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"Ibu dengan seksio sesarea akan menghadapi berbagai macam permasalahan kesehatan, baik masalah fisik maupun psikologis. Permasalahan fisik yang sering terjadi antara lain post operatif ileus yang menyebabkan nyeri "gas pain", distress yang memperlama hari rawat serta meningkatkan resiko infeksi. Hal ini terjadi akibat efek samping anestesi, operasi di abdomen, trauma dan stress operasi. Penelitian ini merupakan penelitian dengan design quasi experimental pretest posttest with control group yang bertujuan untuk mengetahui efektivitas mengunyah penmen karet dalam meningkatkan motilitas saluran cerna (frekuensi bising usus, mual/muntah, kembung dan flatus) di RSUD Koja. Populasi adalah semua ibu yang melahirkan dengan seksio sesarea di RSUD Koja. Jumlah sampel dalam penelitian ini 75 orang yang terdiri dari 37 orang kelompok perlakuan dan 38 orang kelompok kontrol yang pengambilannya dengan cara quota sampling. Uji homogenitas responden antara kelompok perlakuan dan kelompok kontrol didapatkan hasil kedua kelompok homogen (p> 0,05). Analisis efektivitas mengunyah permen karet terhadap frekuensi bising usus dilakukan dengan menggunakan uji t, sedangkan mual/muntah, kembung dan flatus diukur setiap 30 menit dan dianalisis dengan distribusi frekuensi. Hasil penelitian ini menunjukkan bahwa terdapat perbedaan rata-rata frekuensi bising usus diantara kedua kelompok setelah mengunyah permen karet (p=0,00, x 0,05) Baik pada kelompok perlakuan maupun kelompok kontrol tidak ditemukan kejadian mual/muntah dan kembung setelah intervensi, namun demikian pada kelompok perlakuan kejadian mual/muntah lebih cepat hilang satu jam. Mengunyah penmen karet juga memberi efek flatus lebih cepat (13,5%) dibanding dengan yang tidak mengunyah permen karet. Dengan demikian dapat disimpulkan bahwa mengunyah permen karet dapat meningkatkan motilitas saluran cerna. Berdasarkan hasil penelitian ini disarankan untuk memotivasi klien post operasi untuk mengunyah permen karet sebab mengunyah permen karet efektif dalam meningkatkan motilitas saluran cema, simple, mudah ditoleransi, aman dan murah.

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Women with caesarean section will face many health problems physiologically and psychologically. One of the most common physical problems is post ileuses operative such as gas pain, distress and which may causes longer durations of inpatient stay, higher rates of hospital-acquired infection. This problem occurs due to side effect of the anesthesia, abdomen surgery, trauma and the surgical stress. This study used a quasi experimental pretest posttest with control group design to identify the effectiveness of chewing gum toward gastro intestinal tract motility (frequency of bowel wheezing, nausea/vomiting, bloating and flatus) at RSUD Koja. The study included all women in labor at RSUD Koja. A total of 75 women as sample were divided into two groups; 37 women as intervention group and 38 women as control group. They were taken by quota sampling. The result shown that the characteristic between both groups is equal (p 0, 05) it's mean that the both group are homogeny. The study of effectiveness of chewing gum towards bowel sounds frequencies was analyzed by using t test. Whereas, nausea/vomiting, bloating and flatus that has been taken observation every 30 minute were analyzed by distribution frequencies. The study has shown that there are any differences in average of bowel sounds frequencies between intervention group and control group (p.1.00, cc 0.05): Nausea/vomiting and flatus did not appear in both groups after intervention. However reducing the nausea/vomiting in intervention group faster one hour than groups control. The passage of flatus in the gum chewing groups is after intervention obtained 13,5% and than it did not happen in control groups. This study proved that the intervention increase gastro intestinal tract motility. The study recommends motivate post-operation clients to chewing gum because chewed gum speeds recovery post operatif ileus by stimulating bowel motility. The chewing gum is simple, easily tolerate no complication and inexpensive easy method of stimulating intestinal motility."

