perawat agar anak dapat meninggal dalam damai. Metode penelitian adalah kualitatif dengan pendekatan fenomenologi deskriptif melalui wawancara semi berstruktur pada enam partisipan yang memiliki pengalaman memberikan perawatan paliatif pada anak di akhir kehidupan. Penelitian ini mengidentifikasi enam tema, yaitu mengupayakan agar anak tidak menderita, mewujudkan apa yang diinginkan anak, melihat anak merasa nyaman jika keluarga ikhlas dengan kondisi anaknya, menghadapi konflik internal dan eksternal, mengalami perasaan berkecamuk mengetahui kondisi anak, dan membutuhkan dukungan dari berbagai sumber. Penelitian selanjutnya diharapkan dapat meneliti tentang model pengelolaan kondisi emosional perawat paliatif pediatrik yang seringkali terpapar dengan kondisi anak yang sekarat.

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ABSTRACTThe patients need at the end of their life to get comfort are rarely fulfilled. The comfort of children at the end of their life is affected by the understanding of nurses towards the meaning of comfort meant by the children. This research aims to investigate the understanding on the essence and meaning of children rsquo s comfort at the end of their life for nurses in order that they can get dignified death. The research methodology was qualitative with descriptive phenomenology approach using semi structured interview with six participants experiencing in giving palliative care on children at the end of life. This research indentified six themes to prevent the children from suffering the disease, to realize what the children want, to observe wheter the children feel comfortable if their family is sincerely with that condition, to face the internal and external conflict, to experience dilemmatic situation knowing the children rsquo s condition, and to require the support from all. The research was expected to study about the model of emotional management on pediatrics palliative nurses that were mostly exposed with the condition of dying children. "

"ABSTRAKAsuhan keperawatan spiritual akan memberikan aspek positif bagi kualitas hidup pasien tahap akhir kehidupan. Perawat merupakan salah satu pemberi asuhan yang berperan dalam memberikan asuhan spiritual yang bermutu. Penelitian ini bertujuan untuk mengekplorasi pengalaman perawat dalam memberikan asuhan spiritual pada pasien tahap akhir kehidupan disebuah rumah sakit tipe A di propinsi Aceh. Penelitian ini menggunakan desain kualitatif fenomenologi, metode wawancara mendalam semi struktur, durasi 30-50 menit dengan partisipan berjumlah sepuluh orang yang terdiri dari 1 orang kepala ruangan, 3 ketua tim dan 6 perawat pelaksana. Analisis tematik menggunakan metode Colaizzi menghasilkan 181 pernyataan signifikan, 36 subkategori, 12 kategori dan 6 tema, yaitu; (1) perubahan fungsi fisiologis, (2) caring, (3) proses keperawatan berfokus pada pemenuhan kebutuhan dasar henderson; kebutuhan rasa nyaman dan terapi spiritual, (4) perawat menjadi advokatdalam menguatkan support sistem keluarga, (5) interkolaborasi, (6) fungsi manajemen kepala ruangan. Rekomendasi yang diberikan peneliti yaitu peningkatan kompetensi perawat dalam asuhan melalui Continuing Professional Development (CPD), melakukan review terhadap kebijakan rumah sakit dalam hal pendampingan keluarga bagi pasien tahap akhir kehidupan.

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ABSTRACTSpiritual care is an essensial part of end of life patients, provide a positive aspect to the quality of life. This study aims to explore nurses' experience in providing spiritual care to patients in the end of life in hospital in Aceh. This study used a phenomenological qualitative approach, indepth interview lasting for 30-50 minutes to 10 participants. Colaizzi analysis was utilized to derive 181 quotes, 36 subcategory, 12 category and six theme; (1) changes in physiological functions in end of life, (2) caring, (3) the nursing process focuses on basic needs; Henderson‟s, (4) nurses become advocates in strengthening family system support, (5) inter-collaboration in care, (6) management function of head nurse. It is recommended to increasing nurses' competence in nursing care through Continuing Professional Development CPD, to conduct a review of hospital policies in terms of family assistance for end-of-life patients.

