Model Konseptual

keperawatan keluarga
Oleh:
Ns. Tantut Susanto, S.Kep., M.Kep., Sp.Kep.Kom., Ph.D

Departemen Keperawatan Komunitas, Keluarga & Gerontik

Fakultas Keperawatan, Universitas Jember

03/09/2020 1
Tujuan Pembelajaran
• Setelah mengikuti perkuliahan ini diharapkan mahasiswa
mampu menjelaskan dan mengaplikasikan teori dan model
keperawatan yang dapata digunakan dalam asuhan
keperawatan keluarga
Betty Neuman (Sistem)
4
 PSIKOLOGIS :
•GPF – Pengambilan keputusan
setiap hari, komunikasi SOSIO BUDAYA
menejemen stres (verbal atau non :
verbal) •GPF – Pemanfaatan
•GPN – Pola komunikasi dan pelayanan kesehatan, alokasi
pengambilan keputusan, sumberdaya keluarga, tempat
mekanisme berubah, keterikatan tinggal
diantara anggota keluarga •GPN – Peran sosial,
•GP – Nilai-nilai dan kepercayaan aturan/norma sosial
keluarga •GP – Budaya/etnik/adat
•SD – Definisi keluarga kebiasaan/kepercayaan
•SD – Sumber keuangan

•GPF - Garis Pertahanan

Fleksibel
•GPN - Garis Pertahanan
Normal
•GP – Garis Perlawanan
•SD – Struktur Dasar Sumber
Energi
Secara terpisah
Struktur
mewakili lapisan yang
Dasar menggambarkan lima
variabel Sistem
Neuman, dimana satu
dengan lainnya saling
berhubungan termasuk
dengan garis
pertahanan, garis
perlawanan, dan
struktur dasar

FISIOLOGIS : *)
GPF – Lapisan epitelium sebagai barier invasi
bibit penyakit
GPN – Sistem respirasi, hepatik,
simpatoadrenal, sirkulasi, dan tractus urinarius SPIRITUAL :
yang berfungsi secara normal
•GPF – Kondisi spiritual sehari-hari
GP – Aktifasi mekanisme keseimbangan •GPN – Praktek ibadah
(kompensatori) dan atau perubahan fungsi PERKEMBANGAN : •GP – Kepercayaan dan nilai
sistem •GPF – Ketrampilan parenting spiritual
SD – Pola respon, kekuatan organ, kelemahan •GPN – Tugas perkembangan •SD – Sumber daya dan kekuatan
atau kerusakan •GP – Nilai-nilai pribadi yang
berkembang sesuai dengan
pertambahan usia
•SD – Riwayat perkembangan masa lalu

5
Self-Care Deficit Theory of Nursing
• Dorothea E. Orem
• Teori keperawatan yg scr umum membahas ttg hub antara 3 teori :

Ability

Ability Need

Need
Self-Care Self-Care Deficit

Nursing Systems
Framework Konseptual Orem
Self-care
R R

Therapiutic
Self-care R self-care
capabilities
< demand

R R

Nursing
Capabilities
(Nursing
Agency)
Self-Care Framework
• Fokus model Orem adalah memandirikan individu
agar mampu melakukan perawatan dirinya sendiri.
Tiga bentuk praktik keperawatan profesional model
Orem.

Wholly compensatory system Tindakan perawat secara penuh

Partly compensatory system Tindakan perawat bersama pasien

Supportive-education system
Tindakan perawat bersama pasien
lebih aktif
Dynamic interacting systems(King, 1981
dalam Tomey & Alligood, 2006)
•
Proses interaksi manusia yang
menjurus pada transaksi : model
transaksi (King, 1981 dalam Tomey &
Alligood, 2006)
Framework King’s theory of goal attainmet
pada Aggregat Remaja

Transaction

Perception Perception
Agree to Action
means

Nurse Reaction Client

Explore
means
Disturbance

Communication Communication
Mutual
Goal
Setting

Skema King’s theory of goal attainmet (dari King IM: a theory for nursing: systems, concepts, process, New York, 1981, Wiley, p.157
11 Book, Inc., hal. 35)
dalam Christensen, P.J & Kenney, J.W: Nursing Process: Application of conceptual models, St. Louis, 1995, Mosby-Year
Interaksi antara perawat dan pasien dalam model konseptual King
(http://www.ignou.ac.in/edusat/BNS/BNS101-Blk2-3-4/Block1en/67-
80color.pdf
Nursing theories for understanding families

• Roy's Adaptation Theory (1983):

