KONSEP KEPERAWATAN Akut, Kronik, Disabilitas

7/22/2019 KONSEP KEPERAWATAN Akut, Kronik, Disabilitas

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CONCEPT OF ACUTE,

CHRONIC ILLNESS ANDDISABILITY IN PEDIATRIC

Nursing Science ProgramHealth Science Fakulty

Respati UniversityJakarta

Sugeng Hadisaputra, M.Kep


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Acute

Acute illness, any illness

characterized by signs and

symptoms of rapid onset and shortduration. It may be severe and

impair normal functioning.

Sometimes, the health of a patient

in hospital may get worse suddenly(Mosby's Medical Dictionary, 8th

edition. 2009, Elsevier)


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Acute

Acute often also connotes an

illness that is of short duration,

rapidly progressive, and in need ofurgent care.

Acute is the medical term for an

illness or medical problem that

begins and progresses rapidly. Itmay also refer to an illness that

begins and ends quickly.


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Emergencies

A sudden unforeseen crisis

(usually involving danger) that

requires immediate action A life threatening condition.

An emergencyis a situation which

poses an immediate riskto health,

life, propertyor environment.Most

emergencies require urgent

intervention to prevent a worsening

of the situation
http://en.wikipedia.org/wiki/Healthhttp://en.wikipedia.org/wiki/Lifehttp://en.wikipedia.org/wiki/Propertyhttp://en.wikipedia.org/wiki/Natural_environmenthttp://en.wikipedia.org/wiki/Natural_environmenthttp://en.wikipedia.org/wiki/Propertyhttp://en.wikipedia.org/wiki/Lifehttp://en.wikipedia.org/wiki/Health


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Support system

friends and family members

wanting to support a patient or

family member dealing with anacute illness is to be available to

listen and to fully support a family

member

Information should be appropriatefor family anxiety


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Parentsfeeling relatively

disempowered when dealing with

acute illness

in their children. Their experiences of seeking

advicefrom professionals could

leave them feeling uncertain and

uninformed.

Communiction is very important.


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Nursing consideration

Nurse should have competencies

in monitoring, measurement,

interpretation and prompt responseto acutely ill patient, as they need.

Focus to primary prevention and

developmental care.


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CONCEPT OF CHRONIC:

A. DefinitionB. Features (Characteristics) ofchronic illness

C. Theories and ModelsD. Power Resources


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A. DefinitionRefers to an alteredhealth state that willnot be cured by asimple surgicalprocedure or shortcourse of medicaltherapy


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pain was originally defined

as pain that has lasted 6

months or longer. It is nowdefined as pain that persists

longer than the normal

course


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B. Features (Characteristics) ofChronic Illness

1. interfere many normal activitiesand routines2. medical regimen is limited in its

effectiveness3. treatment contributes

substantially to the disruption ofthe usual patterns of living


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1. Risk Factors

* Disease and disabilities

* Genetic Disorders* IUGR, Prematurity, LBW* Teratogens* Disease Severity

* Functional Independence* Psychosocial Stressors

C. Theories and Models


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2. Resistance Factors* Intrapersonal Factors(hope, self-confidence,values)

3. Social-ecological Factors* Family Functioning

* Financial Resources* Stress Processing


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D. Power Resources

1. Physical Strength(individuals ability foroptimal physical functioning

and to physical reserve/ theability of the body tomaintain physical balance

when confronted withthreats or extra demands)


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2. Psychological Stamina (uniqueresiliency present in humans): Social support (relationshipqualities of attachment, socialintegration, opportunity fornurturance, reassurance of worth,sense of reliable alliance, and

guidance from a trustworthy,caring person (Weiss, 74) andtangible support (instrumentalsupport such as help withactivities of daily living),

emotional support, andinformational support(Schaefer,Coyne & Lazarus,1981)


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3. Positive Self Concept: self-

concept is the individuals totalthoughts and feelings about

self (Rosenberg, 1979)

Components: physical self /body image; functional self/

role performance; personal

self/ moral self-self ideal; andself-expectancy (Driever,

1984); and self-esteem /self-

worth.


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4. Energy

(The capacity of a system fordoing work; energy potential is

stored energy; energy also

spent for growth through

learning, work, and play(Ryden, 1977)).

Energy resource include

nutrients, water, rest, andmotivation.


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5. Knowledge and Insight (Havingknowledge and insight aboutwhat is happening to them

enables clients to feel more incontrol and helps to alleviate theanxiety of uncertainty.Knowledge is one structure

provider that decreasesuncertainty (Mishel, 1988) andenables development of acognitive map for ongoing

interpretation of events,enabling persons to findmeaning in illness-relatedevents (Turk, 1979)


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6. Internal awareness(Kinsman et al, 1976)is a

concept for discussion inrelation to the power ofknowledge and insight. IA isthe ability to detect and

interpret physical andpsychological cues so as totake appropriate action tocontrol symptoms and

maintain psychologicalbalance (Miller, 1982)


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6. Motivation (based oncompetence and self-

determination (Deci, 1985).Competence theory refers to theindividuals ability to dealeffectively with the environment

by manipulating the environmentnot only to meet basic needs butalso to have a feeling of efficacy.

