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"Pendahuuan: Risiko Perilaku Kekerasan (RPK) merupakan salah satu gejala positif yang sering terjadi pada klien skizofrenia. RPK merugikan banyak orang termasuk diri sendiri dalam hal keselamatan, dan mengakibatkan dampak psikologis, dampak fisik, dampak ekonomi, termasuk memperpanjang waktu rawat inap dan meningkatkan stigmatisasi. Latihan asertif merupakan terapi keperawatan jiwa spesialis yang terbukti dapat mencegah perilaku kekerasan, menurunkan tanda dan gejala dan meningkatkan kemampuan klien dalam mengontrol RPK. Teori comfort belum banyak dikembangkan pada penelitian-penelitian RPK dengan skizofrenia. Tujuan: menganalisis penerapan terapi keperawatan jiwa spesialis latihan asertif pada klien RPK menggunakan pendekatan teori comfort. Metode: case report dengan pendekatan teori comfort. Hasil: Terdapat penurunan tanda gejala serta peningkatan kemampuan klien dalam mengontrol RPK setelah pemberian terapi keperawatan jiwa spesialis latihan asertif menggunakan pendekatan teori comfort. Kesimpulan: Tulisan ini menggunakan pedekatan teori comfort pada penerapan terapi keperawatan jiwa spesialis latihan asertif yang terbukti menurunkan tanda gejala dan meningkatkan kemampuan klien dalam mengontrol RPK. Rekomendasi: Penerapan terapi keperawatan jiwa spesialis latihan asertif menggunakan pendekatan teori comfort direkomendasikan untuk diberikan pada klien dengan RPK dengan skizofrenia.

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Introduction: The risk of violent behavior (RVB) is one of the positive symptoms that often occurs in schizophrenia. RVB harms many people including oneself in terms of safety, and results in psychological impacts, physical impacts, economic impacts, including length of stay and increasing stigmatization. Assertive training is a specialist psychiatric nursing therapy that is proven to be able to prevent violent behavior, reduce signs and symptoms, and increase the ability to control the RVB. Comfort theory has not been widely developed in RVB studies with schizophrenia.

Purpose: to analyze the application of assertive training, specialist psychiatric nursing therapy to the RVB clients using the comfort theory approach.

Method: case report with comfort theory approach.

Results: There is a decrease in signs and symptoms and an increase in the client's ability to control RVB after giving assertive training, specialist psychiatric nursing therapy, using the comfort theory approach.

Conclusion: This paper uses the comfort theory approach to the application of assertive training, specialist psychiatric nursing therapy, which is proven to reduce signs and symptoms and increase the client's ability to control RVB.

Recommendation: The application of assertive training, specialist psychiatric nursing therapy, using the comfort theory approach is recommended to be given to RVB clients with schizophrenia."

"Perilaku kekerasan adalah suatu respons inividu terhadap perasaan terancam di mana individu mengekspresikannya dengan melakukan tindakan mengancam, mencederai orang lain atau mengganggu lingkungan. Program pencegahan penularan Covid-19 yang menyebabkan pembatasan akses pelayanan RS dapat menjadi penyebab kekambuhan pada klien RPK, sehingga pemberian asuhan keperawatan melalui daring menjadi alternatif yang efektif untuk tetap dapat memberikan pelayanan kepada klien RPK. Tujuan penulisan ini adalah memaparkan hasil pemberian asuhan keperawatan jiwa spesialistik pada klien risiko perilaku kekerasan dengan menggunakan metode daring. Metode penulisan menggunakan metode deskriptif analitik dengan 8 klien yang mendapatkan asuhan keperawatan jiwa spesialistik berupa latihan asertif dan psikoedukasi pada keluarga secara daring. Hasil evaluasi pelaksanaan asuhan keperawatan jiwa spesialistik menunjukan penurunan tanda dan gejala risiko perilaku kekerasan, yang disertai dengan peningkatan kemampuan klien dalam mengontrol perilaku kekerasan. Hasil evaluasi juga menunjukkan adanya peningkatan kemampuan keluarga dalam merawat klien RPK setelah mendapatkan psikoedukasi keluarga. Pemberian asuhan keperawatan spesialis latihan asertif dan psikoedukasi keluarga dengan metode daring sama efektifnya dengan metode tatap muka.

