LAPORAN ANALISA JURNAL

NASIONAL DAN INTERNASIONAL

Untuk Memenuhi Tugas Stase Keperawatan Anak

Disusun Oleh :
Dwi Apriyanti, S.Kep
030520437

PROGRAM STUDI PROFESI NERS

INSTITUTE MEDIKA DRG. SUHERMAN CIKARANG
TAHUN AJARAN 2020/2021
 LAPORAN ANALISA JURNAL
No : Hari : Kamis
Nama Mahasiswa
NPM
Nama Pembimbing
Pencapaian Kompetensi dan
pilihan tema
Tujuan Khusus Isi Jurnal
Judul Jurnal
Penulis Jurnal
Sumber Publikasi
Waktu Publikasi Jurnal
P (population/problem)
I (intervention)
C (comparation/control)
Tanggal : 01 April 2021
: Dwi Apriyanti, S.Kep
: 030520437
: Ibu Mila Sartika, S.Kep., M.Kep
: Memilih jurnal atau EBP
: Tujuan pada penelitian ini adalah untuk mengetahui
pengaruh pemberian tepid sponge terhadap
penurunan suhu tubuh pada anak demam usia
toddler di RSUD Majalengka.
: PENGARUH PEMBERIAN TEPID SPONGE
TERHADAP PENURUNAN SUHU TUBUH
PADA ANAK DEMAM USIATODDLER(1-3
TAHUN)
: Hera Hijriani
: Jurnal Keperawatan dan Kesehatan MEDISINA
AKPER YPIB Majalengka
: 10 Juli 2019
: - Populasi dalam penelitian ini adalah semua
pasien anak demam usia toddler yang di
rawat di ruang Melati RSUD Majalengka.
- pengaruh pemberian teknik tepid sponge
terhadap penurunan suhu tubuh pada anak
demam usia toddler.
: Intervensi pada penelitian ini yaitu teknik tepid
sponge.
: - Pembanding pada penelitian ini yaitu : Hasil
penelitian ini sejalan dengan penelitian Ns.
Sri Haryani S, S.Kep Dan Ns. Syamsul Arif,
M.Kes (2012) tentang “Pengaruh Kompres
Tepid Sponge Hangat Terhadap Penurunan
Suhu TubuhPada Anak Umur 1-10 Tahun
Dengan Hipertermia Di RSUD Tugurejo
Semarang”. Dengan hasil penelitian
menunjukan ada pengaruh kompres tepid
sponge hangat terhadap penurunan suhu
tubuh pada anak umur 1-10 tahun dengan
hipertermia. Dilihat dari hasil rata–rata
penurunan suhu tubuh sebesar 1,4ºC setelah
30 menit dilakukan Kompres Tepid Sponge.
O (outcome) : Berdasarkan hasil penelitian dan pembahasan dapat
di simpulkan beberapa hal sebagai berikut:
1. Rata-rata suhu tubuh pada anak demam usia
toddler (1-3 tahun) di RSUD Majalengka tahun
2017sebelum diberikan teknik tepid sponge adalah
38,3°C dengan standar deviasi 0,24495.
2. Rata-rata suhu tubuh pada anak demam usia
toddler (1-3 tahun) di RSUD Majalengka tahun
2017 sesudah diberikan teknik tepid sponge adalah
37,6°C dengan standar deviasi 0,27222.
3. Ada pengaruh pemberian tepid sponge terhadap
penurunan suhu tubuh pada anak demam usia
toddler (1-3 tahun) di RSUD Majalengka Tahun
2017. Yaitu ada perbedaan yang signifikan antara
sebelum dan sesudah di lakukan tepid sponge
didapatkan nilai p value= 0,000(<0,05)
T (time) : Waktu yang diperlukan dalam penelitian ini relatif
singkat yaitu15menit.
Saran Peningkatan Kualitas : - Nasional : Saran kepada peneliti untuk
isi Jurnal menjelaskan pada penelitiannya bagaimana
cara peneliti melakukan teknik tepid sponge
terhadap responden, dan menjelaskan alat-
alat yang digunakan saat penelitian.
- Internasional : saran kepada peneliti untuk
menjelaskan cara melakukan teknik tepid
sponge dan waktu dilakukan penelitian.
Link Jurnal : https://ejournal.akperypib.ac.id/wp-
content/uploads/2019/07/MEDISINA-Jurnal-
Keperawatan-dan-Kesehatan-AKPER-YPIB-
MajalengkaVolume-V-Nomor-10-Juli-2019-4.pdf
 PENGARUH PEMBERIAN TEPID SPONGE TERHADAP
PENURUNAN SUHU TUBUH PADA ANAK DEMAM USIA
TODDLER (1-3 TAHUN)

Oleh : Hera Hijriani (STIKes

YPIB Majalengka)

ABSTRAK

Demam merupakan suatu kondisi dimana suhu tubuh mengalami peningkatan di atas
normal. Seseorang dapat dikatakan demam jika suhu tubuhnya mencapai lebih dari
37,5°C. Suhu tubuh demam dapat diatasi secara farmakologis dan non farmakologis.
Terapi non farmakologis ada beberapa cara salah satunya dengan metode kompres tepid
sponge. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian tepid sponge
terhadap penurunan suhu tubuh pada anak demam usia toddler (1-3 tahun) di RSUD
Majalengka tahun 2017.
Desain penelitian ini menggunakan quasi eksperimen one group pretest-posttestt. Banyak
sampel yang digunakan dalam penelitian ini adalah 20 responden usia 1-3 tahun. Teknik
pengambilan sampel dalam penelitian ini menggunakan acidental sampling. Dalam
penelitian ini peneliti menggunakan thermometer digital dan air hangat (26°C-35°C).
Hasil penelitian menunjukan ada pengaruh pemberian tepid sponge terhadap penurunan
suhu tubuh pada anak demam usia toddler (1-3 tahun) di RSUD Majalengka tahun 2017.
Dilihat dari hasil analisis uji paired t test di dapat p value sebesar 0,000 < 0,05 dengan
rata- rata penurunan suhu sebelum dan sesudah sebesar 0,64 °C.
Kesimpulan penelitian ini adalah adanya pengaruh pemberian tepid sponge terhadap
penurunan suhu tubuh pada anak demam. Diharapkan penelitian tepid sponge ini dapat
dijadikan tambahan pengetahuan untuk perawat dan orang tua untuk membantu
menurunkan suhu tubuh pada anak demam.

