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"[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.]"

"ABSTRAKMalnutrisi, kaheksia, dan obesitas/overweight merupakan masalah nutrisi yang sering ditemui pada anak kanker akibat dari proses penyakit dan efek kemoterapi. Karya Ilmiah Akhir ini bertujuan memberikan gambaran praktek ners spesialis dalam mengaplikasikan model adaptasi Roy pada asuhan keperawatan anak kanker yang mengalami masalah nutrisi. Praktek ners spesialis dilakukan untuk mencapai kompetensi sesuai peran perawat. Aplikasi model adaptasi Roy tertuang dalam lima kasus terpilih dengan masalah yang ditemukan adalah ketidakseimbangan nutrisi kurang dari kebutuhan tubuh, risiko nutrisi kurang dari kebutuhan tubuh dan obesitas. Pendidikan kesehatan berbasis pembuktian ilmiah digunakan sebagai salah satu intervensi keperawatan untuk meningkatkan adaptasi anak sehingga dapat bertoleransi terhadap pemenuhan kebutuhan nutrisi. Evaluasi keperawatan lima kasus tersebut adalah satu kasus beradaptasi secara integrasi, empat kasus beradaptasi secara kompensasi. Karya ilmiah ini merekomendasikan teori model adaptasi Roy dapat diaplikasikan pada asuhan keperawatan anak kanker dengan masalah nutrisi.

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ABSTRACTMalnutrition, cachexia, and obesity/overweight, is a common nutritional problem in children who have cancer as a result of the disease process and the effects of chemotherapy. The aim of this final assignment was to provide an overview of the practice specialist nurses by applying the Roy adaptation model in nursing care of children who have cancer with nutritional problems. Practice spesialis nurses to achieve competency according the role of nurses. Roy adaptation model was applied in five selected cases and the nursing problem found was imbalance nutrition less than the body needs, risk imbalance nutrition less than the body needs and obesity. Health education is evidence based practice be used as a nursing intervention to improve the adaptation level of the child so that it can tolerate the fulfillment of nutrition needs. Nursing evaluation in five selected cases was one case integrated adaptation level and four cases compensatory adaptation level. This paper recommend Roy adaptation model theory can be applied to nursing care in children who have cancer with nutrition problems.;"

"ABSTRAKPenyakit non infeksi merupakan penyakit yang tidak bisa ditularkan dari satu orang ke orang yang lain.. Penyakit ini membutuhkan perawatan lama yang berdampak pada keterbatasan aktivitas anak. Aktivitas dan istirahat adalah suatu kebutuhan yang terintegrasi, keduanya mempunyai pengaruh satu sama lain. Penulisan karya ilmiah ini bertujuan untuk memberikan gambaran penerapan model self-care Orem dalam asuhan keperawatan pada anak dengan masalah aktivitas dan istirahat serta pencapaian kompetensi selama praktik residensi. Intervensi keperawatan didasarkan pada tujuan untuk meningkatkan kemandirian perawatan diri pasien. Intervensi dilakukan dengan penerapan sleep hygiene. Hasil dari penerapan teori self-care Orem menunjukkan bahwa teori self-care Orem dapat dijadikan sebagai acuan dalam pemberian asuhan keperawatan pada anak dengan penyakit kronis.

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ABSTRACTNon Communicable disease is defined as a type of disease which is not transmitted by a person to another individual. These require long term nursing treatments which potentially affect to limitation of children?s activities. Both activity and rest are highly integrated, and these have mutual influences. In a case of the children?s activity is predisposed, the rest requirement will be also affected. This scientific writing aims to describe the implementation of Dorothea Orem?s Self-Care Theory in nursing care plan, particularly amongst children with problems of activity and sleep deprivation. This paper is also required to obtain competencies of paediatric nursing. The nursing intervention is referred to the main objective in order to develop the independence of self-care patient. The intervention is also implemented by using sleep hygiene theory. Results could be a reference to provide nursing care for children with chronic diseases.;"

"ABSTRAKNyeri merupakan masalah yang sering dihadapi anak dengan kanker. Penatalaksanaan nyeri saat ini belum optimal sehingga meningkatkan morbiditas pada pasien kanker khususnya pada anak. Karya ilmiah ini disusun dengan tujuan untuk menggambarkan aplikasi Theory of Unpleasant Symptoms (TOUS) pada anak yang mengalami nyeri kanker dan optimalisasi peran perawat dalam memberikan edukasi manajemen nyeri pada anak dan keluarga. TOUS memiliki tiga komponen yaitu gejala, faktor yang mempengaruhi dan penampilan akhir klien. Ketiga komponen tersebut saling berhubungan serta dapat diintegrasikan dalam asuhan keperawatan anak. Aplikasi TOUS dan optimalisasi edukasi manajemen nyeri yang diberikan pada lima klien kelolaan efektif dalam meningkatkan kualitas hidup klien. Aplikasi TOUS pada asuhan keperawatan anak harus memperhatikan aspek tumbuh kembang dan psikologis anak.