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"Fokus perawatan kanker stadium akhir yaitu memenuhi kebutuhan fisik, psikologis, sosial, dan spiritual untuk megurangi penderitaan pasien menuju kematian yang bermartabat. Tujuan perawatan paliatif yaitu kenyamanan dan sesuai dengan prinsip asuhan keperawatan paliatif. Keberanian dan pengabdian perawat memenuhi kebutuhan yang kompleks ketika pasien sekarat dan menghadapi kematian menjadi pengalaman unik bagi perawat paliatif. Pengalaman yang unik ini di eksplorasi menggunakan pendekatan fenomenologi deskriptif. Delapan perawat paliatif terlibat sebagai partisipan. Hasil wawancara di analisis menggunakan metode Collaizi. Hasil analisis data penelitian diperoleh enam tema yaitu: asuhan perawatan paliatif di rumah dilakukan diluar pekerjaan utama di rumah sakit, keluarga menganggap peran perawat paliatif sama dengan caregiver, perawat paliatif lebih fokus menangani pemenuhan fisik dan psikologis pasien, Perawat paliatif lebih dominan melakukan kolaborasi untuk mengatasi nyeri dan tindakan edukasi dan motivasi untuk menangani masalah psikologis, Memberikan asuhan menjelang ajal dan kematian sesuai standar operasional prosedur keperawatan menjelang ajal, Tantangan dalam pengambilan keputusan tindakan perawatan paliatif. Direkomendasikan agar meningkatkan layanan menjadi keperawatan paliatif spesialis, meningkatkan pendidikan dan pelatihan perawatan paliatif serta pengaturan kebijakan layanan keperawatan paliatif dalam sistem pelayanan kesehatan nasional.

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The focus of end stage cancer care is to meet physical, psychological, social, and spiritual needs to reduce the suffering of the patient to a dignified death. The goal of palliative care is comfort and in accordance with the principles of palliative care nursing. The courage and dedication of nurses fulfills a complex need when the patient is dying and facing death becomes a unique experience for palliative nurses. This unique experience is explored using a descriptive phenomenology approach. Eight palliative nurses were involved as participants. The results of interviews in the analysis using Collaizi method. The results of the research data analysis obtained six themes, namely care palliative care at home conducted outside the main work in the hospital, the family considers the role of palliative nurse same with caregiver, palliative nurse more focus on handling physical and psychological fulfillment of patients, palliative nurse more dominant to collaborate to overcome pain and educational action and motivation to deal with psychological problems, Providing upturn and death care according to operational standards of dying nursing procedures, Challenges in decision making palliative care measures. It is recommended to improve services to palliative specialist nursing, improve palliative care education and training and palliative care policy setting in the national health care system."

"Perilaku caring dapat membuat sikap perawat peduli terhadap kondisi pasien dan lebih bertanggung jawab. Tujuan penelitian ini mengetahui hubungan antara perilaku caring dengan sikap perawat terhadap end of life care di satu rumah sakit di Jakarta. Desain penelitian ini adalah deskripsi. Sampel data yang diambil 115 perawat di ruang ranap, dan ruang khusus dengan metode incidental sampling. Instrumen penelitian Caring Behavior Assessment Tool (CBA) untuk menilai perilaku caring, dan terjemahan The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) untuk menilai sikap perawat pada end of life. Hasil penelitian terdapat hubungan antara perilaku caring dengan sikap perawat terhadap end of life. Perilaku caring penting untuk dijadikan budaya dalam merawat setiap klien.

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Caring behavior can make nurses care about the patient's condition and be more responsible. The purpose of this study was to determine the relationship between caring behavior and nurses' attitudes towards end-of-life care at a hospital in Jakarta. The research design is descriptive. The data sample was taken by 115 nurses in the concurrent room, and in a special room using the incidental sampling method. The research instrument is the Caring Behavior Assessment Tool (CBA) to assess caring behavior, and the translation of The Frommelt Attitude Toward Care of the Dying Scale (FATCOD) to assess nurses' attitudes towards end-of-life care. The results of the study found a relationship between caring behavior and nurses' attitudes towards end-of-life care. Caring behavior is important to become a culture in caring for each client."

"ABSTRAKPersamaan gender antar perawat dengan pasein kanker ginekologi, menyebabkan perawat merefleksikan kejadian yang dialami pasien terhadap dirinya. Sehingga ada makna tersendiri yang perawat rasakan selama merawat pasien kanker ginekologi. Tujuan penelitian ini mengetahui makna merawat pasien kanker ginekologi bagi perawat perempuan. Penelitian ini menggunakan studi fenomenologi deskriptif dengan wawancara mendalam terhadap lima orang partisipan yang dipilih secara purposive sampling. Data dianalisis menggunakan analisis Colaizzi dan di dapatkan delapan tema. Secara umum perawat merasa bersyukur diberikan kesehatan sebagai bentuk makna yang didapat selama merawat pasien kanker ginekologi. Hasil penelitian ini menyarankan agar perawat lebih bersikap caring terhadap pasien dan himbawan kepada perempuan untuk melakukan papsmear sebagai upaya deteksi dini kanker ginekologi.