Kata Kunci : Tepid Sponge, Suhu Tubuh Demam

Daftar Pustaka : 28 Pustaka (2008-2016)
 EFFECT OF TEPID SPONGE ON THE DECREASE OF
BODY TEMPERATURE IN CHILDREN AT TODDLER AGE
(1-3 YEARS) WITH FEVER

ABSTRACT

Fever is a condition where the body temperature has increased above normal. A
person can be said to have a fever if his body temperature reaches more than
37.5°C. The high temperature can be treated pharmacologically and non-
pharmacologically. There are several ways of non pharmacological therapy, one
of them is by the method of tepid sponge compress. This study aims to determine
the effect of tepid sponge on the decrease of body temperature in children at
toddler age (1-3 years) with fever at District General Hospital Majalengka in
2017.
The design of this study used quasi experimental one group pretest-posttest. The
samples used in this study were 20 respondents aged 1-3 years. Sampling
technique in this study used accidental sampling. In this study the author used a
digital thermometer and warm water (26°C-35°C).
The study results showed that there was an effect of giving tepid sponge on the
decrease of body temperature in children at toddler age (1-3 years) with fever at
District General Hospital Majalengka in 2017. The analysis result of paired t test
showed p value of 0.000 <0,05, with the mean of temperature decrease before
and after treatment of 0.64°C.
The conclusion of this study was that there was an effect of giving tepid sponge on
the decrease of body temperature in children with fever. It is expected that this
tepid sponge study can be used as additional knowledge for nurses and parents to
help lowering body temperature in children with fever.

