Anda di halaman 1dari 29

PERSPEKTIF KEPERAWATAN PADA BERBAGAI RENTANG USIA FAKULTAS ILMU KEPERAWATAN UNIVERSITAS PADJADJARAN logounpad KusmanIbrahim, Ph.

KonsepTumbuhKembang .Tumbuh(Growth): perubahanfisikdanpeningkatandalamukuran. Dapatdiukursecarakuant itatif, sepertiBB, TB, ukurantulang, dsb. .Perkembangan(Development): suatupeningkatandalamkompleksitasfungsidankemajuanke terampilan. Kapasitasdanketerampilanseseoranguntukberadaptasidenganlingkungan. C ontoh: kemampuanberjalan, berbicara, berlari, dsb. .Tumbuh, umumnyaterjadiselamaperiode20 tahunawalkehidupan, sedangkanperkembangan berlangsungterus

PrinsipTumbuhKembang .Continuous, orderly, sequential process .Mengikutipola-polatertentu .Setiaptahapperkembanganpunyakarakteristikmasingmasing .Cephalocaudaldirrection .Proximodistaldirrection .Dari yang sederhanakekompleks .Tahapperkembangantertentubisalebihkritisdariyang lainnya, misalusia10-12 minggupertamasetelahkonsepsi .Belajardapatmendukungataumenghambatprosespematangan

Faktoryang mempengaruhiTumbuhkembang .Genetik(jeniskelamin, karakteristikfisik) .Lingkungan(keluarga, agama, iklim, budaya, sekolah, komunitas, danmakanan) http://t2.gstatic.com/images?q=tbn:ANd9GcTNzjPgySAOmrTgFQayJ_Fckk9FwUIoay2Ve5cSA efEgIWUvgDIaw

TahapTumBang Tahap Usia Karakteristik ImplikasiKeperawatan Neonatal Lahir-28 hari Perilakulebihreflexivedanberkembanglebihterarah Membantuortuuntukmengidentifikasidanmemenuhikebutuhanyang blmterpenuhi Infancy 1 bl 1 th Pertumbuhanfisikcepat Kontrolkondisilingkungansehinggakebutuhanfisikdanpsikologisterpenuhi Toddler 1 3 th Perkembanganmotorikmemungkinkanpeningkatanautonomifisik. Psychosocialskills juga meningkat Keseimbangankeamanandanperilakumengambilresiko Preschool 3 6 th Mengembangkanduniakanak2danbelajarperansosialmllbermain, pertumbuhanfisiklebihlambat Memberikesempatanuntukbermaindanaktifitassosial

TahapTumBang Tahap Usia Karakteristik ImplikasiKeperawatan School age 6 12 th

Perilakudipengaruhipeer grup, peningkatanfperkembanganisik, kognitif, sosial,dankomunikasi Berikanwaktudanenergipadaanakutkmenyalurkanhobidanaktifdikegiatansekolah. Adolescence 12 20 th Konsepdiriberubahseiringperubahanfisik,Nilai-nilaidiuji, stresmeningkatterutamak etikaberhadapandengankonflik Bantu mengembangkankoping, bantu mengembangkanstrategimengelolakonflik YoungAdulthood 20 40 th Mengembangkangayahiduppersonal, membangunhubungandenganyglain danmencobaberkomit menterhadapsesuatu Terimapilihangayahidup, bantu penyesuaianthdkesehatan Middle adulthood 40 65 th Gaya hidupberubahkarenaperubahanpadayglain Bantu klienutkmembuatrencanautkperubahanygbisadiperkirakan

TahapTumBang Tahap Usia Karakteristik ImplikasiKeperawatan Older adulthood: young old 65 74 th

Adaptasithdpensiun, perubahanfisik, berkembangpenyakitkronis Bantu mempertahankankeaktifanfisikdansosialdaninteraksikelompok. Middle-old 75-84 th Adaptasithdpenurunankecepatandangerak, waktureaksi, dantingkatketergantungan Bantu kopingthdkehilangan(pendengaran, penglihatan, sensory, pasangan)., tindakankeamanan Old -old 85 danlebih Meningkatnyamasalahmasalahfisik Bantu mengembangkanself-care, mandirisebisamungkin

Teori-teoriTumbuhKembang .Teoritugasperkembangan -Havighurst(1900-1991) .TeoriPsychosocial -Freud (1856 1939)

-Erikson (1902 1996) -Peck (1968) -Gould (1972)

TeoriFreud Enamkonsep: .Unconscious mind .Defense/adaptive mechanism .Id .Ego .Superego .Libido

Freud s Five Stages of Development .Oral (Birth 1 tahun)

Mulutsebagaipusatkesenagan, rasa amanmrpkebutuhanygpaling dasar, konflikutama; weaning .Anal (1 -3 th) Anus danbladder sebagaipusatkesenangan, konflikutama; toilet training .Phalic(4 6 th) Genital mrppusatkesenangan, konflik: Oedipus or Electra complex .Latency (5 pubertas)

Energidiarahkankeaktivitasfisikdanintelektual, mengembangkanhubungandengantemans ebaya/sejenis .Genital (setelahpuber) Energy diarahkankepematanganfungsiseksualsecarapenuhsertapengembanganketerampila nuntukberadaptasidenganlingkungan

Ericson s Eight Stage of Development Stage Age Central Task Indicators of positive resolution Indicators of negative resolution infancy Birth to 18 mnts Trust vsmistrust Learning to trust other Mistrust, withdrawal, estrangement Early childhood 18 mnth 3 yrs Authonomyvsshame and doubt Self-control without loss of self-esteem Ability to cooperate and to express oneself Compulsive self-restraintor compliance Willfulness and defiance

