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Evidence-Based Nursing Practice dengan Mobilisasi Dini Berdasarkan Teori Defisit Perawatan Diri Orem pada Pasien Stroke Iskemik: Studi Kasus: Evidence-Based Nursing Care with Early Mobilization Based on Orem’s Self-Care Deficit Theory in an Ischemic Stroke Patient: A Case Study Kurnia, Gian M; Agusni, Wulan; Susilawati, Susilawati; Hamami, Ayatullah
Jurnal Abdi Keperawatan dan Kedokteran Vol 5 No 1 (2026): Jurnal Abdi Kesehatan dan Kedokteran
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/jakk.v5i1.156

Abstract

Ischemic’ stroke is a leading cause of disability and mortality worldwide, particularly among older adults, and requires comprehensive, evidence-based management. Nursing care plays a crucial role in optimizing cerebral perfusion, preventing complications, and promoting functional recovery. This case study aims to describe the implementation of comprehensive nursing care using an Evidence-Based Nursing (EBN) approach integrated with Dorothea Orem’s Self-Care Deficit Nursing Theory in a patient with ischemic stroke.Smoking among adolescents remains a major public health concern in Indonesia. One preventive strategy is to enhance students’ self-efficacy to resist peer pressure to smoke. Health education is believed to improve self-efficacy, yet its effectiveness requires further empirical validation. A'descriptive case study was conducted on a 67-year-old female patient diagnosed with ischemic stroke and admitted to an inpatient ward. Comprehensive nursing assessment included neurological, hemodynamic, respiratory, nutritional, mobility, and self-care status. Assessment instruments used were the Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS), and Barthel Index. Nursing diagnoses were established based on the Indonesian Nursing Diagnosis Standards (SDKI), while interventions and outcomes were planned using the Indonesian Nursing Intervention Standards (SIKI) and Indonesian Nursing Outcome Standards (SLKI). The'main nursing diagnoses identified were decreased intracranial adaptive capacity, impaired gas exchange, decreased cardiac output, impaired physical mobility, and nonadherence to the therapeutic regimen. Evidence-based nursing interventions included intracranial pressure management, oxygen therapy, early post-stroke mobilization, self-care support, medication adherence education, and family involvement. Evaluation showed improvement in the patient’s level of consciousness, stabilization of vital signs, reduced headache intensity, increased muscle strength, and enhanced functional independence. NIHSS scores improved from moderate to mild neurological deficit, and the Barthel Index increased from severe to moderate dependency.
Kombinasi Teknik Relaksasi Benson dan Aromaterapi Lavender dalam Menurunkan Nyeri dan Ansietas pada Pasien Lansia dengan Closed Fracture of Neck Femur Dextra: Sebuah Studi Kasus: The Combination of Benson Relaxation Technique and Lavender Aromatherapy in Reducing Pain and Anxiety in Elderly Patients with Closed Fracture of the Right Femoral Neck: A Case Study Agusni, Wulan; Kurnia, Gian M.; Susilawati, Susilawati; Suku, Alexander Mela Geniko
Jurnal Abdi Keperawatan dan Kedokteran Vol 5 No 1 (2026): Jurnal Abdi Kesehatan dan Kedokteran
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/jakk.v5i1.169

Abstract

Background and Objectives: Elderly patients with hip fractures often experience severe pain and anxiety, which can impede recovery. Non-pharmacological interventions such as Benson's relaxation and lavender aromatherapy have shown potential in managing these symptoms, but evidence of their effectiveness in geriatric orthopedic settings remains limited. This case study aimed to evaluate the effects of a combination of both therapies on pain, anxiety, mobility, and vital signs in a geriatric patient following hip fracture surgery. Methods: This study used a single-subject case study design. The sample was a 72-year-old female diagnosed with a closed fracture of the right femoral neck post-hip replacement surgery. The combined intervention of Benson's relaxation (twice daily, 15 minutes) and lavender aromatherapy inhalation (twice daily, 30 minutes) was administered for four days alongside standard care. Measured variables included pain intensity (numerical rating scale 0-10), anxiety level (Hamilton Anxiety Rating Scale / HARS), lower extremity joint range of motion (ROM scale 0-5), and vital signs (blood pressure, pulse, respiration). Data collection instruments comprised observation sheets, the HARS questionnaire, and a numerical pain scale. Main Results: After four days of intervention, significant reductions were observed in pain intensity (from 5/10 to 2/10) and HARS anxiety scores (from 30 [severe] to 9 [mild]). Patient mobility improved, as indicated by an increase in lower extremity ROM from 3/5 to 4/5. Vital signs (blood pressure, pulse, respiration) showed a stabilizing trend within the normal range. No adverse effects or undesirable events were reported during the intervention period. Conclusion: Based on the findings, the combination of Benson's relaxation and lavender aromatherapy was effective in reducing pain and anxiety, improving mobility, and stabilizing vital signs in a geriatric patient post-hip fracture surgery. This combined therapy is safe and has the potential to be integrated as a complementary, evidence-based perioperative management strategy for the geriatric population in orthopedics. Further studies with more robust designs and larger samples are needed to generalize these findings.