STUDI FENOMENOLOGI CARING PERAWAT DALAM KONTEKS PELAYANAN KEPERAWATAN KESEHATAN JIWA PADA PASIEN SKIZOFRENIA DI RUMAH SAKIT ERNALDI BAHAR PALEMBANG

IRA KUSUMAWATY, Prof. dr. Ova Emilia, SpOG(K), MMed.Ed, PhD.; Dr. Fitri Haryanti, SKp., MKes.

2018 | Disertasi | DOKTOR ILMU KEDOKTERAN DAN KESEHATAN

Latar Belakang: Caring sebagai the heart of nursing merupakan komitmen moral perawat untuk sepenuh hati merawat pasien. Gangguan proses pikir, afek dan psikomotor pasien skizofrenia menjadi tantangan berat perawat untuk tetap berperilaku caring. Budaya dapat berkontribusi terhadap perilaku caring perawat. Budaya Palembang telah mengatur cara berinteraksi, saling menghormati, ikhlas, menghargai, dikenal sebagai budaya serah ungkulan, disamping budaya berkomunikasi dengan intonasi suara tinggi dan volume suara keras. Tujuan: Penelitian ini bertujuan untuk mengeksplorasi pengalaman caring perawat terhadap pasien skizofrenia dalam konteks budaya Palembang. Studi ini dapat berkontribusi pada pengetahuan dan praktik caring perawat terhadap pasien skizofrenia dengan melestarikan nilai luhur budaya Palembang. Metoda: Penelitian ini menggunakan pendekatan fenomenologi hermeneutik Max van Manen untuk mengungkapkan pengalaman caring perawat pada pasien skizofrenia. Wawancara mendalam dan observasi partisipasi dilaksanakan selama 6 bulan, dilakukan terhadap 13 perawat di lima ruang rawat inap berdasarkan teknik purposive sampling jenis maximum variation sampling. Triangulasi sumber dilakukan dengan mewawancarai 5 keluarga pasien. Analisis konten diawali penyusunan transkrip, membuat koding, kategori dan terakhir merumuskan tema. Hasil: Dirumuskan 10 tema yang dikelompokkan menjadi tiga tema yang mencerminkan lived body yaitu kesungguhan dan komitmen merawat pasien gangguan jiwa, menghadapi kekerasan dan kebiasaan pasien saat kambuh yang menguras emosi perawat, dan kepedulian merawat sepenuh hati. Empat tema mencerminkan lived relations yaitu mengetahui manfaat caring bagi pasien dan sejawat, mengakomodir pemenuhan kebutuhan holistik pasien, membangun hubungan saling percaya serta memberi dukungan, motivasi, edukasi dan aktivitas bagi pasien dan keluarga. Tema menjalin kolaborasi bersama tim kesehatan lain dan tim pendukung mencerminkan lived space. Tema waktu pelayanan terhadap pasien mempengaruhi kondisi psikologis perawat merupakan tema lived time dan lived things dicerminkan oleh tema kebijakan yang berbasis layanan kepedulian bagi pasien. Kesimpulan: diperlukan upaya perawat menyelami kondisi pasien agar mampu merawat pasien sepenuh hati walau emosi perawat terkuras akibat menjadi korban kekerasan pasien. Caring dimaknai sebagai ruh perawat, empati, kepedulian, kesabaran, tanggung jawab, ketelatenan dan merawat sepenuh hati. Saran: manajer keperawatan diharapkan agar dapat mengoptimalkan kapasitas perilaku caring perawat melalui pendekatan individual dan organisasional dengan memperhatikan budaya setempat.

Background: Caring as the heart of nursing is a moral commitment of nurses to wholeheartedly care for patients. Disturbance of thought processes, affects and psychomotor of schizophrenic patients becomes a nurses heavy challenge to keep behaving caring. Culture can contribute to caring behavior of nurses. Palembang culture has set the way of interaction, mutual respect, sincerity, appreciation, known as the culture of serah ungkulan, on the other hand, the culture of communicating with the intonation of high voice and loud volume. Objective: This study aims to explore the caring experience of nurses on schizophrenic patients in the context of Palembang culture. This study can contribute to the knowledge and practice of caring nurses on schizophrenic patients by preserving the noble values of Palembang culture. Method: This study used Max van Manens hermeneutic phenomenology approach to reveal the caring experience of nurses in schizophrenic patients. In-depth interviews and participant observation were conducted for 6 months, conducted on 13 nurses in five inpatient rooms based on purposive sampling technique of maximum variation sampling type. Triangulation of resources was conducted by interviewing 5 families of patients. Content analysis begins with the preparation of transcripts, coding, category and the last is formulating the theme. Result: Formulated 10 themes are grouped into three themes that reflect the living body is the seriousness and commitment to care for patients mental disorders, facing violence and habits of patients when relapse that drain the emotions of nurses, and caring care wholeheartedly. Four themes reflect the living relations of knowing caring benefits for patients and colleagues, accommodating the holistic needs of patients, building trust relationships and providing support, motivation, education and activities for patients and families. Themes collaborate with other health teams and support teams reflect the lived space. The theme of service time to the patient affects the psychological condition of the nurse is the theme of lived time and lived things reflected by the policy-based theme of care for the patient. Conclusion: It is necessary for the nurse to explore the condition of the patient in order to be able to care for the patient wholeheartedly even though the emotion of the nurse is depleted as a victim of patient violence. Caring is interpreted as the spirit of nurse, empathy, caring, patience, responsibility, diligence and caring wholeheartedly. Recommendation: Nursing managers are expected to optimize the nurses caring behavior capacity through individual and organizational approaches taking into account the local culture.

Kata Kunci : caring, perawat jiwa, skizofrenia, budaya Palembang, caring, mental health, nursing, schizophrenia, Palembang culture