Keywords : Tepid Sponge, Fever Body

Temperature Bibliography : 28 References (2008-
2016)
PENDAHULUAN
Demam merupakan suatu kondisi
dimana suhu tubuh mengalami
peningkatan di atas normal. Seseorang
dapat dikatakan demam jika suhu
tubuhnya mencapai lebih dari 37,5°C.
Demam pada dasarnya dapat dialami oleh
seluruh kalangan usia, mulai dari bayi
sampai orang lanjut usia. Hal ini dapat
terjadi karena pada dasarnya demam
menunjukkan bahwa mekanisme dalam
tubuh berjalan normal dalam melawan
penyakit yang menimbulkan reaksi infeksi
oleh virus, bakteri, jamur, atau parasit
(Sodikin et all, 2012). Badan Kesehatan
Dunia WHO (2013) memperkirakan
jumlah kasus demam di seluruh dunia
mencapai 16 - 33 juta dengan 500 – 600
ribu kematian tiap tahunnya, anak
merupakan yang paling rentan terkena
demam, walaupun gejala yang dialami
anak lebih ringan dari dewasa. Hampir
semua daerah endemik, insidensi demam
banyak terjadi pada anak usia 3-12 tahun.
Data kunjungan ke fasilitas kesehatan
pediatrik di Brazil terdapat sekitar 19%
sampai 30% anak diperiksa karena
menderita demam (Jayanti, 2011;
Supiyanto, 2016). Kompres adalah salah
satu metode fisik untuk menurunkan
suhu tubuh bila mengalami demam.
Adapun beberapa metode kompres yang
 sering digunakan adalah pemberian
kompres air hangat, kompres air biasa,
dan kompres alkohol (Sodikin, 2012).
Tepid sponge merupakan
kombinasi teknik blok dengan seka.
Teknik ini menggunakan kompres blok
tidak hanya di satu tempat saja, melainkan
langsung dibeberapa tempat yang
memiliki pembuluh darah besar. Selain itu
masih ada perlakuan tambahan yaitu
dengan memberikan seka di beberapa area
tubuh sehingga perlakuan yang di
terapkan terhadap klien pada teknik ini
akan semakin komplek dan rumit
dibanding dengan teknik yang lain.
Namun dengan kompres blok langsung
diberbagai tempat ini akan mempasilitasi
penyampaian sinyal ke hipotalamus
dengan lebih gencar. Selain itu pemberian
seka akan mempercepat pelebaran
pembuluh darah perifer akan
mempasilitasi perpindahan panas dari
tubuh kelingkungan sekitar yang akan
METODOLOGI PENELITIAN
Penelitian ini menggunakan
rancangan penelitian metode penelitian
eksperimental dengan pendekatan one
group pretest- posttest. Dalam penelitian
ini untuk mengetahui pengaruh pemberian
tepid sponge terhadap penurunan suhu
tubuh pada anak demam usia toddler (1 –
3 tahun) di Ruang Perawatan Anak di
RSUD Majalengka Tahun 2017.
Populasi dalam penelitian ini
adalah semua pasien anak demam usia
toddler yang di rawat di ruang Melati
RSUD Majalengka. Dalam menentukan
jumlah sampel dalam penelitian ini
menggunakan Acidental sampling yaitu
mengambil kasus atau responden yang
kebetulan ada atau tersedia di suatu tempat
sesuai dengan konteks penelitian
(Notoatmojo, 2010). ). Menurut Sugiyono
(2010) jumlah sampel minimum dalam
penelitian eksperimen adalah 10-20
sampel, maka peneliti mengambil
sampel sebanyak 20 responden. Untuk
mengetahui apakah ada perubahan suhu
tubuh, maka dilakukan tabulasi dan analisa
HASIL PENELITIAN DAN PEMBAHASAN
semakin mempercepat penurunan suhu
tubuh (Reiga, 2010; Hamid, 2011).
Hasil studi pendahuluan
didapatkan prevalensi demam pada anak
di RSUD Majalengka tahun 2016
mengalami peningkatan dari tahun 2015
yaitu sebesar 667 anak (63,89%).
Tindakan yang dilakukan untuk
mengatasi demam pada anak selain
menggunakan terapi antipiretik yaitu
dengan menggunakan kompres hangat
dan menganjurkan banyak minum air
putih. Berdasarkan uraian diatas maka
pertanyaan dari penelitian ini apakah ada
pengaruh pemberian teknik tepid sponge
terhadap penurunan suhu tubuh pada
anak demam usia toddler di RSUD
Majalengka?
Tujuan umum penelitian ini
adalah untuk mengetahui pengaruh
pemberian tepid sponge terhadap
penurunan suhu tubuh pada anak demam
usia toddler di RSUD Majalengka.
data bivariat dengan uji normalitas data
yang menggunakan Shapiro Wilk karena
sampel kurang dari 50 responden. Uji T
test dependen untuk membandingkan data
sebelum dan sesudah dilakukan intervensi
dengan tingkat signifikasi 0,05 dan tingkat
kepercayaan 95%.
Pengambilan data dilakukan
melalui pengamatan dengan
menggunakan lembar obervasi yang telah
disiapkan. Pengisian lembar observasi
dilakukan 2 kali yaitu sebelum dilakuka
tepid sponge dan langsung setelah
dilakukan tepid sponge.
Penelitian dimulai dengan
penentuan sampel yang diambil dari
seluruh pasien demam. Kemudian
melakukan informed consent kepada
keluarga responden dengan memberi
penjelasan mengenai tujuan, manfaat, dan
prosedur intervensi penelitian serta
dimintai persetujuannya. Setelah
mendapat penjelasan, apabila keluarga
responden bersedia, maka keluarga
responden mengisi lembar persetujuan.
1. Mengetahui rata-rata suhu tubuh pada
anak demam usia toddler di RSUD
Majalengka Tahun 2017 sebelum
dilakukan tepid sponge.
Variabel Mean
Suhu Tubuh
Sebelum
Tepid 38,3000
Sponge
Berdasarkan tabel 4.1 dapat
diketahui bahwa rata-rata suhu tubuh anak
demam usia toddler sebelum diberikan
tindakan tepid sponge adalah 38,3 °C,
Median 38,3 °C dengan standar deviasi
0,24495 dan nilai minimum serta
maksimumnya adalah 38,0 °C dan 39,0
°C. Menurut Sodikin (2012) pada
manusia, suhu tubuhnya cenderung
berfluktuasi tiap saat. Ada banyak faktor
yang menjadi penyebab fluktuasi suhu
2. Mengetahui Rata-rata Suhu Tubuh
Pada Anak Demam Usia Toddler Di
RSUD Majalengka Tahun 2017
Sesudah Dilakukan Tepid Sponge.
Variabel Mean
Suhu
Tubuh
Sesudah 37,6600
Tepid
Sponge
Berdasarkan tabel 4.2 dapat
diketahui bahwa rata-rata suhu tubuh
anak demam usia toddler sesudah
diberikan tindakan tepid sponge adalah
37,6 °C, Median 37,6 °C dengan standar
deviasi 0,27222 dan nilai minimum serta
maksimumnya adalah 37,20 °C dan
38,40°C dengan rata-rata penurunan suhu
tubuh sebesr 0,64 °C. Demam terjadi
jika berbagai proses infeksi ataupun non
infeksi saling berinteraksi dengan
Tabel 4.1 Rata-rata Suhu Tubuh Anak
Demam Usia Toddler (1-3 Tahun) di
RSUD Majalengka Tahun 2017
Sebelum Dilakukan Tepid Sponge.
Median Min- SD
Max
38,00-
39,00
38,3000 0,24495
tubuh tersebut, agar suhu tubuh dapat
dipertahankan secara konstan, maka
diperlukan pengaturan (regulasi)
suhu tubuh akan menentukan suhu tubuh.
Keseimbangan tersebut dipengaruhi oleh
karena kecepatan reaksi kimia bervariasi
sesuai suhu, selain itu sistem enzim tubuh
juga memiliki rentang suhu sempit agar
berfungsi optimal, maka fungsi tubuh
yang normal tergantung pada suhu badan