That intrinsically motivated (thoseseeking stimulation and thosereducing incongruity/dissonance)behaviors enable persons to feel

competent and self determining


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7. Belief System (encompasses

belief in God to provide strength

and ability to cope with stress

and overcome it; belief in

therapeutic regimens, with the

accompanying autosuggestionthat therapy will be effective;

belief in caregivers; and belief in

self, that is confidence in onesown capabilities.


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E. Analysis of Coping View coping as a stable personality-

based emotional and behavioral modeof responding; learning escape andavoidance of threatening stimuli (Roch& Cohen, 1986).

As cortical and subcortical stimulationby the hypothalamus resulting inactivation of the pituitary andadrenocortical system (Physiologicalperspective)

As context-specific behavioral andemotional processes in which anindividual appraises, encounters, andrecovers from contact with stressor,whether a monir daily hassle or a majorlife change (Lazarus andFolkman(1984))


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Deals with social environmentaldemands (Mechanics, 1974)

Problem solving: confronting therealities of the problem whilemaintaining integrity offunctioning (Brunner, 1966)

Is the constantly changingcognitive and behavioral effortsused to manage specific externaland/ or internal demands that

are appraised as taxing and thatexceed the resources of theperson (Lazarus and Folkman,1984)


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F. Contingency Model of LongTerm Care

Assumptions:

People behave according to thefacts as they perceive them, not as

the facts are perceived by others All systems have both unique and

common responses and

characteristics All family members should have the

opportunity to be active participantsin health care


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The needs of people with chronic

conditions, and their families, arecomplex and require a team

approach

The patient and family are integralparts of the health care team

It is possible to influence a persons

internal motivation


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Components:

Systems (a complex of elements or

components that interact with eachother in amore or less stable waywithin any particular period oftime)Buckley, 1967; VonBertalanffy, 1968).

Contingency variables (mediatorsinfluencing the impact a chroniccondition has on system

functioning; they affect or may beaffected by it. These variables arethe systems orientation to life,stressors, coping strategies,strengths, and needs)


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Level of functioning (refers to

the systems currentperformance and is determined

by the extend to which it is

accomplishing its developmental

and situational tasks

Nursing Care (refers to

deliberate activities of a nurse to

help the individual and family

systems meet their needs)


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G. Quality of Life

Palliative care Palliative care is any form of medical

care or treatment that concentrates onreducing the severity of the symptoms

of a disease or slows its progressrather than providing a cure.

It aims at improving quality of life, byreducing or eliminating pain and other

physical symptoms, enabling thepatient to ease or resolvepsychological and spiritual problems,and supporting the partner and family..


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Early palliative care can reduce the

length of stay for seriously ill

patients in the medical intensivecare unit by more than seven days

without having an impact on

mortality rates, Patients with terminal illnesses

reach a time when they are faced

with a very difficult choice---whether to take part in

experimental research or enter a

hospice program.


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CONCEPT OF DISABILITY with respect to an individual(A) a

physical or mental impairment thatsubstantially limits one or more ofthe major life activities of suchindividual;

handicap as a disadvantage for agiven individual, resulting from animpairment or a disability, that limitsor prevents the fulfillment of a role

that...


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The Social Security Act defines

disability as the "inability to engagein any substantial gainful activity byreason of a medically determinablephysical

as any restriction or lack (resultingfrom an impairment) of ability toperform an activity in the manner orwithin the range considered normal

for a human...
http://books.google.com/books?id=IXgINd5tJnUC&qtid=dc7e78da&dq=disability+concept&source=gbs_quotes_s&cad=2http://books.google.com/books?id=IXgINd5tJnUC&qtid=7a7e7991&dq=disability+concept&source=gbs_quotes_s&cad=2http://books.google.com/books?id=IXgINd5tJnUC&qtid=dc7e78da&dq=disability+concept&source=gbs_quotes_s&cad=2


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(ADA) defines disability as a

physical or mental

impairment that substantially

limits one or more of the

major life activities of the

individual
http://books.google.com/books?id=IXgINd5tJnUC&qtid=5e7e78f4&dq=disability+concept&source=gbs_quotes_s&cad=2http://books.google.com/books?id=IXgINd5tJnUC&qtid=5e7e78f4&dq=disability+concept&source=gbs_quotes_s&cad=2


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Impairment is defined as any loss or

abnormality of psychological,

physiological, or anatomical structure

or function; disability as any

restriction or...

economy by reason of any medicallydeterminable physical or mental

impairment that can be expected to

result in death or that has lasted or is

expected...
http://books.google.com/books?id=IXgINd5tJnUC&qtid=7a7e7991&dq=disability+concept&source=gbs_quotes_s&cad=2http://books.google.com/books?id=IXgINd5tJnUC&qtid=9a7e78eb&dq=disability+concept&source=gbs_quotes_s&cad=2


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Rehabilitation

As needed

Apropriate

Health education Information

Team work


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TERIMA

KASIHSugeng Hadisaputra, M.Kep

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KONSEP KEPERAWATAN Akut, Kronik, Disabilitas