Palenewen, Lucky Albertus and Dr. Ahsan,, SKp, M.Kes and Dr. Ns. Heni Dwi Windarwati.,, M.Kep., Sp.Kep.J (2023) Pengalaman Perawat Dalam Melaksanakan Tindakan Manajemen Bencana Gempa Bumi Pada ODGJ di Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang Manado. Magister thesis, Universitas Brawijaya.
Abstract
Gempa bumi menjadi salah satu jenis bencana alam yang paling berbahaya dan menyebabkan banyak korban di seluruh dunia. Orang dengan gangguan jiwa (ODGJ) sebagai kelompok rentan mendapat dampak besar bencana gempa seperti dampak fisik langsung, memiliki resiko mengalami post trauma stress disorder (PTSD), lambat pulih dari kejadian bencana dan memperburuk penyakit kejiwaan. Keterbatasan dan kebutuhan ODGJ menuntut peran aktif perawat untuk meminimalisir dampak sehingga kelompok ini dapat bertahan menghadapi situasi bencana. Saat ini penelitian terkait pengalaman perawat dalam melakukan tindakan manajemen bencana pada ODGJ masih kurang karena hanya berfokus pada rentan lainnya seperti penyandang disabilitas, lansia dan anak-anak. Sistem manajemen bencana menjadi kunci bagi rumah sakit dalam meminimalisir dampak bencana pada ODGJ. Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang Manado menjadi satu-satunya rumah sakit yang menjadi pusat pelayanan kesehatan jiwa di Provinsi Sulawesi Utara. Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang Manado saat ini belum memiliki kebijakan manajemen bencana dan sebagian besar perawat belum memiliki pengetahuan yang cukup terkait tindakan manajemen bencana pada ODGJ. Perawat selama ini hanya dapat memberikan respon secara spontan melakukan evakuasi tanpa adanya perencanaan dan standar operasional prosedur yang jelas saat terjadi bencana. Penelitian ini bertujuan untuk mengeksplorasi pengalaman perawat dalam melaksanakan tindakan manajemen bencana gempa bumi pada ODGJ di Rumah Sakit Jiwa. Prof. dr. V.L. Ratumbuysang Manado. Tujuan khusus dari penelitian ini yaitu (1) Mengeksplorasi persepsi perawat terhadap tindakan manajemen bencana, (2) Mengeksplorasi peran perawat pada tindakan manajemen bencana gempa bumi pada ODGJ, (3) Mengeksplorasi hambatan yang dialami perawat dalam penerapan manajemen bencana gempa bumi pada ODGJ dan (4) Mengeksplorasi harapan perawat dalam integrasi penerapan manajemen bencana gempa bumi pada ODGJ. Penelitian ini adalah penelitian kualitatif dengan menggunakan desain penelitian fenomenologi deskriptif untuk mendapatkan gambaran secara mendalam terkait tindakan manajemen bencana gempa pada ODGJ. Populasi dalam penelitian ini adalah seluruh perawat yang bekerja di Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang Manado. Partisipan dalam penelitian ini berjumlah 12 orang yang ditentukan menggunakan teknik purposive sampling. Partisipan dipilih sesuai kriteria inklusi yaitu perawat yang bekerja di Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang Manado, perawat yang memiliki pengalaman terlibat langsung pada situasi bencana di Rumah Sakit Jiwa Prof. Dr. V. L. Ratumbuysang ix Manado, perawat D III keperawatan dengan pengalaman kerja minimal 4 tahun dan 3 tahun bagi perawat yang memiliki latar belakang pendidikan ners. Pengumpulan data dilakukan dengan metode wawancara mendalam secara langsung oleh peneliti dengan menggunakan pedoman wawancara sebagai acuan. Proses pelaksanaan wawancara dilaksanakan dengan menerapkan protokol kesehatan yaitu menjaga jarak dan menggunakan masker. Hasil wawancara yang didapatkan kemudian ditranskrip oleh peneliti untuk dianalisis. Peneliti kemudian menggunakan metode analisis Colaizzi untuk melakukan analisis data pada penelitian fenomenologi ini. Hasil analisa penelitian ini didapatkan 14 tema yaitu: (1) Sigap saat bencana, (2) Mengenalkan potensi bencana serta cara mengamankan diri secara berulang dan melalui TAK, (3) Memberikan akses keluar ruangan dan mengarahkan langsung pasien yang tidak krisis ke lokasi aman, (4) Mengamankan pasien krisis dengan tindakan paksa ke titik kumpul, (5) Memberdayakan ODGJ produktif dalam kegiatan evakuasi, (6) Tanggap menenangkan pasien dan bersikap tenang serta spontan melakukan yang terbaik sesuai kemampuan, (7) Mengutamakan identifikasi dan evakuasi pasien lansia serta ODGJ dengan disabilitas fisik, (8) Melakukan perawatan holistik pasca bencana kepada ODGJ, (9) Kesulitan memahami tindakan manajemen bencana dan mengendalikan ODGJ selama evakuasi, (10) Terkendala pedoman, pendanaan, prasarana dan kesiapan sumberdaya yang belum memadai, (11) Kondisi kognitif dan hambatan komunikasi membatasi edukasi pasien, (12) ODGJ tidak merespon ancaman bencana dan tidak kooperatif saat evakuasi, (13) Berharap dibuatkan pedoman, tim dan edukasi bencana bagi perawat, dan (14) Merasa aman jika difasilitasi sarana prasarana penunjang keselamatan dan evakuasi. Berdasarkan hasil penelitian tindakan manajemen bencana pada ODGJ pada dasarnya tidak jauh berbeda dengan pasien