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"Gangguan rasa nyaman adalah perasaan kurang senang, lega dan sempurna dalam dimensi fisik, psikospiritual, lingkungan dan sosial. Perawat perlu menggunakan beberapa metode dalam mengurangi ketidaknyamanan anak saat di rumah sakit agar tidak memberikan dampak negatif dan trauma dimasa yang akan datang. Tujuan karya tulis ilmiah ini adalah untuk menganalisis penerapan Teori Comfort Kolcaba dalam proses asuhan keperawatan pada anak dengan masalah gangguan rasa nayaman. Metode karya ilmiah ini adalah studi kasus. Terdapat lima kasus anak di ruang IGD anak zona kuning yang diberikan asuhan keperawatan dengan pendekatan Teori Comfort Kolcaba. Aplikasi Comfort Kolcaba membagi tingkat kenyamanan dalam empat konteks yaitu kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural. Intervensi keperawatan yang dilakukan adalah berdasarkan pendekatan berbasis bukti seperti distraksi, modifikasi lingkungan dan keterlibatan keluarga untuk meningkatkan kenyamanan anak. Penggunaan skerem bermotif kartun terbukti kurang efektif dalam menurunkan kecemasan anak saat dilakukan prosedur penusukan vena.

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Comfort disorders is feeling less happy, relieved, and perfect in physical, psychospiritual, environmental, and social dimensions. Nurses need to use several ways to reduce the child's discomfort while in hospital so that it does not have a negative impact and trauma in the future. The purpose of scientific writing is to analyze the application of Kolcaba's Comfort Theory in the nursing care process for children with comfort problems. The method of this scientific work is a case study. There are five cases of children in the yellow zone children's ER who were given nursing care with the Kolcaba Comfort Theory approach. The Comfort Kolcaba application divides the comfort level into four contexts: physical comfort, psychospiritual, environmental, and socio-cultural. Nursing interventions that are carried out are based on evidence-based approaches such as distraction, environmental modification, and family involvement to increase child comfort. The use of cartoon-patterned series proved to be less effective in reducing children's anxiety during the venipuncture procedure."

"Praktek Spesialis Keperawatan Anak peminatan bedah anak ini bertujuan untuk melakukan praktek dengan mengaplikasikan model Teori Comfort Katherina Kolcaba. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang anak yang telah menjalani operasi yang mengalami rasa nyeri, dan satu orang pasien kelolaan utama yaitu pasien post operasi penutupan colostomi. Peran sebagai peneliti dalam melakukan penerapan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing practise) yaitu dengan membuktikan terapi musik sebagai salah satu tehnik penanganan nyeri pada anak post operasi dan tindakan invasif. Peran sebagai inovator melalui penyusunan program pemberian terapi musik pada anak yang mengalami nyeri yang bertujuan untuk mengurangi nyeri dan meningkatkan kenyamanan pasien anak dan meningkatkan kualitas asuhan keperawatan. Hasil praktek ini menunjukan bahwa teori Comfort Katherina Kolcaba digunakan pada pasien yang mengalami rasa nyeri post operasi dan tindakan invasif, dan terapi musik efektif untuk mengurangi rasa nyeri yang dialami anak pada waktu tindakan, terutama nyeri ringan.

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Specialist Nursing Practice Children's specialization in pediatric surgery practice with the aim to apply the theory of Comfort models Katherina Kolcaba. Role as provider of nursing care applied to the 5 children who have undergone surgery are experiencing pain, and one patient that the patient's primary management of postoperative closure colostomi. Role as a researcher in performing nursing actions based on the application of scientific evidence (evidence based nursing practice model) to prove that music therapy as a pain management technique in children and postoperative invasive action.

Role as an innovator through the preparation of a program of music therapy on children who experience pain which aims to reduce pain and increase patient comfort and improve the child's quality of nursing care. This practice results show that the theory Comfort Katherina Kolcaba used in patients experiencing postoperative pain and invasive, and effective music therapy to reduce the pain experienced by the child at the time of the action, especially mild pain."

"Karya Ilmiah Akhir ini memberikan gambaran tentang pelaksanaan Program Residen Ners Spesialis Keperawatan Anak dalam bentuk kegiatan praktik Residensi I dan II. Karya Ilmiah Akhir ini bertujuan untuk memberikan gambaran aplikasi teori comfort Kolcaba dalam asuhan keperawatan pada anak dengan peningkatan suhu tubuh dan pencapaian kompetensi baik sebagai praktisi, pendidik, advokat, pengelola dan peneliti selama praktik residensi. 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 dilakukan adalah memonitor status hemodinamik, menganjurkan keluarga untuk selalu berada di samping pasien, mengajarkan keluarga dalam pemberian kompres air hangat dan mengatur suhu ruangan sesuai suhu tubuh pasien. Salah satu inovasi yang dilakukan adalah mengukur suhu tubuh dengan menggunakan termometer timpani dimana residen menerapkan salah satu kompetensi perawat spesialis sebagai ranah pengembangan profesional sekaligus memberikan kebutuhan rasa nyaman dan mencegah trauma pada anak.