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ABSTRACT

Pain is a common symptom experienced by children with cancer. Currently pain management is not optimized thereby increasing morbidity in patients with cancer, particularly in children. The purpose of this final scientific writing is to give an overview of applications Theory of Unpleasant Symptoms (TOUS) in nursing care for cancer children with pain, this paper also described optimize the role of nurses in providing education management of pain in children and families. TOUS has three components: symptoms, and the factors that affect the final appearance of the client. The three components are interrelated and can be integrated in nursing care for children. Application of TOUS and optimizing pain management which was given for five patient show that was increasing quality of life in patient. Application TOUS on nursing care of children should pay attention to the psychological aspect of growth and development."

"ABSTRAKPraktik Spesialis Keperawatan Anak bertujuan untuk melakukan praktik dengan mengaplikasikan peran perawat melalui pendekatan Model Adaptasi Roy. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5 orang klien anak dengan masalah perkemihan yang mengalami ketidakseimbangan cairan, dimana satu orang klien sebagai kelolaan utama yaitu klien sindroma nefrotik relaps dan hipoalbuminemia yang mengalami edema anasarka. Peran sebagai inovator melalui penyusunan program pemberian edukasi manajemen cairan pada keluarga dan perawat yang bertujuan untuk mengurangi kelebihan volume cairan tubuh, mengurangi udema, meningkatkan diuresis, meningkatkan kenyamanan klien anak dengan masalah perkemihan, dan meningkatkan kualitas asuhan keperawatan dengan menerapkan tindakan keperawatan yang berbasis pembuktian ilmiah (evidence based nursing). Hasil praktik ini menunjukkan bahwa Model Adaptasi Roy efektif digunakan pada klien anak dengan masalah perkemihan yang mengalami ketidakseimbangan cairan, dan edukasi efektif untuk mengurangi risiko masalah yang dapat timbul akibat kelebihan volume cairan tubuh.

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ABSTRACTPractice of Pediatric Nursing Specialist aims to practice the application of the role of nurses through the Roy Adaptation Model approach. Role as nurse provider applied to 5 children clients with urinary problems that undergo fluid imbalance, and one major client is a client of relapse nephritic syndrome and hypoalbuminemia who experienced edema within whole body. Role as an innovator by designing fluid management program of education providing for families and nurses which aims to reduce excess body fluid volume, reduce edema, increase diuresis, improve the comfort of children client with urinary problems, and improve the quality of nursing care by implementing nursing actions based on scientific evidence (evidence based nursing). Roy Adaptation Model is proving that education to families and nurses is one of fluid management techniques in children with urinary problems. The result of this practice indicates that this model is effective to be used on the children client with urinary problems with imbalance of fluid and effective education to reduce the risk of problems due to excess body fluid volume.;"

"ABSTRAKKarya Ilmiah akhir ini dilatar belakangi oleh adanya penurunan sistem imunitaspada anak kanker. Peran sebagai pemberi asuhan keperawatan diterapkan pada 5orang pasien anak kanker yang mengalami masalah penurunan sistem imunitas.Karya ilmiah akhir ini bertujuan mendeskripsikan penerapan model Adaptasi Roydalam asuhan keperawatan pada anak kanker yang mengalami penurunan sistemimunitas. Peran residen sebagai peneliti yaitu dengan membuktikan edukasiterapeutik sebagai salah satu teknik edukasi dalam pencegahan infeksi padapasien dengan penurunan sistem imunitas. Hasil praktik ini menunjukkan edukasiterapeutik mampu meningkatkan tingkat kepatuhan keluarga dalam pencegahaninfeksi. Dalam melakukan asuhan keperawatan, diharapkan mampu melakukanedukasi terapeutik dalam melakukan tindakan pencegahan perluasan infeksi.