yang relatif tetap.
Tabel 4.2 Rata-rata Suhu Tubuh Anak
Demam Usia Toddler (1-3 Tahun) di
RSUD Majalengka Tahun 2017
Sesudah Dilakukan Tepid Sponge
Median Min- SD
Max
37,2
0- 0,27
37,6500 38,4 222
0
mekanisme pertahanan hospes
(penjamu). Kebanyakan demam pada
anak akibat perubahan pada pusat panas
(termoregulasi) di hipotalamus (Sodikin,
2012). Kausa demam selain infeksi juga
dapat disebabkan oleh keadaan toksemia,
karena keganasan atau reaksi terhadap
pemakaian obat. Selain itu juga karena
gangguan pada pusat regulasi suhu
sentral yang menyebabkan peninggian
temperatur seperti pada heat stroke,
perdarahan otak, koma atau gangguan
3. Mengetahui Pengaruh Pemberian
Tepid Sponge Terhadap Penurunan
Suhu Tubuh Pada Anak Demam Usia
Toddler (1-3 Tahun) Di RSUD
Majalengka Tahun 2017.
Variabel Mean SD
Pre test – 0,64 0,09
Post test
Berdasarkan tabel 4.4 hasil
penelitian dengan menggunakan uji
paired T test (T Dependen) di dapatkan
nilai p value = 0,000 < nilai α = 0,05
dengan demikian Ho ditolak, yang artinya
ada pengaruh teknik Tepid Sponge
terhadap penurunan suhu tubuh pada anak
demam usia toddler di RSUD Majalengka
Tahun 2017.
Prosedur pendinginan seperti
mengusap atau mandi air hangat tidak
efektif dalam mengatasi demam pada
anak-anak baik jika digunakan sendiri
atau dikombinasikan dengan antipiretik,
dan menyebabkan ketidak nyamanan
(Sharber, 1997; Wong, et.al, 2009).
Tetapi ada kecenderungan bahwa
pemberian antipiretik yang disertai
dengan tepid sponge mengalami
penurunan suhu lebih besar bila
dibandingkan dengan pemberian
antipiretik saja (Setiawati, 2009; Sodikin,
2012).
Teknik tepid sponge merupakan
sentral lainnya (Sodikin, 2012).
Komplikasi dari demam yang
dapat terjadi yaitu bisa timbulnya kejang,
resiko persisten bakteremia, resiko
meningitis, dan risiko ke arah keseriusan
penyakit (Suriadi, 2010). Menurut Valita
(2008) dalam Supiyanto (2016) dampak
demam jika tidak mendapatkan
penanganan lebih lanjut antara lain
dehidrasi sedang hingga berat, kerusakan
neurologis, dan kejang demam.
Tabel 4.3 Pengaruh Pemberian Tepid
Sponge Terhadap Penurunan Suhu
Tubuh Pada Anak Demam Usia
Toddler (1-3 Tahun) Di RSUD
Majalengka Tahun 2017
CI 95% df P
value
0,5934 - 19 0,000
0,68655
kombinasi teknik blok dengan seka.
Teknik tepid sponge ini menggunakan
kompres blok tidak hanya di satu tempat
saja, melainkan langsung dibeberapa
tempat yang memiliki pembuluh darah
besar seperti di leher, ketiak, dan lipat
paha. Selain itu masih ada perlakuan
tambahan yaitu dengan memberikan seka
dibeberapa area tubuh sehingga perlakuan
yang diterapkan terhadap klien pada
teknik ini akan semakin komplek dan
rumit dibandingkan dengan teknik yang
lain. Namun dengan kompres blok
langsung diberbagai tempat ini akan
memfasilitasi penyampaian sinyal ke
hipotalamus dengan lebih gencar. Selain
itu pemberian seka akan mempercepat
pelebaran pembuluh darah perifer akan
memfasilitasi perpindahan panas di tubuh
ke lingkungan sekitar yang akan semakin
mempercepat penurunan suhu tubuh
(Reiga, 2010; Supiyanto, 2016).
Dalam penelitian (Hamid, 2011) pada
tepid sponge pemberian kompres dapat
diberikan sesuai dengan protap tindakan
yaitu selama 10-15 menit, kemudian
pemberian kompres dihentikan, waslap
diambil dan tubuh dibiarkan terbuka. Hal
ini akan memfasilitasi evaporasi melalui
kulit yang telah berdilatasi kelingkungan
sekitar menjadi maksimal. Tepid sponge
dapat kembali diberikan setelah 90 menit
kemudian. Ini merupakan waktu yang
tepat karena setelah 90 menit efek terapi
tepid sponge mulai menghilang yang
ditandai dengan kembali meningkatnya
suhu pada anak. Pemberian tepid sponge
yang selanjutnya akan mencegah
kenaikan suhu lebih lanjut.Hasil
penelitian ini sejalan dengan penelitian
Ns. Sri Haryani S, S.Kep Dan Ns.
Syamsul Arif, M.Kes (2012) tentang
“Pengaruh Kompres Tepid Sponge
Hangat Terhadap Penurunan Suhu Tubuh
KESIMPULAN
Berdasarkan hasil penelitian dan
pembahasan dapat disimpulkan beberapa
hal sebagai berikut:
1. Rata-rata suhu tubuh pada anak
demam usia toddler (1-3 tahun) di
RSUD Majalengka tahun 2017
sebelum diberikan teknik tepid
sponge adalah 38,3 °C dengan standar
deviasi 0,24495.
2. Rata-rata suhu tubuh pada anak
demam usia toddler (1-3 tahun) di
RSUD Majalengka tahun 2017
SARAN
Berdasarkan hasil penelitian dan
pembahasan ditemukan beberapa hal
untuk dijadikan beberapa saran sebagai
berikut ini:
1. Petugas kesehatan berupaya
menerapkan tindakan tepid sponge
untuk membantu menurunkan suhu
tubuh pada anak demam.
Memberikan informasi kepada
responden untuk membantu
menurunkan suhu tubuh pada anak
demam selain menggunakan
Pada Anak Umur 1-10 Tahun Dengan
Hipertermia Di RSUD Tugurejo
Semarang”. Dengan hasil penelitian
menunjukan ada pengaruh kompres tepid
sponge hangat terhadap penurunan suhu
tubuh pada anak umur 1-10 tahun dengan
hipertermia. Dilihat dari hasil rata – rata
penurunan suhu tubuh sebesar 1,4ºC
setelah 30 menit dilakukan Kompres
Tepid Sponge.
Pemberian kompres tepid sponge dalam
penelitian ini terbukti dapat menurunkan
suhu tubuh pasien. Hasil penelitian
mendapatkan bahwa suhu tubuh pada
pasien anak setelah pemberian kompres
tepid sponge rata-rata dapat mengalami
penurunan sebesar 0,64 °C. Waktu yang
diperlukan dalam penelitian ini relatif
singkat yaitu 15 menit.
sesudah diberikan teknik tepid sponge
adalah 37,6 °C dengan standar deviasi
0,27222.
3. Ada pengaruh pemberian tepid
sponge terhadap penurunan suhu
tubuh pada anak demam usia toddler
(1-3 tahun) di RSUD Majalengka
Tahun 2017. Yaitu ada perbedaan
yang signifikan antara sebelum dan
sesudah di lakukan tepid sponge
didapatkan nilai p value= 0,000
(<0,05).
antipiretik juga dapat
menggunakan kompres tepid
sponge.
2. Petugas kesehatan agar berupaya
menerapkan pengetahuan tentang
kompres tepid sponge kepada orang
tua pasien untuk membantu
menurunkan suhu tubuh pada anak
demam. Memberikan penyuluhan
kepada responden mengenai
tindakan kompres tepid sponge
dengan air hangat yang dilakukan
peneliti dapat membantu
 menurunkan suhu tubuh pada anak
demam.
3. Petugas kesehatan dapat
menerapkan teknik tepid sponge
sebagai alternatif untuk membantu
menurunkan suhu tubuh pada
pasien demam secara mandiri.
Memberikan penyuluhan
kepada responden agar melakukan
kompres tepid sponge secara mandiri
baik di rumah sakit ataupun di rumah
apabila suhu tubuh anak mengalami
peningkatan kembali.