• The client is an individual, family, group, or community in
constant interaction with a changing environment. The family
system is continually changing and attempting to adapt.
• The goal of nursing is to promote adaptation and minimize
ineffective responses.
Social Sciences Theories for understanding
families
• Structural-Functional Theory:
• The family is viewed as part of the social system, with individuals being
parts of the family system.
• The family, as a social system, performs functions that serve both the
individual and society.
• Individuals act in accordance with a set of internalized norms and
values that are learned primarily in the family through socialization.
Social Sciences Theories for understanding
families
• Duvall’s developmental or life-cycle theory (1977):
• Families experience growth and development in much
the same way as individuals.
• Critical role transitions of individual members, such as
birth, retirement, and death of a spouse, are viewed as
resulting in a distinct change in the family life patterns.
• Families develop and change over time in predictable
ways.
• Families and their members perform certain timespecific
tasks that are decided upon by themselves, within their
cultural and societal context.
• Family behavior is the sum of the previous experiences of
its members as incorporated in the present and in their
expectations for the future.
Life cycle context
8 Duvall's Developmental Stages
• Beginning family
• Childbearing family
• Families with preschool children
• Families with school-aged children
• Families with teenagers
• Families launching young adults
• Middle-aged parents
• Families in later years
Culturally Sensitive Care
• Is care provided with awareness of child's and family’s own values and
beliefs and recognize how they influence their attitudes and actions.
• Cultural sensitivity means having an awareness and appreciation of
cultural influences in health care and being respectful of differences in
cultural belief systems and values.
• A multicultural perspective means using appropriate aspects of the
family's cultural orientation to develop health care interventions.
IMPLICATIONS FOR
NURSING
• Nurses can play a vital role in supporting parenting as they
work with families. This work must be done in collaboration
with parents if positive results are to be achieved.
Family-centered Care
“Family-centered care is an approach to the planning, delivery,
and evaluation of health care that is governed by mutually
beneficial partnerships between health care providers,
patients, and families.”

http://www.familycenteredcare.org
• Family-centered vs. Patient-centered – pediatric vs. adult
care
• Family-centered vs. Family-focused – collaborative vs.
expert and “unit of intervention”
• In family-focused care, professionals provide care from the position of
the “expert”…they tell families what to do. They consider the family the
“unit of intervention.”
• Family-centered care is characterized by a collaborative approach to
caregiving and decision-making. Each party respects the knowledge,
skills, and experience the other brings to the health care encounter.
Language…how are your words interpreted?
• “Family unavailable for interview”
• “Compliance is poor”
• “Presented the Chinese food summary, but dad claims the
suggestions don’t apply”
• “One of my cases is a 5-year old Down’s kid”
Family-centered Language

“…When we recognize that people with disabilities are

people first, we can begin to see how people with
disabilities are more like people without disabilities
than they are different.”
Kathie Snow, 1998
Family-centered Language:
“People-first language”

§ Focus on the individual, not the disability; do not refer to the

disability unless it’s relevant
§ Avoid labeling people: “a Down’s kid” vs. “a child who has
Down syndrome”
§ Emphasize abilities not limitations: “confined to a wheelchair”
vs. “uses a wheelchair”
§ Avoid negative or sensational descriptions (achieved a near-
normal life despite suffering from…)
§ Avoid using “normal” to describe people without disabilities
People-first Language

Change the following from “language to avoid” to “people-first language”

the handicapped
normal kid
he is autistic
he’s one of my cases
a quadriplegic
she is learning disabled
a victim of epilepsy
HIPPA and the Privacy Rule

• Patients must have access to their medical

information
• A written consent must be completed before
medical information is released
• More information:
http://www.hhs.gov/ocr/hipaa
http://aspe.hhs.gov/admnsimp
Tugas
• Diskusikan Bersama terkait dengan beberapa permasalahan dibawah
ini?
• Apabila di suatu keluarga ada permasalahan COVID-19 dan
keluarga memerlukan asuhan keperawatan keluarga. Teori dan
model keperawatan keluarga apa yang paling tepat dilakukan?
Dan kenapa?
• Kita mengenal terkait dengan masa physical distancing dan new
normal era. Apa teori dan model keperawatan keluarga yang bisa
digunakan pada setiap masa tersebut? Dan kenapa?
• Diskusikan kedua masalah tersebut Bersama kelompok ?
• Dalam memberikan pendapat setiap kelompok disertai dengan hasil
suatu artikel penelitian dalam 5 tahun terakhir dari hasil penelitian
keperawatan keluarga
 Terima Kasih

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