"Ibu yang melahirkan Bayi Berat Lahir Rendah (BBLR) dan dirawat di NICU menghadapi stimulasi eksternal/stressor yang lebih besar karena dirawat terpisah dengan bayi, kerentanan bayi terhadap masalah kesehatan, rumitnya perawatan BBLR, dan durasi hospitalisasi bayi yang lebih lama. Hal tersebut menyebabkan ibu yang melahirkan BBLR dan dihospitalisasi di NICU berisiko tinggi mengalami maternal stress dan efikasi maternal yang rendah. Karya ilmiah ini bertujuan untuk menggambarkan integrasi teori keperawatan Modeling-Role Modeling (MRM) dan Calgary Family Intervention Model (CFIM) ke dalam asuhan keperawatan pada lima ibu yang dirawat terpisah dengan bayinya, serta penerapan praktik berbasis bukti ‘Intervensi Berbasis Hubungan’ untuk meningkatkan interaksi ibu-bayi, mengurangi tingkat stress/gejala depresi, dan meningkatkan efikasi maternal. Pengelolaan kelima kasus dalam laporan ini dilakukan di dua rumah sakit yang berbeda, dengan variasi tahap psikososial yang berbeda pula. Integrasi teori MRM dan model CFIM ke dalam asuhan keperawatan menciptakan pelayanan kesehatan yang holistik, memperhatikan kebutuhan ibu nifas pada setiap tahap psikososial, serta membentuk ikatan/interaksi antara ibu dan bayi. Penulis merekomendasikan penggunaan teori MRM dan CFIM pada setiap tahap psikososial ibu dan membentuk unit perawatan ibu dan bayi yang terintegrasi dan terpusat dalam satu lokasi yang tidak berjauhan sehingga memudahkan ibu dan keluarga untuk mengunjungi bayinya.

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Mothers who give birth to Low Birth Weight (LBW) babies and are admitted to the Neonatal Intensive Care Unit (NICU) have heightened external stimulation and stress. This is due to the separation between the mother and baby, the baby's increased susceptibility to health issues, the intricate nature of LBW care, and the extended duration of the baby's hospital stay. This results in a heightened vulnerability for mothers who deliver infants with LBW and require hospitalisation in the NICU, increasing their likelihood of encountering maternal stress and diminished maternal efficacy. This paper outlines the incorporation of Modeling-Role Modelling (MRM) and Calgary Family Intervention Model (CFIM) nursing theories in the care of five mothers who were hospitalised separately from their infants. Additionally, it discusses implementing the evidence-based practice 'Relationship-Based Intervention' to enhance mother-infant interactions, decrease stress levels and depressive symptoms, and enhance maternal efficacy. The study discussed the management of five cases in two distinct hospitals, each with its different psychological stages. By incorporating MRM theory and the CFIM model into nursing care, a comprehensive approach to healthcare is established, focusing on the specific requirements of postpartum women at every psychosocial phase and fostering connections and interactions between mothers and infants. The researcher proposed utilising MRM theory and CFIM at every psychological stage of the mother, and suggested the establishment of an integrated and centralised mother and baby care unit nearby, facilitating convenient visitation for mothers and families. "

"ABSTRAKMual muntah dan gangguan pengecapan merupakan efek samping kemoterapiyang dialami oleh pasien kanker yang berdampak terhadap gangguan nutrisi.Edukasi dengan metode dan media yang efektif dapat membantu meningkatkanpengetahuan dan self care pasien untuk mengurangi mual muntah dan gangguanpengecapan. Tujuan: untuk mengetahui cost effectiveness edukasi berulang danbooklet dengan edukasi tunggal dalam mengurangi mual muntah dan gangguanpengecapan pasca kemoterapi. Metode: Desain penelitian quasi eksperimendengan pre-post test design dan pengukuran dilakukan pada hari kedua setelahkemoterapi. Pengambilan sampel menggunakan consecutive sampling denganjumlah sampel sebanyak 38 pasien kanker ginekologi di RS. Kanker DharmaisJakarta. Analisa data menggunakan wilcoxon test dan paired t test. Hasil:Penelitian menunjukkan adanya perbedaan bermakna (p value < 0,05) setelahdiberikan edukasi baik pada kelompok edukasi berulang dan booklet maupunkelompok edukasi tunggal dalam membantu meningkatkan kemampuan pasienuntuk mengurangi keluhan mual muntah dan gangguan pengecapan.Rekomendasi : pemberian edukasi dengan frekuensi satu kali denganmenggunakan media penyuluhan lembar balik lebih efektif dibandingkan denganpemberian edukasi berulang dan booklet. Perawat sebaiknya dapat memberikanedukasi dengan metode dan media yang tepat serta cost effectivenes dalammeningkatkan kemampuan perawatan diri pasien.