DAFTAR PUSTAKA
Haryani Sri, Syamsul Arif. 2012.
Alves, J. G. B., & Almedia, Tepid Sponge Pengaruh Kompres Tepid Sponge
Plus Dypirone Versus Dyvirone Hangat Terhadap Penurunan
Alone In Reducing Body
Temperatur In Febrile Children,
Brazil, 2008.

http://www.scielo.br/scielo.php?s
cr ip=scl_arttex&spid=s1516-
31802008000200008. Diakses
tanggal 12 Febuari 2017.

Anggi Pradila Erlin, Ade Fitriani. 2016.

Asuhan Keperawatan Pada An. D
Usia Pra Sekolah (5 Tahun)

Dengan Febris Di Ruang Melati Badan

Layanan Umum Daerah
Kabupaten Ciamis.
www.ejournal.stikessmucis.ac.id.
Diakses tanggal 13 Febuari 2017.

Arfiana, Arum Lusiana. 2016. Asuhan

Neonatus Bayi Balita dan Anak
Pra Sekolah. Yogyakarta: Trans
Medika.

Hamid Mohammad Ali. 2011.

Keefektifan Kompres Tepid
Sponge Yang Dilakukan Ibu
Dalam Menurunkan Demam
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 Jurnal Ners
This is an Open Access article
Vol. 14, No. 3, Special Issue 2019 distributed under the terms of the
http://dx.doi.org/10.20473/jn.v14i3(si).17173 Creative Commons
Attribution 4.0 International License

Original Research

The Difference Between the Conventional Warm Compress and Tepid Sponge
Technique Warm Compress in the Body Temperature Changes of Pediatric Patients
with Typhoid Fever

Aulya Kartini Dg Karra1, Muh. Aswar Anas2, Muh. Anwar Hafid2, and Rosdiana Rahim2
1Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
2Faculty of Medicine and Health Sciences, Alauddin State Islamic University Makassar, South Sulawesi, Indonesia

ABSTRACT ARTICLE HISTORY

Introduction: The use of warm compresses and warm sponge techniques Received: Dec 26, 2019
as a modality therapy for the management of fever in typhoid children has Accepted: Dec 31, 2019
a good influence. The purpose of this research was to learn of the
differences between conventional warm compress and the tepid sponge KEYWORDS
technique as related to the body temperature changes of pediatric patients typhoid; children; warm; compresses;
with typhoid fever. A fever that does not get a good standard of treatment warm sponge; fever
can cause dehydration, neurological damage and febrile seizures.
CONTACT
Methods: The research design was quasi-experiment with two groups pre-
Aulya Kartini Dg Karra
post test. The population was taken from the Kampili Community Health  aulya.kartini.dg-
Center while the 20 samples were taken using the purposive sampling 2018@fkp.unair.ac.id
technique. Conventional warm compresses were placed on the forehead,  Faculty of Nursing, Universitas
while warm tepid sponges were compressed and placed on the forehead, Airlangga, Surabaya, Indonesia
armpits and the folds of the thighs simultaneously.
Results: . The data of the results were significance tested using the General
linear model repeated measure (p value 0.03 for conventional warm
compresses and p value 0.01 on a warm compress tepid sponge technique).
Conclusion: Statistically, the warm compress tepid sponge technique is
more meaningful and qualitatively, the temperature change is better after
the compression.

Cite this as: Karna, A.K.D., Anas, M.A., Hafid, M.A., & Rahim, R. (2019). The Difference Between the Conventional Warm
Compress and Tepid Sponge Technique Warm Compress in the Body Temperature Changes of Pediatric
Patients with Typhoid Fever. Jurnal Ners, 14(3si),321-326. doi:http://dx.doi.org/10.20473/jn.v14i3(si). 17173

(Gebreyesus
INTRODUCTION
Typhoid fever is a systemic infection caused by Gram
negative bacteria Salmonella Typhi. This bacteria are
on food or drinks associated with poor hygiene and
areas with poor sanitation. Typhoid fever is a serious
health problem and it is a major cause of infant
morbidity and mortality in developing countries
(Almeida & Almeida, 2008). Fevers that do not get a
good treatment can cause dehydration, neurological
damage and febrile seizures (Arbianingsih, 2011).
A report from the WHO revealed that 21 million
cases and > 600,000 deaths every year worldwide
are due to typhoid fever. Developing countries have
the highest number of typhoid fever cases caused by
the rapid population growth, increased urbanization
and limited water and health service hygiene