lainnya. Akan tetapi pada ODGJ perawat harus melakukan intervensi dengan strategi khusus dan kerja lebih ekstra agar pasien mau mendengarkan arahan serta mengikuti perintah perawat guna meminimalisir dampak bencana. Hal ini dikarenakan hambatan yang timbul akibat kondisi dan keterbatasan ODGJ sebagai kelompok rentan. Hambatan komunikasi, kondisi kognitif serta ketidakmampuan ODGJ melihat bencana sebagai ancaman menjadi alasan utama ODGJ membutuhkan peran aktif perawat di setiap fase bencana. Pada fase pra bencana perawat melakukan tindakan yang membantu kesiapan pasien seperti mengenalkan potensi bencana serta cara mengamankan diri secara berulang dan melalui TAK. Pada fase saat bencana terjadi, tindakan evakuasi merupakan tindakan prioritas yang dilakukan untuk mengamankan pasien dari dampak bencana. Beberapa tindakan lain yang perawat lakukan seperti memberdayakan ODGJ produktif dalam kegiatan evakuasi dan mengutamakan identifikasi dan evakuasi pasien lansia serta ODGJ dengan disabilitas fisik. Perawat juga berusaha tanggap menenangkan pasien dan bersikap tenang serta spontan melakukan yang terbaik sesuai kemampuan. Pada fase terakhir perawatan holistik merupakan hal yang diusahakan perawat pada fase setelah bencana. Berbagai pendekatan dan intervensi dilakukan sesuai dengan kebutuhan pasien seperti fisik, mental, psikologis, memanfaatkan x pendekatan spiritual hingga kolaborasi pengobatan. Perawat berharap rumah sakit segera dibuatkan pedoman, tim dan edukasi bencana bagi perawat untuk meningkatkan peran. Selain itu, prasarana penunjang keselamatan dan evakuasi menjadi kebutuhan lain yang diharapkan untuk mendukung pelaksanaan manajemen bencana. Peneliti merekomendasikan pihak rumah sakit agar dapat membentuk tim manajemen bencana dan membuat kebijakan terkait penanggulangan bencana di rumah sakit. Selain itu, perencanaan dan pelaksanaan kegiatan edukasi terkait manajemen bencana dan strategi tindakan evakuasi pada kelompok rentan ODGJ penting diberikan secara rutin kepada perawat
English Abstract
Earthquakes are one of the most dangerous types of natural disasters and cause many victims around the world. People with mental disorders as a vulnerable group receive the major impacts of the earthquake such as direct physical impacts, have a high risk of experiencing post-traumatic stress disorder, are slow to recover from disaster events, and exacerbate mental illness. The limitations and needs of people with mental disorders demand the active role of nurses to minimize the impact so that this group can survive disaster situations. Currently, research related to the experience of nurses in carrying out disaster management actions for people with mental disorders is still lacking because it only focuses on other vulnerable people such as persons with disabilities, the elderly, and children. The disaster management system is the key to minimizing the impact of disasters on people with mental disorders. Prof. Dr. V L. Ratumbuysang Psychiatric Hospital Manado is the only hospital that is a mental health service center in North Sulawesi Province. Prof. Dr. V L. Ratumbuysang Psychiatric Hospital Manado currently does not have a disaster management policy and most of the nurses do not have sufficient knowledge regarding disaster management measures for people with mental disorders. So far, nurses can only respond spontaneously to evacuation without clear planning and standard operating procedures when a disaster occurs. This study aimed to explore the experiences of nurses in carrying out earthquake disaster management measures for people with mental disorders in Prof. Dr. V L. Ratumbuysang Psychiatric Hospital Manado. The specific objectives of this study were to explore nurses' perceptions of disaster management actions, explore the role of nurses in earthquake disaster management actions in people with mental disorders, explore the obstacles experienced by nurses in implementing earthquake disaster management for people with mental disorders and exploring the expectations of nurses in the integration of the application of earthquake disaster management for people with mental disorders. This research is a qualitative research using a descriptive phenomenological research design to get an in-depth description of earthquake disaster management measures for people with mental disorders. The population in this study were all nurses working at Prof. Dr. V L. Ratumbuysang Psychiatric Hospital Manado. There were 12 participants in this study who were determined using a purposive sampling technique. Participants were selected according to the inclusion criteria, namely nurses working at the Prof. Mental Hospital. Dr. V. L. Ratumbuysang Manado, a nurse who has experience being directly involved in disaster situations at the Prof. Dr. V L. Ratumbuysang Psychiatric Hospital Manado, Diploma nurses xii with a minimum of 4 years