Asuhan Keperawatan Defisit Perawatan Diri (Stroke) dengan Penerapan Self Care Training Bertahap di RSUD dr. R. Soedarsono Kota Pasuruan

Abstract

Latar Belakang: Stroke iskemik merupakan gangguan neurologis akibat terhambatnya aliran darah ke otak yang dapat menyebabkan kelemahan ekstremitas, gangguan mobilitas, dan penurunan kemampuan melakukan aktivitas sehari-hari. Kondisi tersebut sering menimbulkan masalah keperawatan defisit perawatan diri, khususnya pada aktivitas berpakaian serta makan dan minum. Salah satu intervensi yang dapat dilakukan untuk meningkatkan kemandirian pasien adalah Self Care Training menggunakan kartu bergambar sebagai media edukasi dan panduan visual. Penelitian ini bertujuan mendeskripsikan asuhan keperawatan defisit perawatan diri pada pasien stroke iskemik dengan penerapan Self Care Training menggunakan kartu bergambar. Metode: Penelitian ini merupakan laporan kasus dengan pendekatan proses asuhan keperawatan selama 3 hari pada satu pasien stroke iskemik yang mengalami defisit perawatan diri. Intervensi yang diberikan berupa Dukungan Perawatan Diri melalui Self Care Training menggunakan kartu bergambar pada aktivitas berpakaian serta makan dan minum. Latihan dilakukan secara bertahap dengan prinsip bantuan minimal (hands-off assistance), pengulangan terstruktur, serta melibatkan keluarga sebagai pendamping selama proses rehabilitasi. Hasil: Berdasarkan hasil pengkajian diperoleh data pasien mengeluhkan kesulitan berpakaian serta makan dan minum secara mandiri akibat kelemahan ekstremitas kiri (hemiparesis sinistra) pasca infark lakunar. Pasien masih memerlukan bantuan keluarga dalam melakukan aktivitas sehari-hari dengan nilai Barthel Index 11 yang menunjukkan ketergantungan sedang. Berdasarkan data tersebut ditegakkan diagnosis keperawatan Defisit Perawatan Diri. Intervensi keperawatan yang diberikan yaitu Dukungan Perawatan Diri dengan Self Care Training menggunakan kartu bergambar selama 3 hari berturut-turut. Hasil evaluasi menunjukkan peningkatan kemampuan pasien dalam berpakaian serta makan dan minum secara mandiri, kemampuan mengikuti urutan langkah pada kartu bergambar, berkurangnya kebutuhan bantuan keluarga, serta meningkatnya kepercayaan diri dan motivasi pasien dalam melakukan aktivitas perawatan diri. Nilai Barthel Index meningkat dari 11 menjadi 12 yang menunjukkan peningkatan tingkat kemandirian pasien. Kesimpulan: Penerapan asuhan keperawatan pada pasien stroke iskemik dengan Defisit Perawatan Diri melalui Self Care Training menggunakan kartu bergambar terbukti membantu meningkatkan kemandirian pasien dalam aktivitas berpakaian serta makan dan minum. Intervensi ini dapat digunakan sebagai salah satu tindakan keperawatan nonfarmakologis untuk meningkatkan kemampuan perawatan diri dan mengurangi ketergantungan pasien pasca stroke

ABSTRACT Introduction: Ischemic stroke is a neurological disorder caused by a blockage in blood flow to the brain, which can lead to weakness in the limbs, mobility issues, and a decline in the ability to perform daily activities. This condition often leads to nursing issues related to self-care deficits, particularly regarding dressing, eating, and drinking. One intervention that can be implemented to enhance patient independence is Self-Care Training using picture cards as an educational tool and visual guide. This study aims to describe nursing care for self-care deficits in ischemic stroke patients through the implementation of Self-Care Training using picture cards. Methods: This study is a case report describing a 3-day nursing care process for a patient with ischemic stroke who had impaired self-care abilities. The intervention provided consisted of self-care support through self-care training using picture cards for activities such as dressing, eating, and drinking. The training was conducted in stages based on the principles of minimal assistance (hands-off assistance), structured repetition, and involving family members as companions during the rehabilitation process. Results: Based on the assessment results, it was found that the patient complained of difficulty dressing and eating and drinking independently due to weakness in the left extremities (left hemiparesis) following a lacunar infarction. The patient still requires family assistance with daily activities, with a Barthel Index score of 11, indicating moderate dependence. Based on this data, a nursing diagnosis of Self-Care Deficit was established. The nursing intervention provided was Self-Care Support through Self-Care Training using picture cards for 3 consecutive days. Evaluation results showed an improvement in the patient’s ability to dress and eat and drink independently, the ability to follow the sequence of steps on the picture cards, a reduction in the need for family assistance, as well as increased self-confidence and motivation in performing self-care activities. The Barthel Index score increased from 11 to 12, indicating an improvement in the patient’s level of independence. Conclusion: The implementation of nursing care for patients with ischemic stroke who have self-care deficits, through self-care training using picture cards, has been shown to help improve patients’ independence in dressing, eating, and drinking. This intervention can be used as a nonpharmacological nursing intervention to improve self-care abilities and reduce dependence in post-stroke patients