& Negash, 2015) Areas with high endemicity
include Central Asia, South Asia, Southeast Asia
and South Africa (Almeida & Almeida, 2008). A
study conducted in urban areas in some Asian
countries focused on children aged 5 - 15 years
showed that the incidence of positive blood
cultures reached 180-194 per 100,000 children in
South Asia in those aged 5-15 years. It was 400–
prevention efforts to respond. In 2008, typhoid
morbidity in Indonesia was reported to be 81.7 per
100,000 population, with the distribution according
to the age group being 0.0 / 100,000 population (0–
1 years), 148.7 / 100,000 population (2-4 years),
180, 3
/ 100,000 (5-15 years) and 51.2 / 100,000 (=
16
years). This figure shows that the highest number of
sufferers is in the 2-15 years old age group
(Kemenkes, 2006)
One effort to reduce fever is with a warm
compress. According to the research, a warm
compress can be used as an independent act by the
nurses to help to reduce the patient’s body
temperature (Surakarta & Ambarwati, n.d.)
Conventional warm compresses (forehead area) can
reduce the body temperature but warm compresses
on the forehead produce insignificant decreases in
temperature (Edbor, Arora, & Mukherjee, 2011).
Another action used to reduce heat is a tepid
sponge. Tepid sponging is a procedure used to
improve the control of body heat loss through
evaporation and conduction, which is usually done
in patients who have a high fever. The purpose of
the tepid sponge action is to reduce the body
temperature in patients who have hyperthermia
(Gebreyesus & Negash, 2015). The tepid sponge
technique is more effective at lowering the body
temperature in the first
15 minutes. The research carried out combining
mothers with the tepid sponge technique showed
that it can reduce the body temperature better than
just using profen mothers only (Hidayati, 2014).
According to a study conducted by (Kania,
2015), the reduction of the body temperature using
a warm sponge with antipyretic drugs was
significantly faster than using only antipyretics and
paracetamol. However, the effects of discomfort
were milder.
Based on the background phenomenon of the
above problems, the researchers wanted to examine
the difference between a conventional warm
compress and the tepid sponge technique related to
the body temperature changes of pediatric patients
with typhoid fever.
MATERIALS AND METHODS
This research was conducted using a quasi-
experimental technique. A quasi-experiment
explains the relationship used as a basis to predict a
phenomenon (Kanj et al., 2015). The types of design
used were two groups of pre-test post-tests. The
500 per 100,000 population in Southeast Asia and in
Northeast Asia, it was less than 100 cases per
100,000 population (Burnside dan M.C Glynn, 2014).
In Indonesia, typhoid fever should get serious
attention from various parties because this disease is
endemic and threatens public health. The problem is
increasingly complex with increasing career cases
(carrier) or relapse and resistance to the drugs used,
thus making it more difficult for treatment and
sample totaled 20 people, consisting of 10 in the
conventional warm intervention groups and 10
people in the group for the tepid sponge technique.
The sample in the research were children aged 3 -
12 years old (preschool and school years) who had
been admitted to the Kampili Health Center
Inpatient Room, who had typhoid fever based on a
medical diagnosis (temperature; 37,20C – 39,50C)
and who had received fluid therapy and antipyretic
therapy.
This study used the research instrument of
observation sheets for the body temperature
research method, in addition to conventional
warm compress equipment, tepid sponge warm
compress equipment, a wrist watch, stationery and
a mercury thermometer for the axillary
measurements. Measuring the body temperature
was done using a mercury thermometer because it
has a 99% accuracy rate. Mercury responds to body
temperature and it is not related to other factors
such as battery usage or damage as might happen to
a digital thermometer machine.
The location of this study was in the Inpatient
Room of the Kampili Community Health Center,
Pallangga District, Gowa Regency. To determine
the effect of the conventional warm compress and
tepid sponge technique warm compress on the
body temperature changes of pediatric patients
with typhoid fever, the data was analyzed using
the General Linear Model-Univariate test. In
addition, the General Linear Model - Repeated
Measure test was also used to determine whether
there were significant differences in the variables
that were measured repeatedly.
RESULTS
Based on the results of the research conducted on
the
20 respondents using a conventional warm
compresses and the tepid sponge technique,
[Table 1] shows the demographic data, namely
the distribution of respondents based on the
highest age at 7 - 12 years especially in reference
to the tepid sponge techniques (60.0%).
Conventionally, those between the ages of 3-6
years old and 7-12 years old were comparable
(50% each), while the distribution of respondents
by sex was that (70%) were women in the
conventional warm compress group while the
sexes were split by 50% each in the tepid sponge
technique. The variable data on the form and
duration of the fever suffered after 4-6 days of
compressing was so for as many as 13
respondents (65%), which is the duration of fever was 38.60C compressed with the tepid sponge
suffered the most. The distribution of the technique. [Table 3] After the General Linear
respondents based on length of the treatment Model-Repeated Measure test is carried out the
performed was 1 day of treatment for 13 following results: Temperature changes between
respondents (65%), which was the most common the pre-test and post- test in the conventional
treatment time. [Table 2] shows that the warm compress groups were as follows: in the 5
distribution of the respondents based on the level minutes after compressing, the p value was 0.07
of fever was, for the conventional warm (p> α) or 0.07> 0.05, which means that
compresses in the pre-test measurements, at the conventional warm compresses are not
highest febrile level, namely 38.50C. The highest statistically significant but they are able to reduce
sub-febrile value was 37.90C. For the tepid the average body temperature by 0,150C in
sponge technique, the highest score was 38.60C quality. At 15 minutes, the p value was 0.01 (p
and the highest sub-febris was 38.20C. The <α) or 0.01 <0.05, which
highest temperature compressed in this research
Table 1. Distribution of the Respondents Based on their Demographic Data
Respondent’s Conventional Warm Warm compress
Characteristics Tepid Sponge
Frequency (%) Frequency (%)
Age
3- 6 years 5 50.0 4 40.0
7-12 years 5 50.0 6 60.0
Total 10 100 10 100
Gender
Male 330.0 5 50.0
Female 770.0 5 50.0
Total 10 100 10 100
Old Fever suffered Frequency Percentage (%)
1 - 3 days 7 35.0
4 – 6 days 13 65.0
Total 20 100
Duration of treatment Frequency Percentage (%)
1 day 13 65.0
2 days 7 35.0
Total 20 100

