Penerapan Standar Asuhan Keperawatan Jiwa Ners untuk Menurunkan Intensitas Waham Pasien Skizofrenia

Fallon Victoryna(1*), Ice Yulia Wardani(2), Fauziah Fauziah(3)


(1) Fakultas Ilmu Keperawatan Universitas Indonesia
(2) Fakultas Ilmu Keperawatan Unversitas Indonesia
(3) Rumah Sakit Dr. Marzoeki Mahdi Bogor
(*) Corresponding Author

Abstract


Skizofrenia merupakan gangguan jiwa yang kompleks. Gejala yang paling sering ditemui adalah waham. Waham dialami oleh 60% penderita skizofrenia dengan intensitas yang lebih berat dibandingkan dengan gangguan jiwa yang lain. Pasien waham memiliki kecenderungan untuk memunculkan reaksi agresif karena adanya upaya konfrontasi dari lingkungan terkait pemikiran dan keyakinannya yang tidak realistis. Kecenderungan tersebut merupakan efek dari besarnya intensitas waham yang dialami pasien. Salah satu cara untuk mengontrol perilaku agresif tersebut adalah melalui latihan deeskalasi. Penanganan yang komprehensif perlu diberikan berdasarkan standar asuhan keperawatan (SAK) jiwa dan pemberian latihan deeskalasi secara adekuat pada pasien dengan gangguan proses pikir waham. Penulisan karya ilmiah akhir ners ini bertujuan untuk menggambarkan penerapan asuhan keperawatan jiwa ners dan latihan deeskalasi terhadap agresifitas pasien untuk menurunkan intensitas waham. Metode yang dilakukan adalah berupa analisis kasus pada pasien yang dirawat di RS Dr. H. Marzoeki Mahdi Bogor, dengan diagnosis keperawatan gangguan proses pikir waham kebesaran. Hasil dari pemberian intervensi selama 8 hari adalah pasien mengalami penurunan intensitas waham dari skor 16 dengan kategori berat menjadi skor 11 dengan kategori sedang. Kesimpulannya terdapat penurunan intensitas waham dengan menerapkan standar asuhan keperawatan jiwa ners dan latihan deeskalasi terhadap agresifitas pada pasien skizofrenia.

 

Kata kunci: deeskalasi, skizofrenia, standar asuhan keperawatan, waham

 

APPLICATION OFPSYCHIATRIC NURSING CARE STANDARDS TO REDUCE THE INTENSITY OF DELUTION SCHIZOPHRENIA

 

ABSTRACT

Schizophrenia is a complex mental disorder. The most common symptom is delusions. Estimated 60% of schizophrenics have more severe intensity compared to other mental disorders with the same diagnose. Patients with delusions tend to elicit aggressive reactions because of attempts at confrontation from the environment related to unrealistic thoughts and beliefs. The tendency is the effect of the amount of delusions experienced by patients. One way to control aggressive behavior is through de-escalation exercises. Comprehensive treatment needs to be given based on psychiatric nursing care standards and the provision of adequate de-escalation exercises to patients with delusional thought processes. The writing of this final scientific work aims to illustrate the application of nursing care and de-escalation exercises to the aggressiveness of patients to reduce the intensity of delusions. The method used is a case analysis in patients treated at Dr. H. Marzoeki Mahdi Bogor, with a nursing diagnosis of oversized thought processes. The result of giving generalist therapy for 8 days is that the patient experienced a decrease in delusions intensity from a score of 16 with a severe category to a score of 11 with a moderate category. In conclusion, there is a decrease in the intensity of delusions by applying psychiatric nursing care standards and de-escalation training on aggressiveness in schizophrenic patients.

 

Keywords: de-escalation, delution, psychiatricnursing care, schizophrenia


Keywords


De-escalation, Dilution, Psychiatric Nursing Care, Schizophrenia;deeskalasi;skizofrenia; standar asuhan keperawatan;waham

Full Text:

PDF

References


Cheung, P., Schweitzer, I., Crowley, K., & Tuckwell, V. (1997). Violence in schizophrenia : role of hallucinations and delusions, 26, 181–190.

Du, M., Wang, X., Yin, S., Shu, W., Hao, R., Zhao, S., Xia, J. (2017). De-escalation techniques for psychosis-induced aggression or agitation. Cochrane Database ofSystematic Reviews 2017. China: Published by John Wiley & Sons, Ltd. 2. https://doi.org/10.1002/14651858.CD009922.pub2.www.cochranelibrary.com

Dudley, R. E. J., & John, C. H. (1997). The effect of self-referent material on the reasoning of people with delusions, 575–584.

Erawati, E. (2013). pengaruh terapi metakognitif terhadap intensitas waham dan kemampuan metakognitif pada klien skizofrenia di rsj prof. dr. soeroyo magelang. universitas indonesia.

