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KEPERAWATAN Harga Diri Rendah

BAB I
PENDAHULUAN

A. Latar Belakang
Gaya hidup dan persaingan hidup menjadi semakin tinggi. Hal i
disebabkan karena tuntutan atau kebutuhan hidup yang semak
meningkat seperti pemenuhan kebutuhan ekonomi sandang, panga
papan, pemenuhan rasa sayang, rasa aman dan aktualisasi diri dap
mengakibatkan tingginya tingkat stress dikalangan masyarakat jug
individu kurang atau tidak mampu dalam menggunakan mekanism
koping dan gagal dalam beradaptasi maka individu mengalami berbag
penyakit baik fisik maupun mental. Akibat-akibat stress terhada
seseorang dapt bermacam-macam dan hal ini tergantung pola kekuata
konsep dirinya yang akhirnya menentukan besar kecilnya toleran
seseorang terhadap stres, tetapi meskipu
demikian fleksibelitas dan adaptasibilitas 
adaptasibilitas  juga diperlukan agar seseoran
dapat menghadapi stresnya dengan baik. (Rasmun,2004,p.1)
Kecenderungan (trend 
(trend ) gangguan mental psikiatri akan semak
meningkat seiring dengan terus berubahnya situasi ekonomi dan politik k
arah tidak menentu, prevalensi bukan
 prevalensi bukan saja pada kalangan menegah
atas sebagai dampak langsung atau tidak langsung ketidakmampua
individu dalam penyesuaian diri terhadap
t erhadap perubahan sosial.
Seseorang dengan harga diri rendah akan merasa tidak berday
frustasi, depresi, dan menjadi korban. Orang tersebut akan sangat renta
terhadap tekanan akibat stress, sementara mereka yang memiliki harg
diri tinggi akan memperlihatkan keyakinan diri dan antusias serta dap
mengatasi rasa frustasi dengan baik karena perasaan harga diri ini sang
penting untuk mengurangi stres secara efektif. (Nation Safety Counc
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akan keadaan dirinya dan cenderung menarik diri dari kehidupan sosia
Kemudian dengan adanya frustasi, depresi dan rasa tidak mampu,ata
tidak berdaya akan mempengaruhi kemampuan klien dalam memenu
kebutuhan dasarnya, misalnya klien menjadi tidak mampu dalam h
perawatan diri, dan kebutuhan spiritualnyapun akan terganggu bahka
timbul waham agama.
Dengan adanya krisis multi dimensi, gaya hidup dan persaingan hidu
yang berat banyak individu yang tidak mampu bertahan sehingg
menyebabkan individu tersebut mengalami gangguan fisik maupun ment
yang berat. Maka dari itu dengan banyaknya prevalensi
banyaknya prevalensi orang yan
terkena ganguan jiwa khususnya harga diri rendah maka penulis tertar
untuk mengangkat studi khusus tentang asuhan keperawatan pada klie
dengan ganguan konsep diri; harga diri rendah.