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Violent behavior is an individual's response psychological response of being threatened which is expressed it by threatening, injuring others, or disturbing the environment. Restricted hospital service accessability due to Covid-19 pandemic can stimulate the risk of violent behavior required ioither effective alternative to access mental health services for clients in need. The purpose of this paper was to describe effectiveness of mental health nursing care provided to the violent behavior’s clients using online therapeutic methods. A descriptive-analysis method was used to explore eight clients who received online assertiveness training and psychoeducation to their family. The results revealed a decrease in signs and symptoms of violent behavior risk, which was accompanied by an increase in the client's ability to control their violent behavior. The results also showed an increase in the family's ability to care for clients with violent behavior after receiving family psychoeducation. The delivery of specialist nursing care with assertiveness training and family psychoeducation using the online method is as effective as the face-to-face method."

"Pendahuluan : Psikosis dan skizofrenia menunjukkan terjadi peningkatan setiap tahunnya baik di Indonesia dan dunia. Skizofrenia adalah penyakit otak kronis yang sindrom klinisnya melibatkan perubahan pikiran, emosi, persepsi, gerakan dan perilaku individu. Gejala positif dari skizofrenia salah satunya halusinasi sedangkan risiko perilaku kekerasan muncul akibat halusinasi dan waham. Klien dengan risiko perilaku kekerasan dan halusinasi, asuhan yang diberikan dalam bentuk tindakan keperawatan generalis dan spesialis. Tindakan keperawatan generalis (individu, kelompok, keluarga) begitu juga dengan Tindakan keperawatan spesialis (individu, kelompok, keluarga) meliputi latihan asertif, terapi kognitif perilaku dan psikoedukasi keluarga. Tujuan : Diketahuinya karakteristik, predisposisi, presipitasi, perubahan tanda gejala, kemampuan, dan perubahan, perbedaan tanda gejala, kemampuan Metode : Desain karya ilmiah akhir spesialis ini menggunakan operational research terdiri dari enam tahap pelaksanaan Hasil : tindakan keperawatan generalis dan spesialis secara bermakna dapat menurunkan tanda gejala risiko perilaku kekerasan dan halusinasi serta secara bermakna meningkatkan kemampuan klien dan keluarga. Kesimpulan : tindakan keperawatan generalis dan spesialis direkomendasikan karena dapat mengurangi tanda gejala dan meningkatkan kemampuan klien dan keluarga.

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Introduction: Psychosis and schizophrenia show an increase every year both in Indonesia and the world. Schizophrenia is a chronic brain disease whose clinical syndrome involves changes in an individual's thoughts, emotions, perceptions, movements and behavior. One of the positive symptoms of schizophrenia is hallucinations, while the risk of violent behavior arises due to hallucinations and delusions. Clients at risk of violent behavior and hallucinations, care is provided in the form of generalist and specialist nursing actions. Generalist nursing actions (individual, group, family) as well as specialist nursing actions (individual, group, family) include assertive training, cognitive behavioral therapy and family psychoeducation. Purpose: To find out characteristics, predisposition, precipitation, changes in signs and symptoms, abilities, and changes, differences in signs and symptoms, abilities. Methods: The design of this specialist's final scientific work using operational research consists of six implementation stages. Results: Generalist and specialist nursing actions can significantly reduce signs of risk of violent behavior and hallucinations and significantly improves the client's and family's abilities. Conclusion: generalist and specialist nursing actions are recommended because they can reduce signs and symptoms and increase the capabilities of clients and families."

"Pendahuluan : Gangguan jiwa merupakan kondisi yang dapat didiagnosis secara klinis yang memiliki pengaruh signifikan pada proses berpikir dan perilaku seseorang. Risiko perilaku kekerasan muncul karena adanya respon terhadap sesuatu yang dapat menyebabkan individu berbuat sesuatu pada diri sendiri, orang lain, dan lingkungan yang dapat mencederai orang lain secara verbal, fisik, dan psikologis. Tindakan keperawatan jiwa spesialis yang dapat diberikan untuk klien risiko perilaku kekerasan diantaranya adalah assertiveness Training dan terapi suportif Tujuan : Memberikan gambaran hasil penerapan assertiveness training dan terapi suportif pada klien risiko perilaku kekerasan menggunakan pendekatan teori pencapaian tujuan Imogen M. King. Hasil : Terdapat penurunan tanda gejala risiko perilaku kekerasandan peningkatan kemampuan klien risiko perilaku kekerasan setelah diberikan assertiveness training dan terapi suportif. Kesimpulan : assertiveness training dan terapi suportif dengan pendekatan teori pencapaian tujuan Imogen M. King. direkomendasikan untuk diberikan pada klien dengan risiko perilaku kekerasan yang menjalani perawatan di rumah sakit jiwa.