Elvira, S. D., Hadisukanto, G. (2017). Buku Ajar Psikiatri (Vol. Edisi ketiga). Jakarta: Badan Penerbit Fakultas Kedokteran Universitas Indonesia

Erawati, E., Keliat, B. A., & Daulima, N. H. C. (2014). The validation of the Indonesian version of psychotic symptoms ratings scale ( PSYRATS ), the Indonesian version of cognitive bias questionnaire for psychosis ( CBQP ) and metacognitive ability questionnaire ( MAQ ), 3(2), 97–100.https://doi.org/10.14419/ijans.v3i2.3132

Fikri, H. T. (2012). Pengaruh menulis pengalaman emosional dalam terapi ekspresif terhadap emosi marah pada remaja. Humanitas, IX(2), 103–121. Retrieved from https://media.neliti.com/media/publications/24580-ID-pengaruh-menulis-pengalaman-emosional-dalam-terapi-ekspresif-terhadap-emosi-mara.pdf

Hallett, N., & Dickens, L. (2017). De-escalation of aggressive behaviour in healthcare settings : Concept analysis. International Journal of Nursing Studies, 75(June), 10–20.https://doi.org/10.1016/j.ijnurstu.2017.07.003

Harrow., Mac, Donald., Angus., et al. (1995). Vulnarability to delution over time in schizophrenia and affective disorder. Schizophrenia Bulletin, 95-109.

Herdman, T. H., Kamitsuru, S. (2018). NANDA-I Diagnosisi Keperawatan Definisi dan Klasifikasi 2018-2020. Jakarta: Penerbit Buku Kedokteran EGC.

Indrono, W., Caturini, E. (2012). IMPLEMENTASI TEKNIK DE-ESKALASI TERHADAP PENURUNAN RESPON MARAH KLIEN DENGAN PERILAKU KEKERASAN Wahyu Indrono 1 , Endang Caturini 2. Jurnal Terpadu Ilmu Kesehatan, 2, 77–83.

Keliat, B. A., Hamid, A. Y. S., Putri, Y. S. E., Daulima, N. H. C., dkk. (2019). Asuhan Keperawatan Jiwa. Jakarta: Penerbit Buku Kedokteran EGC.

Kemkes RI. (2019, Maret 01). Perlu Kepedulian untuk Kendalikan Masalah Kesehatan Jiwa. Retrieved from Kementerian Kesehatan Republik Indonesia:https://www.depkes.go.id/article/view/19030400005/perlu-kepedulian-untuk-kendalikan-masalah-kesehatan-jiwa.html

Mohamed, S., Rosenheck, R., Mcevoy, J., Swartz, M., Stroup, S., & Lieberman, J. A. (2009). Cross-sectional and Longitudinal Relationships Between Insight and Attitudes Toward Medication and Clinical Outcomes in Chronic Schizophrenia, 35(2), 336–346. https://doi.org/10.1093/schbul/sbn067

Patton, D. (2006). Reality orientation : its use and effectiveness within older person mental health care. Journal of Clinical Nursing, 15, 1440–1449. https://doi.org/10.1111/j.1365 2702.2005.01450.x

Price, O., Baker, J., Bee, P., & Lovell, K. (2015). Learning and performance outcomes of mental health staff training in de-escalation techniques for the management of violence and aggression. The British Journal of Psychiatry, 447–455.https://doi.org/10.1192/bjp.bp.114.144576

Ritchie, H., Roser, M. (2019). Mental Health. Retrieved from Published online at OurWorldInData.org: https://ourworldindata.org/mental-health'

Riskesdas. (2018). HASIL UTAMA RISKESDAS 2018. Jakarta.

Shives, L. R. (2012). Basic Concepts of Psychiatric-Mental Heatlth Nursing (Eighth Edi). Philadelphia,: Lippincott Williams & Wilkins. Copyright.

Stuart, G. W. (2013). Principles and Pratice of Psychiatric Nursing (10th Ed). St. Louis, Missouri: Elsevier Mosby Inc.

Townsend, M. C. (2015). Psychiatric Mental Health Nursing Concepts of Care in Evidence-Based Practice (Sixth Edit). Philadelphia: F.A Davis Company.

Videbeck, S. L. (2011). Psychiatric-Mental Health Nursing (Fifth Edit). Wolters Kluwer Health | Lippincott Williams & Wilkins.

Warman, D. M., Lysaker, P. H., Luedtke, B., & Martin, J. M. (2010). Self-Esteem and Delusion Proneness. The Journal of Nervous and Mental Disease, 198(6), 455457.https://doi.org/10.1097/NMD.0b013e3181e086c5

Weinberger, D. R & Harrison, P. J. (2011). Schizophrenia (Third Edit). USA: Blackwell Publishing Ltd.

Yusuf, Ah., Fitryasari, R., Nihayati, H. E. (2015). Buku Ajar Keperawatan Kesehatan Jiwa. Jakarta: Penerbit Salemba Medika.


Article Metrics

Abstract view : 10407 times
PDF - 2284 times

DOI: https://doi.org/10.26714/jkj.8.1.2020.45-52

Refbacks

  • There are currently no refbacks.




View My Stats

PPNI Univ. Muhammadiyah Semarang

Jl. Kedungmundu Raya No. 18 Semarang Gedung NRC University of Muhammadiyah Semarang

Phone: 02476740287
Fax: 02476740287
Email: [email protected]

 

This work is licensed under a Creative Commons Attribution 4.0 International License.