TeoriPiaget .Perkembangankognitifmengacupadacara-caraorangberfikir, beralasan, danmenggunaka nbahasa .Lima faseutama: sensorimotor, prekonsep, intuitif, danoprasikongkrit .Setiapfase, menggunakantigakemampuan: asimilasi, akomodasi, adaptasi

Teori-teoriTumbuhKembang .TeoriCognitive -Piaget (1986 1980) .TeoriMoral -Kohlberg (1927 -Gilligan (1982) .Teorispiritual -Fowler (1985) -Westerhoff(1976) 1987)

PromosiKesehatanPsikososial: Loss, Grieving, and Death .Kehilangan(Loss): suatusituasibaikaktualmaupunpotensialketikasesuatuyang diangg apbernilaiberubah, tidaktersedialagi, atauhilang/pergi. Misal: loss of body image, a significant other, a sense of well-being, a job, beliefs, or sense of self .Dukacita(Grieving): total responterhadappengalamanemosionalakibatkehilangan, di manifestasikandalampikiran, perasaan, danperilakuyang berhubungandengankesedihan yang mendalam .Kematian(Death): kehilanganyang mendasar, baikbagiyang meninggalmaupunyang diti nggalkan

JenisdanSumberkehilangan Jeniskehilangan: .Perceived loss .Anticipatory loss Sumberkehilangan: .Kehilangansebagiandaridirisendiri, misalbagiantubuh, fungsifisiologisataupsikol ogis .Kehilangansuatuobjekdiluartubuh .Keterpisahandarilingkungaanyang biasa .Kehilanganseseorangyang dicintaiatausangatberharga

Kubler-Ross s stage of grieving .Denial .Anger .Bargaining .Depression .acceptance

Faktoryang berpengaruhterhadapresponkehilangan .Usia .Significance of the loss .Culture .Spiritual beliefs .Gender .Status sosioekonomis .Support system .Penyebabkehilangan

Spirituality:'spirare' (Latin) = 'to breathe life', expressing one's values and beliefs about self, humanity, life and God. Literature .spirituality .religion, spirituality . religion Spirituality:the unifying force of person;theessence of being that permeates all of life and is manifested in one s being, knowing, and doing; the interconnectedness with self, others, nature, and God/life (Dossey& Guzzetta, 2000) PromosiKesehatanPsikososial: Spirituality

DEFINITIONS (Cont.) Spirituality:a belief in or relationship with some higher power, creative force,divinebeing, or infinite source of energy (God, Allah, a higher power) Faith:a universal; a feature of living, acting, and self understanding Religion:a belief system and practices of worship related to that system.

SPIRITUAL DEVELOPMENT Undifferentiated Faith (Infancy-Toddler) The seeds of trust, courage, hope, and love are joined to combat such issues as possible inconsistency and abandonment in the infant s environment Intuitive-Projective Faith (3-6 years) Fantasy-filled period, a young child is strongly influenced by examples, moods, actions and stories of visible faith primarily related adults

SPIRITUAL DEVELOPMENT (Cont.) Mythic-Literal Faith (7-12 years) The time when the child begins to internalize stories, beliefs, and observances that symbolize belonging to his or her own faith community Synthetic-Conventional Faith (13-20 years) Adolescent s experiences outside the family unit (school, peers, media, religion). Faith provide a basis for identity and outlook edec_brownieday

Individuative-Reflective Faith (21-30 years) A young adult begins to claim a faith identity no longer defined by the composite of one s roles or meanings to others . .time of personal creativity, individualism, and autonomy Conjunctive Faith (31-40 years) A time of opening to the voices of one s deeper self, and the development of one social conscience . more mature spirituality especially finding meaning of his/her illness Universalizing Faith (> 40 years) Culmination of the work of all of the previous faith stages, a time of relating to the imperative of absolute love and justice toward all humankind

SPIRITUAL NEEDS .A person s need to maintain, increase, or restore beliefs and faith and to fulfill religious obligations .Certain spiritual needs underlie all religion; (1) need for meaning and purpose (2) need for love and relatedness (3) need for forgiveness

SPIRITUAL, RELIGION AND ILLNESS Spiritual and religious beliefs are important in many people s lives .influence life-style, attitudes, and feeling about illness and death Spiritual beliefs may assume greater importance at time of illness than at any other time in a person s life Some people may look illness as a test of faith, or punishment for past sins Spiritual beliefs help people to accept illness and to plan for the future, religion help people prepare for death and strengthen them during life Certain spiritual beliefs are in conflict with accepted medical practice

THEORETICAL FOUNDATIONSFOR SPIRITUAL CARE .Whole person care as the essence of nursing care .Spiritual component of Nursing .Supportive theories in other disciplines (e.g., Lazarus stress and coping framework .spiritual beliefs and religious practices can be viewed as coping strategies)

Clients who may desire spiritual assistance: .Appear lonely and have few visitors .Express fear and anxiety .Having surgery .Having illness related to the emotions or religious or social implication .Life-style change as a result of illness or injury

Outcome Criteria of spiritual distress, the client: .Expresses comfort with spiritual beliefs .Continuous spiritual practices appropriate to health status .Expresses decreased feeling of guilt .States acceptance of moral decision .Displays positive affect .Expresses finding positive meaning in the present situation and in own existence .Verbalizes relief from or acceptance of suffering .Verbalizes relief of anger toward transcendent being, self, and other .Verbalizes a closeness with God .Experiences a sense of forgiveness

j0282867 Terima Kasih