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KEPERAWATAN Harga Diri R

BAB I
PENDAHULUAN

A. Latar Belakang
Gaya hidup dan persaingan hidup menjadi semakin tinggi. Ha
disebabkan karena tuntutan atau kebutuhan hidup yang sem
meningkat seperti pemenuhan kebutuhan ekonomi sandang, pan
papan, pemenuhan rasa sayang, rasa aman dan aktualisasi diri d
mengakibatkan tingginya tingkat stress dikalangan masyarakat
individu kurang atau tidak mampu dalam menggunakan mekani
koping dan gagal dalam beradaptasi maka individu mengalami berb
penyakit baik fisik maupun mental. Akibat-akibat stress terha
seseorang dapt bermacam-macam dan hal ini tergantung pola keku
konsep dirinya yang akhirnya menentukan besar kecilnya toler
seseorang terhadap stres, tetapi mesk
demikian fleksibelitas dan adaptasibilitas  juga diperlukan agar seseo
dapat menghadapi stresnya dengan baik. (Rasmun,2004,p.1)
Kecenderungan (trend)  gangguan mental psikiatri akan
sem meningkat seiring dengan terus berubahnya situasi ekonomi dan
politi arah tidak menentu, prevalensi bukan saja pada kalangan
menegah atas sebagai dampak langsung atau tidak langsung
ketidakmamp individu dalam penyesuaian diri terhadap perubahan
sosial.
Seseorang dengan harga diri rendah akan merasa tidak berd
frustasi, depresi, dan menjadi korban. Orang tersebut akan sangat re
terhadap tekanan akibat stress, sementara mereka yang memiliki h
diri tinggi akan memperlihatkan keyakinan diri dan antusias serta d
mengatasi rasa frustasi dengan baik karena perasaan harga diri ini
sa penting untuk mengurangi stres secara efektif. (Nation Safety
Cou
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akan keadaan dirinya dan cenderung menarik diri dari kehidupan so

Kemudian dengan adanya frustasi, depresi dan rasa tidak mampu,
tidak berdaya akan mempengaruhi kemampuan klien dalam meme
kebutuhan dasarnya, misalnya klien menjadi tidak mampu dalam
perawatan diri, dan kebutuhan spiritualnyapun akan terganggu bah
timbul waham agama.
Dengan adanya krisis multi dimensi, gaya hidup dan persaingan
h yang berat banyak individu yang tidak mampu bertahan sehin
menyebabkan individu tersebut mengalami gangguan fisik maupun
me yang berat. Maka dari itu dengan banyaknya prevalensi orang
terkena ganguan jiwa khususnya harga diri rendah maka penulis ter
untuk mengangkat studi khusus tentang asuhan keperawatan pada k
dengan ganguan konsep diri; harga diri rendah.

B. Rumusan Masalah
1.Apa pengertian dari harga di rendah ?
2.Apa tanda dan gejala dari harga diri rendah ?
3.Bagaimana psikodinamika dari harga diri rendah ?
4. Bagaimana rentang respon dari harga diri rendah ?
5.Bagaimana asuhan keperawatan pada gangguan harga
rendah ?
6.Apa terapi aktifitas kelompok pada harga diri rendah ?
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D. Manfaat
Dapat menambah pengetahuan tentang ruang lingkup dan asu
keperawatan harga diri rendah.
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BAB II
PEMBAHASAN

A. Pengertian Harga Diri Rendah

Konsep diri didefinisikan sebagai semua pikiran, keyakinan
kepercayaan yang membuat seseorang mengetahui tentang dirinya
mempengaruhi hubungannya dengan orang lain (Stuart, Gail, W,
1998
Konsep diri rendah adalah semua ide, pikiran, peras
kepercayaan, dan pendirian yang diketahui individu dalam hubun
dengan orang lain (Suliswati, 2005).
Harga diri rendah adalah evaluasi diri dan perasaan tentang diri
kemampuan diri yang negatif, dapat seara langsung atau tidak langs
diekspresikan ( Town, send, Maryc, 1998).
Harga diri rendah adalah suatu keadaan dimana individu menga
atau beresiko mengalami evaluasi diri negative tentang kemampuan
(Carpenito, 2000).
Harga diri rendah adalah keadaan dimana individu menga
evaluasi diri negative yang mengenai diri atau kemampuan dalam w
lama (Lynda wall, edisi 8, 2001).
Harga diri rendah adalah penilaian individu tentng nilai personal y
diperoleh dengan menganalisa seberapa baik perilaku seseorang se
dengan ideal diri ( Keliat, Budi, Anna, 2005)
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3. Merendahkan martabat misalnya, saya tidak bisa, saya t