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This Final Scientific Paper provides an overview of the implementation of the Resident Program Specialist Nurses in the form of practical activities Residency I and II. This Final Scientific aims is in order to provide an overview Comfort Kolcaba Theory Application of children nursing care by increased body temperature and achievement of competency either as a practitioner, educator, advocate, manager and researcher during practice residency. According to Kolcaba comfort theory, increasing body temperature is one of the comfortable sense of fulfillment disorders are strongly associated with physical comfort needs psikospiritual, sociocultural and environmental. Interventions need to be done is to monitor hemodynamic status, advised the family to accompanied the patient, the family teaches the provision of warm water compress and maintain the room's temperature according the patient's body temperature. One inovation need to be done is measure the body temperature using a thermometer tympanic where residents apply one domain competence as a specialist nurse professional development needs as well as providing a sense of comfort and prevent trauma to child."

"Nyeri saat pemasangan intravena kateter masih menjadi salah satu aspek yang paling membuat stres selama rawat inap pada anak. Penggunaan terapi non farmakologis membantu untuk mengurangi nyeri saat pemasangan intravena kateter pada anak sehingga dapat menurunkan tingkat nyeri pada anak, meningkatkan pelayanan diruang rawat inap. Teori kenyamanan Kolcaba membantu perawat untuk memberikan asuhan keperawatan secara holistik melalui pengkajian fisik, psikospiritual, sosiokultural dan lingkungan dengan mengevaluasi menggunakan tiga taksonomi yaitu relief, ease dan transcendence. Tujuan penulisan karya ilmiah akhir spesialis ini adalah memberikan gambaran mengenai aplikasi teori kenyamanan Kolcaba dalam pemenuhan kebutuhan nyeri dan kenyamanan pada anak dirawat di ruang infeksi. Berdasarkan hasil pengkajian pada lima anak dengan gangguan nyeri saat pemasangan intravena kateter didapatkan hasil bahwa terdapat penurunan skoring nyeri pada anak. Penerapan quality improvement project dengan pemberian ice gel untuk menurunkan nyeri pada saat pemasngan intravena kateter terbukti efektif yang menunjukkan bahwa terdapat penurunan tingkat nyeri pada anak setelah pemberian ice gel pada saat pemasangan intravena kateter (venapunture) dengan p value < 0.005 (p= 0.001). Kesimpulan aplikasi teori kenyamanan Kolcaba dapat diterapkan pada anak dengan gangguan nyeri dan kenyamanan di ruang rawat infeksi.

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Pain during intravenous catheter insertion is still one of the most stressful aspects of hospitalization in children. The use of non-pharmacological therapy helps to reduce pain when installing an intravenous catheter in children so that it can reduce the level of pain in children, improve services in inpatient rooms. Kolcaba's comfort theory helps nurses to provide holistic nursing care through physical, psychospiritual, sociocultural and environmental assessments by evaluating using three taxonomies, namely relief, ease and transcendence. The aim of writing this final specialist scientific paper is to provide an overview of the application of Kolcaba's comfort theory in meeting the pain and comfort needs of children treated in the infection room. Based on the results of a study on five children with pain disorders during intravenous catheter, it was found that there was a decrease in pain scoring in children. The implementation of the quality improvement project by administering ice gel to reduce pain during intravenous catheter has proven to be effective, showing that there is a reduction in the level of pain in children after giving ice gel when installing an intravenous catheter (venapuncture) with a p value < 0.005 (p= 0.001). Conclusion: The application of Kolcaba's comfort theory can be applied to children with pain and comfort disorders in the infection ward."

"[ABSTRAKNyeri merupakan salah satu masalah utama pada pasien kanker anak. Karya Ilmiah Akhir ini bertujuan memberikan gambaran penerapan, analisis Comfort Theory Kolcaba pada pasien kanker anak dengan nyeri, dan pencapaian kompetensi ners spesialis keperawatan anak. Penerapan teori dilakukan pada lima pasien, menggunakan pendekatan proses keperawatan. Pengkajian dan penetapan masalah keperawatan menggunakan struktur taksonomi Kolcaba. Intervensi dan implementasi menggunakan intervensi kenyamanan standar, coaching, dan comfort food for the soul. Evaluasi menggunakan comfort behavior scale menunjukkan hasil diakhir perawatan, nyeri berkurang, terkontrol, dan kenyamanan bertambah. Kompetensi tercapai sesuai target. Comfort Theory bisa menjadi pilihan dalam merawat pasien kanker anak dengan nyeri.