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ABSTRACTNausea, vomiting and disturbance of taste is a chemotherapy side effect which isexperienced by cancer patients that lead to nutritional deficiencies. Education witheffective methods and media can help to improve patient’s knowledge and selfcareto relieve nausea, vomiting and taste disturbance. Purpose: to determine thecost effectiveness recurrent education and booklet with single education inrelieving nausea, vomiting and taste disturbance after chemotherapy. Methods:The study design quasi-experimental with pre-post test design and themeasurement is performed on the second day after chemotherapy. Sampling testtaken by using Consecutive sampling with 38 cancer gynaecology patientsat Dharmais Cancer Hospital Jakarta. Data analysis uses Wilcoxon Test andPaired T Test. Results: The results showed significant differences (p value <0.05)after being given education both in recurrent education group and booklet alsosingle education group in helping to improve the patient's ability to relievecomplaints of nausea, vomiting and tasting disturbance. Recommendation:Education Provision with one frequency by using flipchart media counceling ismore effective than recurrent education and booklets. Nurses should be able toprovide education with appropriate methods and cost effectivenes in improvingpatient’s self care ability."

"Ners spesialis keperawatan maternitas mempunyai kompetensi dalam penanganan kasus obstetri komplikasi untuk mewujudkan tujuan Millennium Development Goals Penyusunan laporan praktik residensi ini memberikan gambaran tentang peran dan fungsi ners spesialis keperawatan maternitas dalam pencapaian kompetensi Laporan ini memfokuskan penerapan teori need for help Wiedenbach pada asuhan keperawatan ibu hamil yang mengalami ketuban pecah dini Preterm Premature Rupture of Membrane PPROM dengan kelahiran prematur Penerapan teori dalam asuhan keperawatan ini merupakan salah satu dari sembilan peran mandiri perawat ners spesialis keperawatan maternitas yaitu sebagai pemberi pelayanan keperawatan Peran lainnya adalah sebagai edukator konselor advokat pengelola kolaborator komunikator dan koordinator agen perubah dan peneliti Penerapan teori need for help sangat tepat karena sesuai dengan kondisi kasus bahwa PPROM dengan kelahiran prematur adalah salah satu kondisi kegawatan obstetri Penerapan teori tersebut berhasil membantu menyelesaikan masalah keperawatan klien dengan baik

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Maternity nursing specialist contributes in handling obstetric cases to achieve the MDG rsquo s goals This clinical practice report aimed to describes the roles and functions of maternity nursing specialist in achieving competencies This report focuses on the application of the Wiedenbach rsquo s lsquo need for help rsquo theory to pregnant women who were experiencing preterm premature rupture of membranes PPROM with preterm birth The application of this theory in nursing care is one independent roles of the maternity nursing specialist namely care giver Another roles are educator counselor advocate manager collaborator communicator and coordinator change agent and researcher The application of need for help theory was very appropriate because it was fit to the conditions of the cases where PPROM with preterm birth is one of obstetric emergency conditions The application of the theory had successfully helped to solve the client rsquo s nursing problem well "

"Laporan Praktek Spesialis Keperawatan Maternitas Fokus Pada Penerapan Teori Keperawatan Need For Help 'Wiedenbach' Dan Goal Attainment 'King' Pada Asuhan Keperawatan Ibu Hamil Dengan Plasenta Previa ABSTRAK Petugas kesehatan termasuk perawat spesialis maternitas bertanggung jawab dalam upaya menurunkan angka kematian ibu Program Ners Spesialis Keperawatan Maternitas merupakan program pendidikan yang bertujuan untuk memberikan pengetahuan keterampilan serta sikap untuk dapat menjalankan peran dan fungsi dalam memberikan asuhan keperawatan Melalui program ini para calon Ners Spesialis Keperawatan Maternitas melaksanakan peran dan fungsinya sebagai care giver edukator konselor komunikator pengelola advokat kolabolator change agent dan peneliti baik ditatanan klinik maupun di komunitas Salah satu fungsi yang dilaksanakan adalah memberikan asuhan keperawatan dengan penerapan teori keperawatan need for help 'Wiedenbach' dan teori goal attainment 'King' pada ibu hamil dengan plasenta previa Integrasi kedua teori ini tepat digunakan dalam membantu mempertahankan kesehatan ibu dan janin serta mencegah terjadinya komplikasi Kata kunci Plasenta previa need for help goal attainment