work experience and 3 years for bachelor nurses who have a nursing educational background. Data collection was carried out using in-depth interviews directly by researchers using interview guidelines as a reference. The interview process was carried out by implementing health protocols, namely maintaining distance and using masks. The interview results obtained were then transcribed by the researcher for analysis. The researcher then used the Colaizzi analysis method to carry out data analysis in this phenomenological study. The results of the analysis of this study obtained 14 themes, namely: (1) Be alert during a disaster, (2) Introduce potential disasters and how to protect yourself repeatedly and through group activity therapy, (3) Provide access to exit the room and direct patients who are not in crisis to the location safe, (4) Securing crisis patients by forcing them to the gathering point, (5) Empowering people with mental disorders who are productive in evacuation activities, (6) Responding to calming patients and being calm and spontaneous doing their best according to ability, (7) Prioritizing identification and evacuation of elderly patients and people with mental disorders with physical disabilities, (8) Performing post-disaster holistic care for people with mental disorders, (9) Difficulty understanding disaster management measures and controlling people with mental disorders during evacuation, (10) Constrained by inadequate guidelines, funding, infrastructure and resource readiness, (11) Cognitive conditions and communication barriers cation limits patient education, (12) People with mental disorders do not respond to disaster threats and are uncooperative during evacuation, (13) Hope that guidelines, teams and disaster education will be made for nurses, and (14) Feel safe if they are facilitated by safety and infrastructure support facilities evacuation. Based on the results of research on disaster management actions in people with mental disorders, basically they are not much different from other patients. However, for people with mental disorders, nurses must intervene with special strategies and extra work so that patients want to listen to directions and follow nurses' orders to minimize the impact of a disaster. This is due to obstacles that arise due to the conditions and limitations of people with mental disorders as a vulnerable group. Communication barriers, cognitive conditions and the inability of people with mental disorders to see disasters as a threat are the main reasons people with mental disorders need the active role of nurses in every phase of a disaster. In the pre-disaster phase, nurses take actions that help patient readiness, such as introducing potential disasters and how to protect themselves repeatedly and through group activity therapy. In the phase when a disaster occurs, evacuation is a priority action to protect patients from the effects of the disaster. several other actions that nurses take such as empowering people with mental disorders in evacuation activities and prioritizing the identification and evacuation of elderly patients and people with mental disorders with physical disabilities. Nurses also try to be responsive to calm themselves and patients and spontaneously do their best according to their abilities. In the last phase, holistic care is something that nurses try to do in the post-disaster phase. various approaches and interventions are carried out according to the patient's needs such xiii as physical, mental, psychological, utilizing a spiritual approach to treatment collaboration. Nurses hope that the hospital will immediately make guidelines, teams and disaster education for nurses to increase their role. In addition, safety and evacuation support infrastructure is another requirement that is expected to support the implementation of disaster management. The researcher recommends that the hospital be able to form a disaster management team and make policies related to disaster management in the hospital. In addition, planning and implementing educational activities related to disaster management and evacuation action strategies for people with mental disorders are important to be given regularly to nurses.
Other obstract
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| Item Type: | Thesis (Magister) |
|---|---|
| Identification Number: | 0423160007 |
| Subjects: | 600 Technology (Applied sciences) > 610 Medicine and health > 610.7 Education, research, nursing, services of allied health personnel > 610.73 Nursing and services of allied health personnel |
| Divisions: | S2/S3 > Magister Keperawatan, Fakultas Kedokteran |
| Depositing User: | soegeng sugeng |
| Date Deposited: | 08 May 2023 07:02 |
| Last Modified: | 08 May 2023 07:02 |
| URI: | http://repository.ub.ac.id/id/eprint/198941 |
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