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ABSTRACTThe background of scientific by decline the immunity system for children withcancer. Role as nursing care applied 5 patients with cancer children whosedecline the immune system. This final scientific thesis to describe the experiencethe cult residency application Roy Adaptation models in nursing care in childrenwith cancer whose decline immune system. The role of residence as researchersto prove Therapeutic Education as one of education method in prevention ofinfection in patients with immune system deficiencies. The result of practiceshows that therapeutic education can improve level of compliance family toprevention infection. In doing nursing care, should be able therapeutic educationtake precautions extension of infection.;"

"Latar Belakang: Retinoblastoma adalah keganasan intraokular paling sering dan juga salah satu tumor padat tersering pada anak-anak. Di negara berkembang dimana terdapat perawatan dan deteksi dini yang baik, prognosis umumnya baik dengan tingkat kesintasan tinggi. Sayangnya, di negara berkembang termasuk Indonesia diagnosis umumnya tertunda dan kesintasan masih rendah. Hitung darah lengkap merupakan uji yang secara relative mudah dan murah serta dikatakan dapat memberikan informasi prognostik yang bernilai dan membantu menilai kesintasan pada berbagai jenis kanker. Namun, studi mengenai hal tersebut masih sangat sedikit pada kasus retinoblastoma. Tujuan: Penelitian ini bertujuan untuk mengidentifikasi hubungan antara profil darah tepi pada presentasi awal dan kesintasan pada retinoblastoma. Metode: Penelitian ini menggunakan desain potong lintang retrospektif dengan cara mengumpulkan rekam medis pasien retinoblastoma yang didiagnosis sejak Januari 2011 sampai Desember 2013 di Rumah Sakit Ibu dan Anak Cipto Mangunkusumo 'Kiara'. Demografi dan profil klinis pasien dikumpulkan dan keluaran dikategorikan menjadi event mati dan censored tidak mati . Analisis kesintasan dilakukan menggunakan metode Kaplan Meier dengan SPSS. Hasil: Analsis survival dengan metode Kaplan-Meier dan log-rank test menunjukkan tidak ada perbedaan signifikan antar kesintasan pasien, baik berdasarkan status hemoglobin p=0,219 , status leukosit p=0,903 , dan status trombosit p=0,649 sebelum menerima terapi sistemik. Namun demikian, terlihat ada trend kesintasan.

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Background: Retinoblastoma is the most common intraocular malignancy and is also one of the most common solid tumors in children. In developed countries where treatment is good and early detection is available, the prognosis and survival is good. Unfortunately, in developing countries including Indonesia diagnosis is still often delayed and survival is still low. Complete blood count as a relatively accessible and affordable test has been studied to provide valuable prognostic information and help in assessing the survival in various types of cancers. However, such studies is still very limited in retinoblastoma cases.

Objectives: This study aims to identify the relation between peripheral blood profile on first presentation and survival in retinoblastoma.

Methods: This study uses retrospective cross sectional study design by collecting medical records of retinoblastoma patients diagnosed from January 2011 to December 2013 in Cipto Mangunkusumo Children and Maternal Hospital 'Kiara'. The demography and clinical profile of patients is collected and outcome is categorized into event dead and censored not dead. Survival analysis is done using Kaplan Meier with SPSS.

Results: Survival analysis using Kaplan Meier method and log rank test shows no significant difference in survival between patients, either according to hemoglobin status p 0,219 , leukocyte status p 0,903 , and thrombocyte status p 0,649 before receiving systemic therapy. Nevertheless, there seem to be a trend of lower mean survival in group with abnormal Hb and leukocyte, although such relation is not seen in thrombocyte.Conclusion Although there is no significant relation, there seem to be a trend in which patients with worse peripheral blood profile has worse survival."

"Kanker merupakan penyakit degeneratif yang dapat diderita oleh orang dewasa dan anak-anak dengan angka kejadian cukup tinggi di dunia. Sebanyak 50 anak dengan kanker mengalami gangguan dalam melaksanakan aktivitas perawatan diri sebagai akibat dari kanker tersebut maupun efek samping dari terapi kanker. Tujuan dari pembuatan karya ilmiah akhir ini adalah untuk memberikan gambaran mengenai aplikasi teori self-care Orem pada klien anak dengan kanker yang mengalami defisit perawatan diri: perawatan mulut di RSUPN Dr Cipto Mangunkusumo Jakarta. Selain itu, karya ilmiah akhir ini juga bertujuan untuk memberikan gambaran mengenai peran perawat spesialis anak di ruang rawat anak non infeksi. Terdapat lima kasus kelolaan yang dibahas dalam karya ilmiah ini yang semuanya memiliki masalah defisit perawatan diri: perawatan mulut. Asuhan keperawatan diberikan menggunakan pendekatan teori self-care Orem mulai dari pengkajian sampai dengan evaluasi. Hasil evaluasi menunjukkan ada klien yang dapat lebih mandiri dalam melakukan higiene oral namun ada pula yang tidak berhasil. Penulis merekomendasikan untuk memperhatikan usia dan tahap tumbuh kembang klien yang akan diberikan intervensi dengan aplikasi teori self-care karena hal tersebut berpengaruh terhadap keberhasilan intervensi.