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Introduction: Mental health is an integral component of health and well-being that Introduction: Mental disorders are conditions that can be diagnosed clinically that have a significant influence on a person's thought processes and behavior. The risk of violent behavior arises because of a response to something that can cause an individual to do something to themselves, others and the environment that can injure others verbally, physically and psychologically. Specialist psychiatric nursing actions that can be given to clients at risk of violent behavior include assertiveness training and supportive therapy. Objective: To provide an overview of the results of applying assertiveness training and supportive therapy to clients at risk of violent behavior using Imogen M. King's goal achievement theory approach. Results: There was a decrease in signs of risk of violent behavior and an increase in the ability of clients at risk of violent behavior after being given assertiveness training and supportive therapy. Conclusion: assertiveness training and supportive therapy using Imogen M. King's goal achievement theory approach. recommended to be given to clients at risk of violent behavior who are undergoing treatment in mental hospitals."

"Risiko perilaku kekerasan merupakan salah satu masalah yang dialami klien dengan skizofrenia. Tanda dan gejala yang dialami klien dengan risiko perilaku kekerasan salah satunya adalah marah dan merusak lingkungan sekitar, klien dengan risiko perilaku kekerasan membutuhkan latihan assertive training untuk pengubahan perilaku yang tujuan utamanya membimbing, melatih serta mendorong seseorang agar berperilaku asertif di berbagai keadaan. Pemberian terapi assertive training selama ini dilakukan oleh perawat spesialis dalam praktik klinik guna peningkatan asuhan keperawatan secara optimal. Keefektifan pemberian assertive training memiliki kekurangan yaitu tidak mudah untuk diingat dan umpan balik dapat di bawah standar karena keterbatasan memori atau pengamatan. Tujuan penulisan karya ilmiah ini untuk menggambarkan manajemen kasus spesialis melalui penerapan media audio-visual dalam pemberian intervensi keperawatan spesialis; assertive training pada klien dengan risiko perilaku kekerasan. Metode yang digunakan adalah case series. Manajemen kasus ini dilakukan pada 6 klien yang mendapatkan tindakan keperawatan ners dan tindakan keperawatan spesialis assertive training. Pengkajian menggunakan instrumen Buss_Perry Aggression Questionnaire (BPAQ) untuk mengkaji tingkat agresif klien dengan risiko perilaku kekerasan. Hasil analisa kasus menunjukkan perubahan penurunan tingkat agresif klien sebelum dan sesudah diberikan tindakan assertive training dengan penerapan media audio-visual. Tindakan keperawatan spesialis direkomendasikan dilakukan oleh perawat spesialis jiwa dalam membantu klien melakukan latihan assertive training.

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The risk of violent behavior is one of the problems experienced by clients with schizophrenia. Signs and symptoms experienced by clients at risk of violent behavior, one of which is anger and damage to the surrounding environment, clients at risk of violent behavior require assertive training for behavior change whose main purpose is to guide, train and encourage someone to behave assertively in various circumstances. The provision of assertive training therapy has been carried out by specialist nurses in clinical practice in order to improve nursing care optimally. The effectiveness of giving assertive training has drawbacks, namely it is not easy to remember and feedback can be substandard due to memory or observation limitations. The purpose of writing this scientific paper is to describe specialist case management through the application of audio-visual media in providing specialist nursing interventions; assertive training on clients at risk of violent behavior. The method used is case series. This case management was carried out on 6 clients who received nursing actions from nurses and specialist nursing actions for assertive training. The assessment uses the Buss_Perry Aggression Questionnaire (BPAQ) instrument to assess the aggressive level of clients at risk of violent behavior. The results of the case analysis showed a change in the decrease in the client's aggressive level before being given action with after being given assertive training. Specialist nursing actions are recommended to be carried out by mental specialist nurses in helping clients carry out assertive training exercises."

"Alasan klien gangguan jiwa masuk rumah sakit karena adanya perilaku nyata yang maladaptif, seperti mencederai diri sendiri, orang lain atau lingkungan, sehingga membutuhkan perawatan segera, yaitu dengan mengontrol perilaku klien yang mengganggu. Terapi perilaku merupakan terapi yang digunakan untuk memodifikasi perilaku maladaptif. Tujuan penulisan karya ilmiah ini adalah untuk mengetahui penerapan terapi perilaku pada klien halusinasi dan risiko perilaku kekerasan. Analisa ini dilakukan pada 5 klien yang mendapatkan terapi perilaku dengan diagnosa keperawatan halusinasi dan risiko perilaku kekerasan. Hasil analisa menunjukkan ada perubahan tanda gejala serta kemampuan antara sebelum dan sesudah diberikan terapi perilaku. Terapi perilaku dapat dilakukan bukan hanya pada klien defisit perawatan diri, namun pada setiap klien yang mempunyai perilaku maladptif, baik halusinasi, perilaku kekerasan atau perilaku lain. Terapi perilaku tepat digunakan bagi klien di ruang akut yang memperlihatkan perilaku maladaptif.