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ABSTRACTPain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.;Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer., Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.]"

"Demam merupakan respon tubuh terhadap adanya infeksi. Anak dengan demam dapat mengalami gangguan fisiologis, gelisah, dehidrasi, dan ketidaknyamanan. Penanganan demam dilakukan dengan menurunkan suhu tubuh secara perlahan dan memberikan kenyamanan pada anak. Salah satu penanganan demam nonfarmakologi berupa tepid water sponge yang menjadi rekomendasi jika dipadukan dengan terapi farmakologi. Pendekatan keperawatan untuk memberikan kenyamanan pada pasien didasarkan pada teori Comfort Kolcaba yang meliputi aspek kenyamanan fisik, psikospiritual, sosiokultural, dan lingkungan. Asuhan keperawatan menggunakan teori Comfort Kolcaba dapat digunakan sebagai salah satu acuan dalam pemberian asuhan keperawatan pada anak dengan demam.

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Fever is the body's response to infection. Children with fever may experience physiological disorders, anxiety, dehydration, and discomfort. Handling fever is done by slowly lowering the body temperature and provide comfort to the child. One of non pharmacological treatment to fever is tepid water sponge that recommended when it combined with pharmacological therapy. The nursing approach to comforting patient is based on Kolcaba Comfort theory which includes aspects of physical comfort, psychospiritual, sociocultural, and environment. Kolcaba comfort theory can be used as a reference in the provision of nursing care in children with fever."

"Anak yang mengalami penyakit ginjal kronis (PGK) dapat mengalami gangguan ketidakseimbangan cairan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran aplikasi Model Adaptasi Roy (MAR) dalam memberikan asuhan keperawatan pada anak penyakit ginjal kronis yang mengalami ketidakseimbangan cairan. Teori Roy mengkonseptualisasikan proses keperawatan menjadi enam langkah yaitu pengkajian perilaku, pengkajian stimulus, diagnosis keperawatan, penetapan tujuan, intervensi, dan evaluasi. Metode karya ilmiah ini adalah studi kasus yang terdiri atas lima kasus anak PGK yang menjalani hemodialisis yang diberikan asuhan keperawatan dengan pendekatan Model Adaptasi Roy. Berdasarkan hasil pengkajian pala lima anak masalah yang muncul yaitu ketidakseimbangan cairan, selain itu masalah lainya seperti gangguan tumbuh kembang, penampilan peran tidak efektif, risiko penurunan curah jantung, risiko perdarahan, risiko infeksi, defisit pengetahuan. Intervensi keperawatan yang diberikan pada masalah ketidakseimbangan cairan yaitu menimbang berat badan pra HD, mengkaji berat badan kering, berat badan sebelumnya, melakukan perawatan akses kateter dan memberikan edukasi tentang edukasi kebutuhan gizi, cairan dan perawatan akses menggunakan video. Kesimpulan aplikasi teori Roy dapat diterapkan pada anak penyakit ginjal kronis dengan masalah ketidaseimbangan cairan.

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Children with chronic kidney disease (CKD) can experience imbalance disorders. Fluid restriction is one of the nursing interventions to overcome fluid balance disorders. This final scientific work aims to provide an overview of the application of the Roy Adaptation Model (MAR) in providing nursing care to children with chronic kidney disease who experience fluid imbalance. Roy's theory conceptualizes the nursing process into six steps, namely behavioral assessment, stimulus assessment, nursing diagnosis, goal setting, intervention, evaluation. Provides an overview of the application of nursing care to children with chronic kidney disease who experience fluid imbalance in the dialysis unit using the Roy Adaptation Model approach. The method of this scientific work is a case study consisting of five cases of CKD children undergoing hemodialysis who were given nursing care using the Roy Adaptation Model approach. The nursing intervention provided based on evidence-based practice is providing education about nutritional needs, fluids and access care using videos. Implementing a quality improvement project by providing effective education increases the knowledge of caregivers of children with chronic kidney disease undergoing hemolysis. The conclusion is that the application of Roy's theory can be applied to children with chronic kidney disease who have fluid imbalance problems."