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Maternity Nursing Specialist Practice Report Focused on the Application of Wiedenbach's 'Need For Help' and King's 'Goal Attainment' Nursing theory in Nursing Care of Pregnant Women with Placenta Previa ABSTRACT Health professionals including maternity nursing specialist are responsible in an attempt to reduce maternal mortality rate Maternity Nursing Specialist Program is an educational program that aims to provide the knowledge skills and attitudes to be able to perform the role and functions in providing nursing care Through this program the candidates of Maternity Nursing Specialist performed the role and function as a care giver an educator a counselor a communicator a manager an advocate a collaborator a change agent and a researcher both in the clinical area and in the community One of the functions implemented was providing nursing care with the application of Wiedenbach's 'Need For Help' and King's 'Goal Attainment' Nursing theory to pregnant women with placenta previa The integration of both theories was appropriate to maintain the health of the mother and fetus and to avoid complications Keywords Placenta previa need for help goal attainment "

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

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

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

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

"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."

"Laporan ini merupakan rangkuman kegiatan praktek residensi spesialis keperawatan maternitas selama satu tahun untuk menerapkan peran dan fungsi perawat maternitas dengan mengambil contoh penerapan teori model keperawatan Conservation Levine's pada ibu post partum paska perdarahan. Penerapan teori Levine pada kelima kasus dilaporkan menurut kemampuan adaptasi klien terhadap konservasi energi, konservasi integritas struktural, konservasi integritas personal dan konservasi integritas sosial. Kekuatan teori Levine pada kasus post partum paska perdarahan adalah pengkajian sudah terfokus pada setiap konservasi sedangkan kelemahan teori Levine tidak ada pengkajian psikologis ibu akibat keterpisahan ibu dan bayinya. Disamping itu dilaporkan kegiatan pencapaian kompetensi perawat spesialis maternitas sebagai pemberi asuhan, konselor, pendidik, advokat, kolaborator, peneliti dan change agent serta inovasi yang dilakukan di lahan praktek.

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This report is a summary report of the activities that have been done during clinical practice of maternity nurse specialist. The focus of interest in clinical practice have focused by application of Levine's theory in nursing care of the post partum hemorrhage cases. The theory of Levine's focused in adaptability through to the conservation of energy, structural integrity, personal integrity and social integrity. The strength of Levine's theory in the case is assessment have focused in each of conservation and the weakness is no assessment of maternal psychological separation the mother and her baby. Besides the activities reported achieving competence as a nurse specialist maternity, counselor, educator, advocate, collaborator, researcher and change agent and the innovation that have done in clinical practice."

"Laporan ini merupakan rangkuman laporan praktek keperawatan maternitas residen selama satu tahun. Residen menjalankan peran dan fungsi sebagai pemberi pelayanan keperawatan, konselor, advokad, edukator, koordinator, pengelola, kolaborator, dan peneliti dalam upaya meningkatkan kesehatan reproduksi perempuan selama melaksanakan praktek di rumah sakit dan komunitas. Diantara sekian banyak masalah kesehatan reproduksi perempuan, kanker serviks stadium lanjut merupakan fokus of interest residen dengan menerapkan teori keperawatan adaptasi Roy. Diagnosa kanker selalu menimbulkan krisis yang menuntut klien dan keluarga untuk selalu beradaptasi dengan perubahan status kesehatannya. Penerapan teori ini terbukti dapat memberikan asuhan keperawatan pada klien secara komprehensif. Selama menjalani praktek residen banyak mendapatkan dukungan dan beberapa hambatan yang menjadi wahana pembelajaran untuk pendewasaan diri residen.

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This report is a summary of residential practice report of maternity nursing specialist during one year. The resident performed the role and function as a maternity care provider, a counselor, an advocate, an educator, a coordinator, a manager, a collaborator, and a researcher to improve the women reproductive health during implementing nursing practice in the hospital and community. Among many female reproductive health problems, the late-stage cervical cancer was the resident's focus of interest with the application of Roy’s Adaptation Nursing Theory. A cancer diagnosis always causes a crisis demanding a client and the family to adapt to the changes of his/her health status. It is proved that the application of this theory could provide a comprehensive nursing care to a client. During the practice period the resident obtained much supports and some obstacles that educated the resident to be a mature person."