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ABSTRACTGender equality among nurses and their patients with gynecologic cancer made nurses reflect on the events experienced by the patients toward her, so that nurses felt a special meaning when treating patient with gynecologic cancer. The purpose of this study is to determine the meaning of caring patients with gynecologic cancer. This study used a descriptive phenomenological study of in-depth interviews with five participants who selected by purposive sampling. Data were analyzed using analysis Colaizzi and get eight themes. In general, nurses feel grateful for given health as a form of meaning which they obtained while caring patients with gynecologic cancer. The results of these study are to suggest nurses to give more caring towards their patients and suggest women to do pap smear as an early detection of gynecologic cancer."

"Latar Belakang: Ketidaknyamanan kerja perawat semakin meningkat akibat stres, kelelahan serta kecemasan tertular Covid-19 yang mengakibatkan penurunan kinerja dan berdampak pada pelayanan yang tidak aman. Perawat manajer dapat memodifikasi lingkungan kerja menggunakan teknologi terapi sinar biru yang memiliki panjang gelombang nanometer untuk meningkatkan kenyamanan kerja perawat. Penelitian ini bertujuan untuk mengembangkan alat kenyamanan kerja menggunakan nano wave light emitting diode (Nano-LED) dan mengukur efektifitasnya terhadap kenyamanan dan efikasi diri perawat di ruang perawatan Covid-19. Metode: Penelitian ini menggunakan desain Research and Development dengan tiga tahap penelitian. Penelitian tahap 1 mengidentifikasi masalah dan kebutuhan peningkatan kenyamanan kerja menggunakan Nano-LED, tahap 2 mengembangkan alat Nano-LED, dan tahap 3 mengukur efektifitasnya terhadap kenyamanan kerja dan efikasi diri perawat. Penelitian dilakukan di dua rumah sakit rujukan Covid-19 di wilayah DKI Jakarta sebagai kelompok intervensi dan kelompok kontrol. Jumlah sampel sebanyak 187 perawat menggunakan total sampling. Analisis data menggunakan uji Wilcoxon, Mann Whitney dan regresi linear berganda. Hasil: Penelitian tahap 1 menemukan 5 tema. Partisipan perawat manajer dan perawat pelaksana melalui focus group discussion mengonfirmasi perlunya peningkatan kenyamanan kerja perawat menggunakan Nano-LED. Tahap 2 menghasilkan alat Nano-LED blue turquoise light SMD 2835 panjang gelombang 460—470 nm. Tahap 3 diperoleh hasil ada perbedaan signifikan peningkatan rerata kenyamanan kerja (p < 0,001) dan efikasi diri perawat (p < 0,001) sebelum dan setelah intervensi pada responden kelompok intervensi. Selanjutnya ditemukan ada perbedaan signifikan peningkatan rerata kenyamanan kerja perawat (p = 0,002) dan efikasi diri perawat (p = 0,001) antara kelompok intervensi dan kelompok kontrol setelah intervensi. Kesimpulan: Intervensi Nano-LED efektif meningkatkan kenyamanan kerja dan efikasi diri perawat. Hasil penelitian merekomendasikan agar Nano-LED dapat diaplikasikan di ruang rawat untuk meningkatkan kenyamanan kerja dan efikasi diri perawat.

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Background: Nurses' work discomfort due to stress, fatigue and anxiety of contracting Covid-19 can have an impact on decreasing performance and unsafe services for patients. Nurse managers can modify the work environment using blue light therapy technology which has a nanometer wavelength to increase the comfort of nurses' work. The research aims to develop a work comfort tool using a nano wave light emitting diode (Nano-LED) and measure its effectiveness on the comfort and self-efficacy of nurses in the Covid-19 ward. Methods: The study used a Research and Development design with three phases of research. Phase 1 research identifies problems and needs for increasing work comfort using Nano-LED, phase 2 develops Nano-LED device, and phase 3 measures its effectiveness on work comfort and nurse self-efficacy. The study was conducted at two Covid-19 referral hospitals in the DKI Jakarta area as an intervention group and a control group. The number of samples was 187 nurses using total sampling. Data analysis used Wilcoxon test, Mann Whitney and multiple linear regression. Result: Phase 1 study found 5 themes. Participant nurse managers and nurse staffs through focus group discussions confirmed the need to increase the comfort of nurses' work using Nano-LED. Phase 2 produces a Nano-LED blue turquoise light SMD 2835 with a wavelength of 460—470 nm. Phase 3 showed that there was a significant difference in the average increase in work comfort (p < 0.001) and nurses' self-efficacy (p < 0.001) before and after the intervention in the intervention group respondents. Furthermore, it was also found that there was a significant difference in the average increase in nurses' work comfort (p = 0.002) and nurses' self-efficacy (p = 0.001) between the intervention group and the control group after the intervention. Conclusion: The Nano-LED intervention is effective in increasing the work comfort and self-efficacy of nurses. The results of the study recommend that Nano-LED can be applied in the treatment room to increase work comfort and nurse self-efficacy."

