EKSPLORASI TENTANG PERAWATAN BERPUSAT PADA KELUARGA DI RUANG PERAWATAN INTENSIF ANAK (PICU) RSUP DR. SARDJITO

ANDRA SAFERI WIJAYA, DR. Fitri Haryanti, S.Kp., M.Kes.; bu DR. Dra. Indria Laksmi Gamayanti, M.Si., Psi.

2016 | Tesis | S2 Keperawatan

Latar Belakang: Keterlibatan keluarga merupakan komponen utama dalam konsep perawatan berpusat pada keluarga (PBK). PICU merupakan ruang perawatan dengan keterlibatan dan kehadiran keluarga yang terbatas, hal ini menjadi tantangan penerapan PBK. Mengetahui persepsi orangtua dan perawat tentang PBK dapat menjelaskan gambaran tentang PBK di ruang PICU, sehingga perlu dilakukan eksplorasi mendalam mengenai penerapan PBK di ruang PICU. Tujuan: Mengeksplorasi perawatan berpusat pada keluarga di ruang perawatan anak kritis PICU RSUP DR. Sardjito Yogyakarta Metode: Penelitian kualitatif dengan pendekatan fenomenologi yang dilaksanakan di Ruang PICU RSUP DR. Sardjito Yogyakarta pada bulan Agustus-Oktober 2015. Pengambilan data dilakukan dengan metode wawancara mendalam menggunakan pedoman wawancara semi terstruktur tehadap 10 partisipan utama (5 orangtua pasien dan 5 perawat) dan 2 orang dokter sebagai partisipan triangulasi yang dipilih melalui purposive sampling serta dilakukan observasi dan studi dokumentasi. Analisis data dilakukan secara manual dengan tahapan analisis menurut Colaizzi dengan bantuan software OpenCode versi 4.0.2.3. Hasil: Makna anak yang dirawat di PICU bagi orangtua yaitu aspek, proses dan stresor psikologis bagi orangtua. Orangtua dan perawat memiliki persamaan persepsi tentang PBK yaitu kehadiran keluarga merupakan aspek penting untuk terlibat, berkolaborasi dan memberikan dukungan dalam perawatan anak. Sedangkan aktivitas penerapan PBK di PICU yaitu adanya partisipasi keluarga dan berbagi informasi dalam perawatan anak. Manfaat PBK berdasarkan persepsi perawat dan orangtua yaitu meningkatkan keberhasilan pengobatan anak, memberikan kenyamanan bagi orangtua, dan pekerjaan petugas lebih mudah. Sedangkan tantangan pelaksanaan PBK di ruang PICU yaitu tantangan sikap, emosional, dan kognitif serta hambatan faktor ruangan. Selain itu peneliti juga menemukan harapan petugas dan orangtua terkait penerapan PBK di ruang PICU. Kesimpulan: Orangtua dan perawat menunjukan kesamaan pendapat mengenai kemaknaan, persepsi, manfaat, dan tantangan terkait perawatan berpusat pada keluarga. Sedangkan penerapan PBK tidak dapat dilaksanakan secara maksimal disebabkan banyaknya tantangan faktor ruang PICU itu sendiri. Harapan keluarga adanya kebijakan yang dapat memfasilitasi keterlibatan keluarga di ruangan PICU dan desain ruangan yang mendukung kehadiran keluarga.

Background: The family involvement is a main component in concept of family centered care. PICU is a treatment room with limited access for family involvement and presence. This is a challenge for family centered care implementation. Knowing perception of parents and nurses about family centered care will be explain the description of family centered care in PICU. So it needs in-depth exploration about implementation of family centered cared in PICU. Purpose: To explore the implementation of family centered care for child critical care in PICU, Dr. Sardjito Hospital Yogyakarta Method: Method of this study was a qualitative with phenomenology approach. Study was conducted in PICU ward at Dr. Sardjito General Hospital, Yogyakarta in August October 2015. The collecting data was conducted by In-depth interview were guided by semi structured interviews guidelines toward 10 main participants (5 patients parents and 5 nurses) and 2 physicians as triangulation participant that chosen by purposive sampling, and also conducted observation and study of document. Data analysis was conducted manually with Colaizzi analysis steps and used Open Code version 4.0.2.3 software. Results: Findings of this study showed the meaning of children admitted in to PICU for parents are aspect, processes and psychological stressors for parents. Parents and nurses have a similar perception about FCC are family presence of is an important aspect to engage, collaborate and provide support in child care. Whereas, the activitys of FCC implementation in PICU is there a kind of familys participation and information sharing in child care. The benefits of FCC based on the perception of nurses and parents are to improve success of treatment for children, provide comfort for the parents, and health care staff job is easier. Even though challenges of the implementation of FCC in the PICU is attitudes obstacles, emotional, and cognitive and also bariers of rooms factor. In addition, researchers also found the officers and parental expectations related to the implementation FCC in the PICU. Conclusion: Parents and nurses showed the similarity of their opinion about meaning, perception, useful and challenges that related FCC. Whereas, the implemented as maximal as it should be, it is because ther are many bariers of rooms factors it self. However, the hopes of families are there should be a wisdom and policy which can facilitate the involvement of families in PICUs room and room interior design that support the presence of families.

Kata Kunci : family centered care, PICU, child critical care