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All Journal Indonesian Journal of Global Health research MAHESA : Malahayati Health Student Journal
Freitas, Lurdes Acorta
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Dentistry Education Health Professions Languange, Linguistic, Communication & Media Nursing Public Health

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Pengalaman Perawat Dalam Menghadapi Dilema Etik Pada Pasien Paliative Di ICU: A Scoping Review Rizkianti, Intan; Freitas, Lurdes Acorta; Sesilia, Fitri; Kurhayati, Kurhayati; Reis, Silvestre Dos; Nasrullah, Kurnia; Trisyani, Yanny
MAHESA : Malahayati Health Student Journal Vol 5, No 7 (2025): Volume 5 Nomor 7 (2025)
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mahesa.v5i7.18922

Abstract

ABSTRACT Nurses in intensive care units (ICU) often face ethical dilemmas when caring for palliative patients. Decisions made at this late stage of a patient's life have a major impact on the quality of life of the patient and their family, and can trigger conflicts between professional values, patient expectations, and family needs. This study aimed toexplore the experiences of ICU nurses in facing ethical dilemmas in palliative patients and to map the main ethicalissues faced. Methods: This study used a scoping review approach with literature search through several databases, such as Pubmed, Ebsco, and Science Direct. The article searches and analysis was from November to December 2024. Inclusion criteria included studies published from 2014-2024 related to ethical dilemmas in palliative care in the ICU, with experimental, case study, and qualitative descriptive research designs. Relevant articles were screened following PRISMA guidelines and analyzed qualitatively descriptively. Of the 19,765 articles identified, 8 articles metthe inclusion criteria and were analyzed further. Nurses faced ethical dilemmas that included conflicts in carrying outprofessional roles, feeling sandwiched between patient wishes and family expectations, and organizational policylimitations. The two main categories found were conflict within the professional role and conflict between personal autonomy and external demands, including pressure from family and coworkers. The importance of improvingeffective communication, emotional support, multidisciplinary teamwork, clinical ethics training and education, developing adaptive coping strategies, and support policies in an effort to minimize the stress experienced by nurses infacing ethical dilemmas in caring for palliative patients. Keywords: Ethics, Nurse, Palliative Care ABSTRAK Perawat di unit perawatan intensif (ICU) sering menghadapi dilema etik ketika merawat pasien paliatif. Keputusan yang diambil pada tahap akhir kehidupan pasien ini memiliki dampak besar terhadap kualitas hidup pasien dan keluarganya, serta dapat memicu konflik antara nilai profesional, harapan pasien, dan kebutuhan keluarga. Penelitian ini bertujuan untuk menggali pengalaman perawat ICU dalam menghadapi dilema etis pada pasien paliatif dan dalammemetakan isu-isu etika utama yang dihadapi. Studi ini menggunakan metode pendekatan scoping review dengan pencarian literature melalui beberapa database, seperti Pubmed, Ebsco, dan Science Direct. Pencarian serta analisis artikel dilakukan bulan November hingga Desember 2024. Dengan Kriteria inklusi meliputi studi yang dipublikasikansejak 2014-2024 yang berkaitan dengan dilema etika dalam perawatan paliatif di ICU, dengan desain penelitian eksperimental, studi kasus, dan deskriptif kualitatif. Artikel yang relevan diseleksi mengikuti pedoman PRISMA dan dianalisis secara kualitatif deskriptif. Dari 19.765 artikel yang teridentifikasi, 8 artikel memenuhi kriteria inklusi dan dianalisis lebih lanjut. Perawat menghadapi dilema etis yang mencakup konflik dalam melaksanakan peran profesional, perasaan terjepit antara keinginan pasien dan harapan keluarga, serta keterbatasan kebijakan organisasi.Dua kategori utama yang ditemukan adalah konflik dalam peran profesional dan konflik antara otonomi pribadi dengan tuntutan eksternal, termasuk tekanan dari keluarga dan rekan kerja. Pentingnya peningkatan komunikasi efektif, dukungan emosional, kerja sama tim multidisplin, pelatihan dan edukasi etik klinik, pengembangan strategi koping adaptif, dan dukungan organisasi dalam upaya meminimalisir stress yang dialami oleh perawat dalam menghadapi dilema etik merawat pasien paliatif. Kata Kunci: Dilema Etik, Perawat, Perawatan Paliatif
Septic Shock due to Acinetobacter Baumannii Infection with Complications of Acute Respiratory Distress Syndrome: A Case Report Christina, Mikha; Noya, Fricilia; Freitas, Lurdes Acorta; Reis, Silvestre Dos; Priambodo, Ayu Prawesti; Mirwanti, Ristina
Indonesian Journal of Global Health Research Vol 6 No 5 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i5.3466