"Pasca pembedahan, anak berisiko mengalami gangguan keamanan yaitu risiko aspirasi akibat pemberian minum sebelum tingkat kesadarannya pulih. Gangguan keamanan tersebut akan mengakibatkan ketidaknyamanan pada anak berupa rasa nyeri dan sesak di daerah dada. Teori Comfort dari Kolcaba memberikan arahan dalam pemenuhan rasa nyaman pada pasien. Karya ilmiah ini bertujuan memberikan gambaran asuhan keperawatan pada anak pasca pembedahan dengan mengaplikasikan teori comfort Kolcaba yang berfokus pada pemenuhan kebutuhan keamanan. Asuhan keperawatan dilakukan berdasarkan tahapan comfort yaitu pengkajian (kenyamanan fisik, psikospiritual, lingkungan dan sosiokultural), merumuskan diagnosa keperawatan, menetapkan intervensi (berdasarkan standar comfort, coaching, dan comfort food for the soul), implementasi dan evaluasi. Pada lima pasien kelolaan yang berisiko mengalami aspirasi pasca pembedahan, empat pasien tidak mengalami aspirasi dan satu pasien mengalami aspirasi. Aspirasi terjadi dikarenakan kenyamanan sosiokultural tidak terpenuhi yaitu dukungan dan keterlibatan dari orangtua dalam perawatan anaknya. Sehingga terlihat bahwa ke empat aspek kenyamanan harus saling mendukung untuk pencapaian kenyamanan secara holistik.

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Post surgery children are in risk for safety problem such as aspiration becouse of fluid intake before they are fully conscious. The aspiration will cause comfort problem which manifestated as chest pain and chest tightness. Comfort theory from Kolcaba provides direction on meeting patient need of comfort. This paper aims to give an overview of post surgical children focused on meeting the need of safety. Nursing care was provided throught the stages of comfort assessment (physical comfort, psychospiritual, environtment and sociocultural), nursing diagnosis formulation, interventions plan (based on standard comfort, coaching, and comfort food for the soul), implementation and evaluation. Among five post surgical children which were in risk of aspiration, four children didn’t experience aspiration and one patient experienced aspiration. The aspiration was happened becouse of sociocultural comfort was not satisfied, where the support and involvement from parents in the care of their children was not adequate. So that the four aspects of comfort should be mutually supportive to the achievement of holistic comfort."

"Neonatus yang mengalami transportasi mempunyai risiko tinggi untuk terjadinya hipotermia. Perawat yang melakukan transportasi neonatus intra rumah sakit seharusnya dibekali pedoman dalam mengurangi masalah hipotermia dan meningkatkan praktik transportasi. Tujuan karya ilmiah ini adalah untuk mengaplikasikan Teori Kenyamanan/Comfort Kolcaba dalam asuhan keperawatan hipotermia saat transportasi neonatus intra rumah sakit. Penelitian ini dilakukan dengan metode studi kasus terhadap lima bayi yang melakukan transportasi neonatus intra rumah sakit melalui pendekatan proses keperawatan.Aplikasi Teori Kenyamanan memperhatikan empat konteks kenyamanan yaitu kenyamanan fisik, psikospritual, sosiokultural, dan lingkungan.Intervesi keperawatan yang dilakukan berdasarkan evidence-based nursing practice >seperti mengatur suhu inkubator, menggukana topi atau plastik pada bayi dengan berat badan kurang dari 1500 gram, memposisikan bayi di dalam nesting, gentle human touch, dan intervensi lainnya.Edukasi transportasi neonatus intra rumah sakit terbukti efektif dapat meningkatkan pengetahuan, sikap, dan keterampilan perawat dalam mencegah hipotermia, sehingga dapat menjadi bahan pengembangan asuhan keperawatan dan kajian untuk menyusun standar prosedur operasional transportasi neonatus intra rumah sakit.

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Neonates who undergo transportation have a high risk for hypothermia. Nurses who carry out intrahospital transportation of neonates should be provided with guidelines to reduce hypothermia problems and improve transport practices. The purpose of this scientific work is to apply Kolcaba's Comfort Theory in nursing care for hypothermia during intrahospital transportation of neonates. This research was conducted using a case study method on five infants who carried out intra-hospital neonatal transportation through a nursing process approach. The application of Comfort Theory pays attention to four contexts of comfort, namely physical, psycho-spiritual, sociocultural, and environmental comfort. Nursing interventions are based on evidence-based nursing practice. such as regulating the temperature of the incubator, using a cap or plastic for infants weighing less than 1500 grams, positioning the baby in nesting, gentle human touch, and other interventions. Intra-hospital neonatal transportation education has been proven to be effective in improving the knowledge, attitudes, and skills of nurses in preventing hypothermia, so that it can be used as material for developing nursing care and studies to develop standard operating procedures for intra-hospital neonatal transportation."

"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."