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Clients with mental disorder usually admited to the hospital because of their maladaptive behavior, such as hurting themselves, other people or destroying environment. This condition need immediate treatment by controling client’disruptive behaviors. Behavior therapy is a therapy used to modify maladaptive behavior becomes adaptive. The purpose of this study was to determine the application of behavior therapy for hallucination and violent risked behavior clients. The analysis of this paper consisted of 5 clients with hallucination and violent risked behavior who were the subjects of behavior therapy. The results showed that there were alteration of signs and symptoms, and ability of clients. Behavior therapy can be used not only for clients with self care deficit but also for clients with hallucinations and violent risked behavior. Behavior therapy appropriately used for acute inpatients with maladaptive behavior."

"Alasan klien gangguan jiwa masuk rumah sakit karena adanya perilaku nyata yang maladaptif, seperti mencederai diri sendiri, orang lain atau lingkungan, sehingga membutuhkan perawatan segera, yaitu dengan mengontrol perilaku klien yang mengganggu. Terapi perilaku merupakan terapi yang digunakan untuk memodifikasi perilaku maladaptif. Tujuan penulisan karya ilmiah ini adalah untuk mengetahui penerapan terapi perilaku pada klien halusinasi dan risiko perilaku kekerasan. Analisa ini dilakukan pada 5 klien yang mendapatkan terapi perilaku dengan diagnosa keperawatan halusinasi dan risiko perilaku kekerasan. Hasil analisa menunjukkan ada perubahan tanda gejala serta kemampuan antara sebelum dan sesudah diberikan terapi perilaku. Terapi perilaku dapat dilakukan bukan hanya pada klien defisit perawatan diri, namun pada setiap klien yang mempunyai perilaku maladptif, baik halusinasi, perilaku kekerasan atau perilaku lain. Terapi perilaku tepat digunakan bagi klien di ruang akut yang memperlihatkan perilaku maladaptif.

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Clients with mental disorder usually admited to the hospital because of their maladaptive behavior, such as hurting themselves, other people or destroying environment. This condition need immediate treatment by controling client’disruptive behaviors. Behavior therapy is a therapy used to modify maladaptive behavior becomes adaptive. The purpose of this study was to determine the application of behavior therapy for hallucination and violent risked behavior clients. The analysis of this paper consisted of 5 clients with hallucination and violent risked behavior who were the subjects of behavior therapy. The results showed that there were alteration of signs and symptoms, and ability of clients. Behavior therapy can be used not only for clients with self care deficit but also for clients with hallucinations and violent risked behavior. Behavior therapy appropriately used for acute inpatients with maladaptive behavior."

"[ABSTRAKAlasan klien gangguan jiwa masuk rumah sakit karena adanya perilaku nyata yang maladaptif, seperti mencederai diri sendiri, orang lain atau lingkungan, sehingga membutuhkan perawatan segera, yaitu dengan mengontrol perilaku klien yang mengganggu. Terapi perilaku merupakan terapi yang digunakan untuk memodifikasi perilaku maladaptif. Tujuan penulisan karya ilmiah ini adalah untuk mengetahui penerapan terapi perilaku pada klien halusinasi dan risiko perilaku kekerasan. Analisa ini dilakukan pada 10 klien yang mendapatkan terapi perilaku dengan diagnosa keperawatan halusinasi dan risiko perilaku kekerasan. Hasil analisa menunjukkan ada perubahan tanda gejala serta kemampuan antara sebelum dan sesudah diberikan terapi perilaku. Terapi perilaku dapat dilakukan bukan hanya pada klien defisit perawatan diri, namun pada setiap klien yang mempunyai perilaku maladptif, baik halusinasi, perilaku kekerasan atau perilaku lain. Terapi perilaku tepat digunakan bagi klien di ruang akut yang memperlihatkan perilaku maladaptif.