mampu, saya memang bodoh dan tidak tahu apa – apa.
4. Gangguan hubungan sosial, seperti menarik diri, klien tak
bertemu orang lain, lebih suka menyendiri.
5. Percaya diri kurang, klien sukar mengambil keputusan yang
su mungkin memilih alternatif tindakan.
6. Mencederai diri dan akibat HDR disertai dengan harapan y
suram mungin klien ingin mengakhiri kehidupan.
Menurut Struart & Sundden (1998) perilaku klien HDR ditunjuk
tanda – tanda sebagai berikut :
1.Produktivitas menurun.
2.Mengukur diri sendiri dan orang lain.
3. Destructif pada orang lain.
4. Gangguan dalam berhubungan.
5. Perasaan tidak mampu.
6.Rasa bersalah.
7.Mudah tersinggung atau marah yang berlebihan.
8. Perasaan negatif terhadap tubuhnya sendiri.
9. Ketegangan peran yang dihadapi atau dirasakan.
10. Pandangan hidup yang pesimis.
11. Keluhan fisik.
12. Pandangan hidup yang bertentangan.
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2.Rasa bersalah terhadap diri sendiri (mengkritik/menyalahkan

sendiri)
3.Gangguan hubungan sosial (menarik diri)
4.Percaya diri kurang (sukar mengambil keputusan)
5.Mencederai diri (akibat dari harga diri yang rendah dis
harapan yang suram, mungkin klien akan meng
kehidupannya.
Menurut Carpenito, L.J (1998: 352); Keliat, B.A (1994:20); peri
yang berhubungan dengan harga diri rendah antara lain:
1.Mengkritik diri sendiri atau orang lain
2.Perasaan dirinya sangat penting yang berlebih-lebihan
3. Perasaan tidak mampu
4.Rasa bersalah
5.Sikap negatif pada diri sendiri 6.
Sikap pesimis pada kehidupan 7.
Keluhan sakit fisik
8. Pandangan hidup yang terpolarisasi
9. Menolak kemampuan diri sendiri
10. Pengurangan diri/mengejek diri sendiri
11. cemas dan takut
12. Merasionalisasi penolakan/menjauh dari umpan balik positif
13. Mengungkapkan kegagalan pribadi
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C. Psikodinamika
1.Etiologi
Gangguan harga diri yang disebut sebagai harga diri rendah
d terjadi secara:
a.Situasional yaitu terjadi trauma yang tiba-tiba, misalnya h
operasi, kecelakaan, diceraikan suami, putus sekolah, p
hubungan kerja, perasaan malu karena sesuau terjadi
(ko perkosaan, dituduh KKN, dipenjara tiba-tiba).
1)Pada klien yang dirawat dapat terjadi HDR, karena pri
yang kurang diperhatikan, misalnya pemeriksaan
yang sembarangan, pemeriksaan alat yang tidak so
(pencukuran kumis, pemasangan kateter, pemeriks
perineal).
2)Harapan akan sturktur, bentuk dan fungsi tubuh yang t
tercapai karena dirawat atau sakit atau penyakit.
3)Perlakuan petugas kesehatan yang tidak mengha
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diri karena keluarga dapat memberikan perasaan mampu dan t

mampu. Perasaan diterima atau ditolak dan dalam keluarga indi
mempunyai kesempatan untuk mengidentifikasi perilaku orang
dan mempunyai penghargaan yang pantas tentang tujuan, peri
dan nilai.
Harga diri adalah penilaian individu tentang pencapaian
dengan menganalisa seberapa jauh perilaku sesuai dengan ideal
Pencapaian ideal diri atau cita-cita / harapan langsung menghasi
perasaan berharga.
Penilaian pribadi terhadap hasil yang dicapai dari mengan
seberapa jauh perilaku memenuhi ideal diri. Harga diri diperoleh
diri sendiri dan orang lain. Individu akan merasa harga dirinya ti
bila sering mengalami keberhasilan, sebaliknya individu akan me
harga dirinya rendah bila sering mengalami kegagalan, tidak dic
atau tidak diterima lingkungan. Harga diri dibentuk sejak kecil
adanya penerimaan dan perhatian. Harga diri akan meningkat se
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C. Rentang Respon

Respon Adaptif Respon Malad

 Aktualisasi Konsep diri Harga Kerancauan Depersonal

Diri positif Diri Rendah Identitas

Salah satu komponen konsep diri yaitu harga diri dimana harga
adalah penilaian individu tentang pencapaian diri dengan mengan
seberapa jauh perilaku sesuai dengan ideal diri (Keliat, 1999).
Sedangkan harga diri rendah adalah menolak dirinya sebagai ses
yang berharga dan tidak bertanggungjawab atas kehidupannya sen
Jika individu sering gagal maka cenderung harga diri rendah.
Harga diri rendah jika kehilangan kasih sayang dan pengharg
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2.Ketegangan peran beruhubungan dengan peran atau posisi

diharapkan dimana individu mengalami frustrasi. Ada tiga
transisi peran :
a.Transisi peran perkembangan adalah perubahan nor
yang berkaitan dengan pertumbuhan. Perubahan ini
terma tahap perkembangan dalam kehidupan individu
atau kelu dan norma-norma budaya,
nilai-nilai tekanan u peyesuaian diri.
b.Transisi peran situasi terjadi dengan bertambah
berkurangnya anggota keluarga melalui kelahiran
kematian.
c.Transisi peran sehat sakit sebagai akibat pergeseran
keadaan sehat ke keadaan sakit. Transisi ini mun
dicetuskan oleh kehilangan bagian tubuh, perubahan uku
bentuk, penampilan dan fungsi tubuh, perubahan f
prosedur medis dan keperawatan.
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dan masyarakat untuk mencapai tingkat kesehatan yang optimal. Pro