"Dispnea, batuk, demam, tersedak dan peningkatan frekuensi pernapasan merupakan beberapa tanda pneumonia yang menyebabkan terjadinya distres pernapasan pada anak yang dihospitalisasi sehingga memerlukan manajemen yang akurat agar anak tidak jatuh ke dalam kondisi gagal napas. Tujuan dari karya ilmiah akhir ini adalah untuk memberikan gambaran aplikasi teori comfort Kolcaba pada asuhan keperawatan melalui pemberian positioning (posisi semi pronasi dan semi recumbent) untuk memperbaiki saturasi oksigen dan laju pernapasan pada anak pneumonia dengan masalah gangguan pernapasan. Teori comfort Kolcaba mampu memberikan manfaat secara holistik dan memberikan panduan bagi perawat dalam melakukan pengkajian secara sistematis. Penerapan pemberian posisi semi pronasi dan semi recumbent sebagai salah satu intervensi dalam asuhan keperawatan dapat memberikan rasa nyaman dan terbukti meningkatkan saturasi oksigen dan menurunkan laju pernapasan. Penerapan teori Kolcaba dan pemberian posisi semi pronasi dan semi recumbent diharapkan dapat diterapkan dalam asuhan keperawatan anak pneumonia dengan gangguan pernapasan.

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Dyspnea, cough, fever, choking and increased respiratory rate are some of the signs of pneumonia which cause respiratory distress in hospitalized children, requiring accurate management so that the child does not fall into a state of respiratory failure. The purpose of this final scientific work is to provide an overview of the application of Kolcaba's comfort theory to nursing care through positioning (semi-pronated and semi-recumbent positions) to improve oxygen saturation and respiratory rate in children with pneumonia with respiratory problems. Kolcaba's comfort theory is able to provide benefits holistically and provide guidance for nurses in carrying out systematic assessments. The application of semi-pronation and semi-recumbent positions as an intervention in nursing care can provide a sense of comfort and is proven to increase oxygen saturation and reduce respiratory rate. It is hoped that the application of Kolcaba's theory and the provision of semi-pronate and semi-recumbent positions can be applied in the nursing care of children with pneumonia with respiratory problems."

"Nyeri merupakan salah satu gejala yang paling sering dialami oleh pasien anak di ruang perawatan intensif yang dilakukan prosedur tindakan pengambilan darah. Perawat perlu memberikan asuhan keperawatan dengan menitikberatkan pada kenyamanan anak selama prosedur tindakan pengambilan darah di rumah sakit karena kenyamanan adalah hal penting dalam kualitas hidup pasien anak. Tujuan karya ilmiah ini adalah untuk menganalisis penerapan Teori Kenyamanan Kolcaba dalam proses asuhan keperawatan pada anak di ruang perawatan intensif yang mengalami nyeri saat pengambilan darah melalui pemberian intervensi terapi musik. Metode karya ilmiah ini adalah studi kasus pada lima pasien anak yang dirawat di ruang perawatan intensif yang mendapatkan prosedur tindakan pengambilan darah. Terdapat lima kasus pasien anak yang terpasang ventilasi mekanik yang diberikan asuhan keperawatan dengan pendekan Teori Kenyamanan Kolcaba dengan intervensi kenyamanan yang berbasis bukti yaitu intervensi terapi musik. Hasil menunjukkan bahwa Teori Kenyamanan Kolcaba dapat diterapkan dalam asuhan keperawatan anak dan terapi musik  efektif dalam menurunkan nyeri  pada anak yang dilakukan tindakan pengambilan darah.

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Pain is one of the most common symptoms experienced by pediatric patients in intensive care unit who are undergoing blood collection procedures. Nurses need to provide nursing care with an emphasis on children's comfort during blood collection procedures in hospitals because comfort is important in the quality of life of pediatric patients. The aim of this scientific work is to analyze the application of Kolcaba's Comfort Theory in the care process for children in intensive care who experience pain when taking blood through providing music therapy interventions. The method of this scientific work is a case study of five pediatric patients treated in intensive care who received a blood collection procedure. There were five cases of pediatric patients on mechanical ventilation who were given treatment using Kolcaba's Comfort Theory approach with evidence-based comfort interventions, namely music therapy interventions. The results show that Kolcaba's Comfort Theory can be applied in childcare and music therapy is effective in reducing pain in children who undergo blood sampling."