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ABSTRACTClients with mental disorder usually admited to the hospital because of their maladaptive behavior, such as hurting themselves, other people or destroying environment. This condition need immediate treatment by controling client?disruptive behaviors. Behavior therapy is a therapy used to modify maladaptive behavior becomes adaptive. The purpose of this study was to determine the application of behavior therapy for hallucination and violent risked behavior clients. The analysis of this paper consisted of 10 clients with hallucination and violent risked behavior who were the subjects of behavior therapy. The results showed that there were alteration of signs and symptoms, and ability of clients. Behavior therapy can be used not only for clients with self care deficit but also for clients with hallucinations and violent risked behavior. Behavior therapy appropriately used for acute inpatients with maladaptive behavior.;Clients with mental disorder usually admited to the hospital because of their maladaptive behavior, such as hurting themselves, other people or destroying environment. This condition need immediate treatment by controling client?disruptive behaviors. Behavior therapy is a therapy used to modify maladaptive behavior becomes adaptive. The purpose of this study was to determine the application of behavior therapy for hallucination and violent risked behavior clients. The analysis of this paper consisted of 10 clients with hallucination and violent risked behavior who were the subjects of behavior therapy. The results showed that there were alteration of signs and symptoms, and ability of clients. Behavior therapy can be used not only for clients with self care deficit but also for clients with hallucinations and violent risked behavior. Behavior therapy appropriately used for acute inpatients with maladaptive behavior., Clients with mental disorder usually admited to the hospital because of their maladaptive behavior, such as hurting themselves, other people or destroying environment. This condition need immediate treatment by controling client’disruptive behaviors. Behavior therapy is a therapy used to modify maladaptive behavior becomes adaptive. The purpose of this study was to determine the application of behavior therapy for hallucination and violent risked behavior clients. The analysis of this paper consisted of 10 clients with hallucination and violent risked behavior who were the subjects of behavior therapy. The results showed that there were alteration of signs and symptoms, and ability of clients. Behavior therapy can be used not only for clients with self care deficit but also for clients with hallucinations and violent risked behavior. Behavior therapy appropriately used for acute inpatients with maladaptive behavior.]"

"[ABSTRAK Resiko Perilaku Kekerasan merupakan diagnosa keperawatan yang terbanyak ditemukan di ruang Intensive Kresna Pria Rumah Sakit Dr. H Marzoeki Mahdi Bogor sebanyak 70%. Tujuan Karya Ilmiah Akhir ini untuk menjelaskan penerapan terapi Assertiveness Training (AT), Cognitive Behaviour Therapy (CBT), dengan menggunakan pendekatan Teori Interpersonal Peplau, Stress Adaptasi Stuart. Analisis dilakukan pada 39 klien AT, dan 20 klien CBT dalam kurun waktu 16 Februari -17 April 2015. Hasil pelaksanaan AT dan CBT meningkatkan kemampuan mengatasi perilaku kekerasan, meningkatkan penurunan tanda gejala perilaku kekerasan pada aspek kognitif, afektif, fisiologis, perilaku dan sosial. AT dan CBT merupakan terapi yang efektif untuk mengatasi masalah risiko perilaku kekerasan. ABSTRACT Violent risk behaviours as one of nursing diagnosis usually found at Male Intensive Care Ward as approximately 70%. The purpose of this scientific paper was to describe the application of Assertiveness Training (AT), and Cognitive Behaviour Therapy (CBT), utilizing Peplau?s Interpersonal Theory and Stuart?s Stress-Adaptation Theory as approach. The result of assertiveness training to 39 clients cognitive behaviour therapy to 20 clients during a period of 16 February-17 April 2015 showed that those combination of therapies could improve the ability of clients to deal with their aggressive behaviours, and decreased the signs and symprotms of violent behaviours in cognitive, affective, physiological, behaviour and social aspects. These

therapies had proved to be effective for treating the clients with violent risk behaviors. , Violent risk behaviours as one of nursing diagnosis usually found at Male Intensive Care Ward as approximately 70%. The purpose of this scientific paper was to describe the application of Assertiveness Training (AT), and Cognitive Behaviour Therapy (CBT), utilizing Peplau’s Interpersonal Theory and Stuart’s Stress-Adaptation Theory as approach. The result of assertiveness training to 39 clients cognitive behaviour therapy to 20 clients during a period of 16 February-17 April 2015 showed that those combination of therapies could improve the ability of clients to deal with their aggressive behaviours, and decreased the signs and symprotms of violent behaviours in cognitive, affective, physiological, behaviour and social aspects. These

therapies had proved to be effective for treating the clients with violent risk behaviors. ]"