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Cancer is a degenerative illness suffered by adults and children with high incidence in the world. Around 50 children with cancer are having difficulties in performing daily activities as a result of cancer itself or side effect of cancer therapy. This final report is a description of Internship Pediatric Nursing Program clinical practice. The aim of this final report is to give a brief description about the application of Orem rsquo s self care theory on children with cancer performing self care deficit oral hygiene thus giving description about the role of pediatric nurse in non infection children ward. There are five cases of children who are performing self care deficit oral hygiene explained here. Nursing care was performed using self care theory approach from assessment to evaluation. The result is that there are children who finally able to do oral hygiene independently, but there are also children who can not do oral hygiene independently. The recommendation of this report is that the children must be selected based on their age and developmental stage because those two factors contribute to the success of intervention."

"Anak dengan penyakit kronik sering mengalami gangguan rasa nyaman akibat perjalanan penyakit, pemeriksaan diagnostik dan proses pengobatan, sehingga membutuhkan asuhan keperawatan yang tepat. Karya Ilmiah Akhir ini disusun dengan tujuan untuk menggambarkan aplikasi Theory of Unpleasant Symptoms (TOUS) pada anak dengan penyakit kronik yang mengalami gangguan rasa nyaman serta menganalisis keefektifannya. TOUS memiliki tiga komponen yaitu gejala, faktor yang mempengaruhi dan performance akhir klien. Ketiganya dapat saling mempengaruhi dan dapat diintegrasikan dalam asuhan keperawatan anak. TOUS dapat diaplikasikan pada asuhan keperawatan anak penyakit kronik dengan gangguan rasa nyaman karena melalui manajemen gejala berbasis TOUS, kebutuhan rasa nyaman anak akan terpenuhi meski gejala tak menyenangkan masih muncul. Aplikasi TOUS pada asuhan keperawatan anak hendaknya memperhatikan aspek tumbuh kembang dan aspek psikologis anak. Saat mengaplikasikan konsep TOUS, Ners spesialis telah dapat melakukan berbagai peran diantaranya sebagai praktisi, edukator, kolaborator, peneliti serta advokat bagi klien dan keluarga.

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Chronically ill children often experience uncomfortable issue due to the disease pathophysiology, the diagnostic examination and medication process, so the child needs proper nursing care. This Scientific Final Assignment was arranged to describe the application of Theory of Unpleasant Symptoms (TOUS) to chronically ill children who have uncomfortable issues and also to analyze its effectiveness. TOUS has three main components which are symptoms, influencing factors and performance outcomes. Those three components influence each other and can be integrated in pediatric nursing process. TOUS can be applied in chronically ill children nursing process especially child with uncomfortable issue because through symptoms management based on TOUS, the comfort need of children can be fulfilled even the unpleasant symptoms still occur. The application of TOUS should pay attention to growth and development aspects of the children and also to the psychological aspect. When the specialist pediatric nurse applied TOUS concept, the nurse has done many role such as nurse practitioner, educator, collaborator, researcher and advocate for client and the family. "

"ABSTRAK Kanker merupakan penyakit dengan insiden kematian yang besar yang menyebabkan permasalahan yang kompleks pada anak. Tujuan dari studi kasus ini adalah melakukan analisis optimalisasi perawatan paliatif melalui Pediatric Palliative Screening Scale Skala PaPaS pada anak kanker dengan pendekatan Teori Peaceful End of Life PEOL . Lima kasus terpilih menunjukkan adanya masalah biologis, psikologis dan spiritual. Pendekatan Teori PEOL mampu mengatasi masalah keperawatan dengan standar domain bebas nyeri, rasa nyaman, dihargai dan dihormati, kedamaian serta kedekatan dengan orang yang bermakna. Hasil skrining kebutuhan perawatan paliatif pada anak kanker menggunakan Skala PaPaS didapatkan mayoritas kebutuhan paliatif level tinggi. Penerapan Teori PEOL bersamaan dengan skala PaPaS direkomendasikan sebagai pendekatan untuk mencapai asuhan keperawatan paliatif yang optimal.

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ABSTRACTCancer is a disease with large number of death incidence that causes complicated problems in children. The purpose of this study analyze palliative care optimalization use Pediatric Palliative Screening Scale PaPaS Scale in cancer children with the Peaceful End of Life Theory approach. Five cases were chosen to show a biological, psychological and spiritual problem. The Peaceful End of Life Theory PEOL is able to overcome nursing problems by domain standard of painless, comfortable, respect and dignity, peaceful and closeness with meaningful people. The results of screening found high level of majority palliative needs. The application of PEOL Theory along with PaPaS Scale is recommended as an approach to achieve optimal palliative nursing care."