Table 2. Respondent’s Frequency Distribution Based on the Dependent Variables

Warm Compress Warmth Level Highest Value Pre-test
(0C)
Conventional Febris 38,5
Subfebris 37,9
Febris 38.6
Sub-febris 38,2

Table 3. Effect of Compression on Changes in Body Temperature at Every Time of Measurement

Technique Transfer Temperature Change P value
Conventional Pre-test-minute ke 5 0,07
(p value 0,03) Pre-test-minute ke 15 0,01
Pre-test-minute ke 30 0,78
Pre-test-minute ke 60 0,21
Tepid sponge Pre-test minute ke 5 0,01
(p value 0,01) Pre-test-minute ke 15 0,01
Pre-test-minute ke 30 0,02
Pre-test-minute ke 60 0,11

Table 4. Effect of Compression on Changes in Body Temperature - Multivariate Analysis

Warm Technique Temperature Change P value
Conventional Pillai's Trace ,003
Wilks' Lambda ,003
Hotelling's Trace ,003
Roy's Largest Root ,003
Pillai's Trace 0,01
Tepid Sponge Wilks' Lambda 0,01
Hotelling's Trace 0,01
 Roy's Largest Root
means that conventional warm compresses in the
15th minute after compressing caused a decrease in
body temperature. At 30 minutes, the p value was 0,
78 (p> α) or 0.78> 0.05, which means that there is no
decrease in body temperature and it even tends to
increase from the pre-test value. At 60 minutes, we
got a p value of 0.21 (p> α) or 0, 21> 0.05, which
means that conventional warm compresses 60
minutes after the compression do not lower the body
temperature and it even tends to increase from the
pre test value.
The temperature changes between the pre-test
and post-test in the warm compress group for the
tepid sponge technique were as follows. In the 5
minutes after compressing, it got a p value of 0.01
(p
<α) or 0.01 <0.05, which means that the tepid
sponge technique affects the decrease in body
temperature. At 15 minutes, p value 0.01 was
obtained (p <α) or
1.1 <0.05, which means that the tepid sponge
technique has an effect on decreasing the
body temperature in the 15 minutes after
compressing. In the 30 minutes after
compressing, the p value was
0.1 (p> α) or 0.02> 0.05, which means that the tepid
sponge technique is not statistically significant
but it is able to reduce the average body
temperature by 0.110 C 30 minutes after
compressing. At 60 minutes, the p value was
0.11 (p> α) or 0.11> 0.05, which means that
the tepid sponge technique does not reduce
the body temperature 60 minutes after
compressing, which is even higher than the
pre test value [Table 4]. The effect of the
compress on changes in body temperature
analyzed using multivariate analysis was
done to find out whether the mean of the
post-test measurements differed
significantly. Multivariate tests were carried
out by looking at Table 4.8. From all of the
tests, it was concluded that they all rejected
Ho because all of the tests produced the
same p-value, which was 0.03 <0.05. There
was a significant difference in the changes in
body temperature with the conventional
warm compresses. For the tepid sponge
technique, all tests produced the same p-
value, that is 0.01 <0.05. There was a
significant difference in the changes in body
temperature. Of the two types of
compresses based on the analysis, the tepid
sponge technique was more statistically
significant because the p value was lower
than that of the conventional warm
0,01
compresses (0.01<0.03). The multivariate tests
included Pillai's Trace test, Wilks' Lamda,
Hotelling's Trace and Roy's Largest Root; the
values of the 4 tests were also used to
strengthen the results of the hypothesis.
DISCUSSION
A heat or fever conditions is where the brain fixes the
body temperature above the normal setting, which is
above 380C. However, true heat is when the
temperature is > 38.50C. As a result of the increasing
demand, the body will produce heat. Infection is the
entry of microorganisms (microorganisms or very
small living things that are generally not visible to the
eye) into the body. The entry of microorganisms does
not necessarily cause us to fall sick, depending on
many things. Among others, it depends on how strong
our immune system is. If our immune system is strong,
then we may not get sick. Even if we are sick, our body
then forms immune substances (antibodies).
Microorganisms can include germicidal bacteria,
viruses and fungi. In children who have an infection,
the signs of an elevated body heat often appear. It has
been proven that a fever is deliberately made by our
body as an effort to help the body get rid of infection.
When attacked by an infection, the body must eradicate
it. The trick is by deploying the immune system.
Commanding the forces to fight infection are the
white blood cells. In carrying out their duties to be
effective and on target, white blood cells cannot be
alone. Support is needed by many parties including
pyrogens. Pyrogens have a complex role in the
regulatory mechanism that exists in the human body.
Pyrogens have 2 missions: 1. Deploy the white
blood cells or leukocytes to the site of infection and 2.
cause a fever that will kill the virus. This is because
viruses do not deal well with high temperatures. The
typhoid virus thrives at low temperatures (Djuwariyah,
2011).
The occurrence of fever when someone has an
infection in one of his organs, for example, is not a
negative sign like it is in typhoid. Typhoid fever has
the typical symptom of a continuous fever. This is a
fever that persists with a maximum fluctuation of
0,40C over a 24 hour period (Kemenkes, 2006).
Typhoid fever is more common in school-aged
children (Nasution, 2015). In typhoid fever patients,
there is a fever that is not too high and that lasts for 3
weeks. The first week is where there is an increase in
fluctuating body temperature. Usually the body
temperature increases at night and decreases in the
morning (NurrochmadC & Williams, 2014). The
first step in managing the fever is to make the
diagnosis as precise as possible before establishing
treatment modalities that are not necessarily drugs
(Pujiarto, 2008).
One effort to reduce fever is warm compresses
that cause the body temperature to warm up. The
body will interpret that the temperature is quite
hot and eventually the body will reduce the
temperature control in the brain so as not to
increase the body's temperature further. Warmer
temperatures make the vessels carrying the