Abstract

Sepsis shock, characterized by sepsis-induced circulatory or metabolic disturbances, remains the leading cause of death in ICUs globally. Infection by Acinetobacter baumannii, which is frequently found in medical environments, can trigger life-threatening sepsis shock. This condition occurs when the bacteria or its bacterial products trigger adverse reactions from the immune system. ARDS, as a serious complication, results from endothelial damage that causes fluid to enter the alveoli, disrupting gas exchange and leading to respiratory failure. Purpose to describe a case in a patient diagnosed with epilepticus, with a history of autistic disorder, and non-specific pneumonia aged 30 years. This case report reviews a 30-year-old man admitted with a diagnosis of status epilepticus, with a history of autistic disorder, and non-specific pneumonia. The patient showed progressive improvement with initial therapy, including antiepileptic therapy and empirical antibiotics for pneumonia. However, the patient's condition deteriorated later, resulting in Acute Respiratory Distress Syndrome (ARDS) due to septic shock by Acinetobacter baumannii. The patient required mechanical ventilation and intensive management, including a change in antibiotic therapy and tracheostomy. With appropriate intervention, the patient showed improvement and was successfully discharged from mechanical ventilation. This patient with severe ARDS caused by sepsis shock due to Acinetobacter baumannii infection, demonstrates the importance of prompt and appropriate management of the complications of sepsis to prevent the patient's death. Acinetobacter baumannii infection causing ARDS and sepsis shock is a serious and rarely reported case, where aggressive treatment of sepsis with appropriate antibiotics and careful management of mechanical ventilation can improve the progression of ARDS.
Interventions for Reducing Post-Traumatic Stress Disorder in Intensive Care Unit Survivors: A Scoping Review Ramdani, Dadan; Larashati, Defa; Freitas, Lurdes Acorta; Lilikliswati, Nur Azmi; Suryani, Suryani
Indonesian Journal of Global Health Research Vol 6 No 6 (2024): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v6i6.3746

Abstract

Post Traumatic Stress Disorder (PTSD) is a serious condition that patients often experience after undergoing intensive treatment in the ICU. Traumatic experiences during ICU care can cause significant and prolonged symptoms. PTSD has a major impact on patients' quality of life after discharge from the ICU. Various literatures have not comprehensively discussed PTSD in ICU survivors. Objective: To explore interventions in reducing PTSD symptoms in ICU survivors. Method: This study used the scoping review method with article searches from three databases, namely CINAHL, PubMed, and Medline. Keywords used included "ICU diaries," “interventions,” "post-ICU recovery program," and "PTSD." Inclusion criteria included original research articles with quasi-experimental or RCT designs, written in English, focusing on ICU survivors and the impact of PTSD, and a publication period of the last 10 years (2014-2024). Data extraction used manual tables. Data were analyzed using qualitative descriptive methods. Results: Eight relevant articles discussing interventions to reduce PTSD in ICU survivors were found. The study results indicate that there are two types of interventions, ICU diaries and post-ICU recovery programs, which are effective in reducing PTSD, anxiety, and depression symptoms in ICU survivors. The effectiveness of these interventions is supported by active family involvement, personalization of the intervention, and support from medical staff. Influencing variables include family involvement, method of intervention implementation, and continuous support from the medical team. Conclusion: This scoping review identifies that ICU diaries and post-ICU recovery programs are effective in reducing PTSD symptoms in ICU survivors. Further research is needed to explore the long-term effectiveness of these interventions and the development of best practices in post-ICU care.
Co-Authors Ayu Prawesti Priambodo Christina, Mikha Kurhayati, Kurhayati Larashati, Defa Lilikliswati, Nur Azmi Nasrullah, Kurnia Noya, Fricilia Reis, Silvestre Dos Ristina Mirwanti, Ristina Rizkianti, Intan Sesilia, Fitri Suryani Suryani Yanny Trisyani