"Kondisi gawat darurat pada anak membutuhkan penanganan yang cepat dan tepat serta pendekatan yang sesuai dengan perkembangan anak untuk mengatasi masalah kenyamanan pada anak. Kondisi ruangan gawat darurat yang ramai dan asing memicu timbulnya perilaku distress pada anak serta menimbulkan ketidaknyamanan. Modifikasi lingkungan dengan konsip atraumatic care dirancang dengan menggunakan prinsip Teori Kenyamanan Kolcaba. Penerapan evidence based nursing (EBN) dilakukan dengan metode quasy experiment dengan pendekatan post test only non equivalent control group. Intervensi yang diterapkan berupa modifikasi ruangan gawat darurat dengan menambahkan gambar menarik pada ruangan terutama di tiang infus. Jumlah sampel dalam penelitian ini adalah 93 anak dengan teknik non probability sampling dengan metode purposive sampling. Hasil analisis bivariat menunjukkan ada perbedaan yang bermakna perilaku distress antara kelompok kontrol dan intervensi menurut persepsi orangtua (p=0,003) serta menurut pengamatan perawat (OSBD-R) (p<0,001). Dengan demikian pemberian asuhan keperawatan dengan konsep atraumatic care dapat membantu mengatasi masalah gangguan kenyamanan pada anak di ruang gawat darurat.

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Emergency conditions in children require fast and appropriate handling and approaches that are appropriate for the child's development to overcome the child's comfort problems. The condition of a crowded and unfamiliar emergency room triggers distress in children and causes discomfort. Environmental modification with the concept of emergency care is designed using the Kolcaba Comfort Theory principle. The application of evidence based nursing (EBN) is done by the quasy experiment method with a post test only non equivalent control group approach. The intervention was implemented in the form of modification of the emergency room by adding interesting images to the room, especially on the infusion pole. The number of samples in this study were 93 children with non probability sampling techniques with purposive sampling method. The bivariate analysis showed that there were significant differences in distress behavior between the control and intervention groups according to parental perceptions (p = 0.003) and according to nurses' observations (OSBD-R) (p <0.001). Thus the provision of nursing care with the concept of atraumatic care can help overcome the problem of comfort disorders in children in the emergency room."

"Karya ilmiah ahkir ini memberikan gambaran tentang aplikasi teori comfort Kolcaba dalam asuhan keperawatan pada anak dengan peningkatan suhu tubuh dan aplikasi warm water sponge pada anak dengan peningkatan suhu tubuh. Tujuan karya ilmiah akhir ini untuk memberikan gambaran aplikasi teori comfort Kolcaba dalam asuhan keperawatan pada anak dengan masalah peningkatan suhu tubuh dan penerapan proyek inovasi berdasarkan evidence based practice yaitu penerapan warm water sponge pada pasien anak dengan peningkatan suhu tubuh. Menurut comfort Kolcaba, peningkatan suhu tubuh merupakan salah satu gangguan pemenuhan kebutuhan rasa nyaman fisik yang berkaitan erat dengan kebutuhan rasa nyaman psikospiritual, sosiokultural dan lingkungan. Intervensi yang dilakkukan adalah memonitor status hemodinamik, mennganjurkan keluarga untuk selalu berada di samping pasien, mengajarkan keluarga dalam pemberian kompres hangat menggunakan teknik warm water sponge. Salah satu inovasi yang dilakukan adalah dengan memberikan warm water sponge sesuai evidence based practice untuk menurunkan suhu tubuh sekaligus memberikan kebutuhan rasa nyaman dan mencegah trauma pada anak.

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This final scientific work provides an overview of the application of Kolcaba's comfort theory in nursing care for children with increased body temperature and the application of warm water sponge to children with increased body temperature. The purpose of this final scientific paper is to provide an overview of the application of Kolcaba's comfort theory in nursing care for children with increased body temperature problems and the application of innovation projects based on evidence based practice, namely the application of warm water sponges in pediatric patients with increased body temperature. According to Comfort Kolcaba, an increase in body temperature is one of the disorders of fulfilling the need for physical comfort which is closely related to the need for psychospiritual, sociocultural and environmental comfort. The interventions carried out were monitoring hemodynamic status, encouraging the family to always be by the patient's side, teaching the family to give warm compresses using the warm water sponge technique. One of the innovations made is to provide a warm water sponge according to evidence-based practice to reduce body temperature while providing comfort and preventing trauma to children."