peripheral blood widen and vasodilate, so the skin
pores will open and facilitate heat dissipation.
Changes in body temperature will therefore occur
(Djuwariyah, 2011). A warm compress on the skin
can inhibit shivering and the resulting metabolic
effects. In addition, a warm compress also induce
peripheral vasodilation, thereby increasing the
amount of body heat coming out (Purba &
Wandra, 2016). A warm compress can be made by
coating the surface of the skin with a towel soaked
in warm water. The results of the research
conducted proved that a compress of wet warmth
is effective at lowering the body temperature in
fever patients diagnosed with typhoid fever
(Purwanti & Ambarwati, 2008). The non-
pharmacological treatment of fever that can be
done includes compressing. The compress
techniques that can be used come in the form of a
conventional warm compress or the tepid sponge
technique. Warm water compresses are more
effective by 74.6% at reducing the body
temperature of pediatric patients with a fever than
compress plasters (Yuliani, 2006). The tepid
sponge is one of the warm compress techniques
that combines a block technique related to the
superficial large vessels with the seka technique
throughout the body. The results of the research
conducted shows there to be a significant
comparison of effectiveness between a tepid
sponge compress and warm water compress
toward the body temperature reduction in typhoid
fever children with hyperthermia. The tepid
sponge compress show a greater reduction in
numbers compared to the warm water compress
(Susanti, 2012). Child nursing uses
the principle of a family care center that there is a
family partner in contact related to child care. The
associated nurse provides appropriate information
for them to make decisions, assesses the family
needs and gathers the families to help them learn of
appropriate resources in their environment (Suyanto,
2011).
This research was carried out for 3 weeks by
compressing 1 respondent for 15 - 20 minutes (to
avoid the rebound phenomenon). The respondents
were children who had typhoid fever in the inpatient
ward of the Kampili health center, totaling 20
respondents.
The respondents in this study each received
parenteral fluid therapy in the form of IVFD Ringer
Lactat and antiperetic therapy. None of the
respondents had any secondary diseases. This was
based on the medical diagnoses concluded from the
clinical examinations and laboratory examinations
(widal test). The researchers also first examined for the
existence of a wound,; if no wound was found, then
compressing could be done. The average value of the
respondent's body temperature before being
compressed (pre test) was 37.80C for the conventional
warm compresses whereas for the tepid sponge
technique, it was 38.040C.
From the Differential Univariate-General Linear
Model and the General Linear Model-Repeated
Measure test, it is known that conventional warm
compresses and the tepid sponge technique
significantly influence body temperature changes.
Based on the results of the testing using the Univariate-
General Linear Model, it showed a value of p <α
(0,03<0,05) which concluded that there was a
difference between conventional warm compresses
and the tepid sponge technique (H0 rejected).
Based on the General Linear Model-Repeated
Measure test, the p value for conventional warm
compresses was obtained after compressing: after 5
minutes (0.07)> 0.05, the average effect given was a
decrease in body temperature of 0,150C, in 5 minutes
and up to 15 (0.01) <0.05, the average effect given was
a decrease in body temperature of 0.280C, at 30
minutes (0.78)> 0.05, the average effect given was a
decrease in body temperature of 0.010 C and at 60
minutes (0.21)> 0.05, the average effect given was an
increase in body temperature of 0.690C from the initial
temperature of the compress.
Based on the results of the statistical tests on the
changes in body temperature after being compressed,
the decrease was only found in the 5 to 15 minute
period for the conventional warm compresses while
the tepid sponge technique decreased the temperature
for between 5 to 30 minutes; 60 minutes after both
types of compress were used, there was an increase in
temperature again. Because this research was only
empirical, the researchers assume that it is influenced
by the placement of the compression cloth.
Conventional warm-sensitive neurons are less
sensitized because the compress is only placed at 1
point. Impulses from afferent nerve fibers received by
the hypothalamus to control body temperature are
determined by the receptors. Unlike what is the case
with warm compresses, the tepid sponge technique and
the placement of the compress cloth at 3 points of
afferent nerve fibers allows for the stimulus to the
receptor to be stronger which allows for decrease in
temperature for longer, up to 30 minutes after
compressing.
CONCLUSION
Based on the results of the study, it was obtained
that the average for the conventional warm
compress pre- test body temperature was 37.830C
while the average tepid sponge technique warm
compress pre-test body temperature was 38.040C.
Changes in the body temperature fluctuated in both
the conventional warm compresses and tepid sponge
technique. From the Different Univariate-General
Linear Model test, it is known that both the
conventional warm compresses and tepid sponge
technique significantly influence changes in body
temperature p = 0.03. The tepid sponge technique
is better used for fever management in children
with typhoid fever than conventional warm
compresses because the decrease in body
temperature occurs from 5 minutes through 30
minutes while the conventional warm compresses’
decrease in body temperature only lasts for 15
minutes after compressing.
Angka Persalinan Seksio Caesar Dengan Program
Jampersal Di Rsud Moewardi Surakarta, 6.
Pujiarto, P. S. (2008). Demam pada Anak. Majalah
Kedokteran Indonesia.
Http://Indonesia.Digitaljournals.Org/Index.Php
/Idnmed/Article/Download/900/899.
Purba, I. E., & Wandra, T. (2016). Program
Pengendalian Demam Tifoid di Indonesia :
tantangan dan peluang. (February 2017).
https://doi.org/10.22435/mpk.v26i2.5447.99-
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