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

A. Pengertian Harga Diri Rendah

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

mampu, saya memang bodoh dan tidak tahu apa –
apa  – apa.
 apa.
4. Gangguan hubungan sosial, seperti menarik diri, klien tak ma
bertemu orang lain, lebih suka menyendiri.
5. Percaya diri kurang, klien sukar mengambil keputusan yang sura
mungkin memilih alternatif tindakan.
6. Mencederai diri dan akibat HDR disertai dengan harapan yan
suram mungin klien ingin mengakhiri kehidupan.
Menurut Struart & Sundden (1998) perilaku klien HDR ditunjukka
tanda –
tanda – 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
yang pesimis.
11. Keluhan fisik.
12. Pandangan hidup yang
yang bertentangan.
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2. Rasa bersalah
bersalah terhadap
terhadap diri sendiri (mengkritik/menyalahkan
(mengkritik/menyalahkan
sendiri)
3. Gangguan hubungan sosial (menarik diri)
4. Percaya diri kurang (sukar mengambil keputusan)
5. Mencederai diri (akibat dari harga
harga diri yang rendah diser
harapan yang suram, mungkin klien akan mengak
kehidupannya.
Menurut Carpenito, L.J (1998: 352); Keliat, B.A (1994:20); perilak
yang berhubungan dengan harga diri rendah antara
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/mengejek diri sendiri
11. cemas dan takut
12. Merasionalisasi penolakan/menjauh
penolakan/menjauh dari umpan balik positif
13. Mengungkapkan kegagalan
kegagalan pribadi
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C. Psikodinamika
1. Etiologi
Gangguan harga diri yang disebut sebagai harga diri rendah dap
terjadi secara:
a. Situasional yaitu terjadi trauma yang
yang tiba-tiba, misalnya har
operasi, kecelakaan, diceraikan suami, putus sekolah, putu
hubungan kerja, perasaan malu karena sesuau terjadi (korba
perkosaan, dituduh KKN, dipenjara tiba-tiba).
1) Pada klien yang
yang dirawat
dirawat dapat terjadi HDR, karena priva
yang kurang diperhatikan, misalnya pemeriksaan fis
yang sembarangan, pemeriksaan alat yang tidak sopa
(pencukuran kumis, pemasangan kateter, pemeriksaa
perineal).
2) Harapan akan sturktur,
sturktur, bentuk dan fungsi
fungsi tubuh yang tida
tercapai karena dirawat atau sakit atau penyakit.
3) Perlakuan petugas kesehatan yang tidak mengharga
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diri karena keluarga dapat memberikan perasaan mampu dan tida

mampu. Perasaan diterima atau ditolak dan dalam keluarga individ
mempunyai kesempatan untuk mengidentifikasi perilaku orang la
dan mempunyai penghargaan yang pantas tentang tujuan, perilak
dan nilai.
Harga diri adalah penilaian individu tentang pencapaian d
dengan menganalisa seberapa jauh perilaku sesuai dengan ideal di
Pencapaian ideal diri atau cita-cita / harapan langsung menghasilka
perasaan berharga.
Penilaian pribadi terhadap hasil yang dicapai dari menganalis
seberapa jauh perilaku memenuhi ideal diri. Harga diri diperoleh da
diri sendiri dan orang lain. Individu akan merasa harga dirinya ting
bila sering mengalami keberhasilan, sebaliknya individu akan meras
harga dirinya rendah bila sering mengalami kegagalan, tidak dicint
atau tidak diterima lingkungan. Harga diri dibentuk sejak kecil da
adanya penerimaan dan perhatian. Harga diri akan meningkat sesu
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C. Rentang Respon

Respon Adaptif Respon Maladap

 Aktualisasi Konsep diri Harga Kerancauan Depersonalisa

Diri positif Diri Rendah Identitas

Salah satu komponen konsep diri yaitu harga diri dimana harga d
adalah penilaian individu tentang pencapaian diri dengan menganalis
seberapa jauh perilaku sesuai dengan ideal diri (Keliat, 1999).
Sedangkan harga diri rendah adalah menolak dirinya sebagai sesua
yang berharga dan tidak bertanggungjawab atas kehidupannya sendi
Jika individu sering gagal maka cenderung harga diri rendah.
Harga diri rendah jika kehilangan kasih sayang dan penghargaa
orang lain. Harga diri diperoleh dari diri sendiri dan orang lain, aspe
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2. Ketegangan peran beruhubungan

beruhubungan dengan peran atau
atau posisi
posisi yan
diharapkan dimana individu mengalami frustrasi. Ada tiga je
transisi peran :
a. Transisi peran perkembangan
perkembangan adalah perubahan
perubahan norma
yang berkaitan dengan pertumbuhan. Perubahan ini termasu
tahap perkembangan dalam kehidupan individu atau keluarg
dan norma-norma budaya, nilai-nilai tekanan untu
peyesuaian diri.
b. Transisi peran situasi terjadi dengan bertambah ata
berkurangnya anggota keluarga melalui kelahiran ata
kematian.
c. Transisi peran sehat sakit
sakit sebagai akibat pergeseran
pergeseran da
keadaan sehat ke keadaan sakit. Transisi ini mungk
dicetuskan oleh kehilangan bagian tubuh, perubahan ukura
bentuk, penampilan dan fungsi tubuh, perubahan fisi
prosedur medis dan keperawatan.
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dan masyarakat untuk mencapai tingkat kesehatan yang optimal. Prose