keperawatan bertujuan untuk memberikan asuhan keperawatan se
dengan kebutuhan dan masalah klien sehingga mutu pelaya
keperawatan menjadi optimal. Kebutuhan dan masalah klien d
diidentifikasikan, diprioritaskan untuk dipenuhi, serta diselesaikan.
1.Pengkajian
a. Faktor predisposisi
1)Faktor yang mempengaruhi citra tubuh:Kehilangan/ kerus
bagian tubuh (anatomi dan fisiologi);
a)Perubahan ukuran, bentuk dan penampilan tubuh a
penyakit;
b)Proses penyakit dan dampaknya terhadap struktur
fungsi tubuh;
c)Proses pengobatan seperti radiasi dan kemoterapi.
2)Faktor yang mempengaruhi harga diri:
a) Penolakan;
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1)Trauma
Masalah spesifik dengan konsep diri adalah situasi y
membuat individu sulit menyesuaikan diri, khususnya tra
emosi seperti penganiayaan seksual dan psikologis p
masa anak-anak atau merasa terancam atau menyaks
kejadian yang mengancam kehidupan.
2)Ketegangan peran
Ketegangan peran adalah rasa frustasi saat individu me
tidak mampu melakukan peran yang bertentangan den
hatinya atau tidak merasa sesuai dalam melakukan peran
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d.Mekanisme koping
Mekanisme koping adalah segala usaha yang diarahkan u
menanggulangi stress. Usaha ini dapat berorientasi pada tu
dan meliputi usaha pemecahan masalah langsung.
1)Pertahanan jangka pendek
a)Aktivitas yang dapat memberikan pelarian sementara
kritis, misalnya: kerja keras, nonton, dll.
b)Aktivitas yang dapat memberikan identitas pengg
sementara, misalnya: ikut kegiatan social, politik, aga
dll.
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e.Sumber koping
Sumber koping adalah suatu evaluasi terhadap pilihan
koping strategi seseorang.
1)Individu; 2)
Keluarga;
3) Teman bermain;
4) Masyarakat.
f.Pemeriksaan diagnostik
1)MMPI (Minnesota Multiphasie Personality Inventory)
Yaitu suatu tes yang bertujuan untuk mengetahui gamb
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3. Perencanaan Keperawatan
Diagnosa keperawatan : Harga diri
rendah a. Tujuan umum
Klien memiliki konsep diri yang positif.
b. Tujuan khusus
TUK 1 : Klien dapat membina hubungan saling percaya den
perawat.
Kriteria Evaluasi:
Setelah … kali interaksi klien menunjukan ekspresi w
bersahabat, menunjukan rasa senang, ada kontak mata,
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Rencana Tindakan:
1)Diskusikan dengan klien tentang:
a)Aspek positif yang dimiliki klien, keluarga, lingkungan.
b)Kemampuan yang dimiliki klien.
2) Bersama klien buat daftar tentang:
a)Aspek positif klien, keluarga, lingkungan.
b)Kemampuan yang dimiliki klien.
3) Beri pujian yang realistis, hindarkan memberi penil
negative.
TUK 3 : Klien dapat menilai kemampuan yang dimiliki u
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TUK 5 : Klien dapat melakukan kegiatan sesuai rencana y

dibuat.
Kriteria Evaluasi:
Setelah … kali interaksi klien melakukan kegiatan sesuai ja
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neuron ke neuron lain melintasi ruang (sinaps) dian

mereka.
c) Terapi elektrokonvulsif (ECT)
2) Antipsikotik (neuroleptik)
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Mekanisme kerja : Obat anti psikosis dalam memblok

dopamine pada reseptor pasca sinaptik neuron di
khususnya system ekstra pyramidal.
Efek samping : Sedasi dan inhibisi psikomotor, gangg
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1)Terapi keluarga adalah membantu individu dalam keluarga agar t

didominasi oleh reaktivitas emosi dan untuk mencapai tin
diferensiasi diri yang lebih tinggi.
2)Terapi structural adalah mendorong terjadinya perubahan d
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Fokus tahap pelaksanaan tindakan keperawatan adalah kegi

pelaksanaan tindakan dari perencanaan untuk memnuhi kebutuhan
dan emosional. Pendekatan tindakan keperawatan meliputi:
a. Independen
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Makalah HDR
Uploaded by Jelly Karina Matulessy 
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KEPERAWATAN Harga Diri R

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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep H
KEPERAWATAN Harga Diri R

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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep H
KEPERAWATAN Harga Diri R

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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep H
KEPERAWATAN Harga Diri R

Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep H
KEPERAWATAN Harga Diri R

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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Trusted by over 1 million members

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