keperawatan bertujuan untuk memberikan asuhan keperawatan sesu
dengan kebutuhan dan masalah klien sehingga mutu pelayana
keperawatan menjadi optimal. Kebutuhan dan masalah klien dap
diidentifikasikan, diprioritaskan untuk dipenuhi, serta diselesaikan.
1. Pengkajian
a. Faktor predisposisi
1) Faktor yang mempengaruhi citra tubuh:Kehilangan/ kerusaka
bagian tubuh (anatomi dan fisiologi);
a) Perubahan ukuran, bentuk
bentuk dan penampilan tubuh akib
penyakit;
b) Proses penyakit
penyakit dan dampaknya
dampaknya terhadap struktur da
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 yan
membuat individu sulit menyesuaikan diri, khususnya traum
emosi seperti penganiayaan seksual dan psikologis pad
masa anak-anak atau merasa terancam atau menyaksika
kejadian yang mengancam kehidupan.
2) Ketegangan peran
Ketegangan peran adalah rasa frustasi saat individu meras
tidak mampu melakukan peran yang bertentangan denga
hatinya atau tidak merasa sesuai dalam melakukan peranny
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d. Mekanisme koping
Mekanisme koping adalah segala usaha yang diarahkan untu
menanggulangi stress. Usaha ini dapat berorientasi pada tuga
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 penggan
sementara, misalnya: ikut kegiatan social, politik, agam
dll.
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e. Sumber koping
Sumber koping adalah suatu evaluasi terhadap pilihan koping da
strategi seseorang.
1) Individu;
2) Keluarga;
3) Teman bermain;
4) Masyarakat.
f. Pemeriksaan diagnostik
1) MMPI (Minnesota
(Minnesota Multiphasie Personality Inventory)
Yaitu suatu tes yang bertujuan untuk mengetahui gambara
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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 denga
perawat.
Kriteria Evaluasi:
Setelah … kali interaksi klien menunjukan ekspresi waja
bersahabat, menunjukan rasa senang, ada kontak mata, ma
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Rencana Tindakan:
1) Diskusikan dengan klien tentang:
a) Aspek positif yang
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 penilaia
negative.
TUK 3 : Klien dapat menilai kemampuan yang dimiliki untu
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TUK 5 : Klien dapat melakukan kegiatan sesuai rencana yan

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

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

dopamine pada reseptor pasca sinaptik neuron di ota
khususnya system ekstra pyramidal.
Efek samping : Sedasi dan inhibisi psikomotor, ganggua
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1) Terapi keluarga adalah membantu

membantu individu dalam keluarga
keluarga agar tida
didominasi oleh reaktivitas emosi dan untuk mencapai tingk
diferensiasi diri yang lebih tinggi.
2) Terapi structural adalah mendorong terjadinya perubahan dala
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Fokus tahap pelaksanaan tindakan keperawatan adalah kegiata

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

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591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep Harga Dir
KEPERAWATAN Harga Diri Rendah

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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 Harga Dir
KEPERAWATAN Harga Diri Rendah

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 Harga Dir
KEPERAWATAN Harga Diri Rendah

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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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep Harga Dir
KEPERAWATAN Harga Diri Rendah

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 Harga Dir
KEPERAWATAN Harga Diri Rendah

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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 RELATED TITLES
591 views 0 0

Makalah HDR
Uploaded by Jelly Karina Matulessy 
Full description

   
Save Embed Share Print ASUHAN Makalah HDR Makalah Konsep Harga Dir
KEPERAWATAN Harga Diri Rendah

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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