holistik nursing practice
TRANSCRIPT
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Holistik NursingPractice
Presented by : Sofiana
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NURSE HEALER OBJECTIVES
• THEORETICAL1. Synthesize the concepts of natural systems theory2. Compare and contrast the allopathic and holistic models of
health care3. Describe the components of the bio-psycho-social-spiritual
model4. Describe the practice and standards of holistic nursing5. Compare and contrast the different eras of medicine6. Discuss the activities of the National Center for
Complementary and Alternative Medicine (NCCAM)
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• CLINICALExplore two ways to integrate a natural systems view into your
clinical practiceDetermine if you use a bio-psycho-social-spiritual model to guide
your clinical practiceIntegrate the standards of holistic nursing established by the
American Hilistic Nurses Association (AHNA) into clinical practice, education and research
Integrate complementary and alternative therapies into clinical practice
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• PERSONALIntegrate complementary and alternative therapies into your
daily life to enhance your well beingDevelop short and long term goals related to increasing your
commitment to the holistic developmental process
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DEFINISI
• Allopathic/traditional therapies ; medical, surgery, prosedur perawatan diagnostik invasif dan non invasif
• Caring-healing intervention : terapi non tradisional yang dapat digabungkan dengan terapi tradisional medical dan surgical, dapat digunakan sebagai pelengkap perawatan konvensional medical dan surgical, dapat disebut juga sbg alternative/complementary/integrative therapies or intervention
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• Client of holistic nursing : individu, keluarga, kelompok, atau komunitas manusia yang berinteraksi dengan perawat holistik dengan memperhatikan pada pengalaman subjektif klien tentang kesehatan, kepercayaan tentang kesehatan, nilai-nilai, orientasi seksual, dan pilihan pribadi.
• Cultural competence : kemampuan untuk membuat agar petugas kesehatan mengetahui dan sensitif terhadap faktor budaya yang terdapat pada kebiasaaan kesehatan seseorang
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• Environment : segala sesuatu yang berada di sekitar manusia, baik berupa eksternal dan internal (fisik, mental, emosional, dan spiritual)
• Healing : proses menyatukan aspek diri seseorang, tubuh-pikiran-jiwa pada tingkat yang lebih dalam untuk mengetahui dan mengarah pada integrasi dan keseimbangan dengan masing2 aspek yg memiliki kepentingan nilai yang sama; dapat menyebabkan tingkat pemahaman dan pemaknaan yang kompleks; mungkin sinkron tetapi tidak sama dengan mengobati
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• Healing process; proses yang terus menerus untuk berubah dan berkembang pada diri seseorang selama hidup; kesadaran terpola yang mendukung atau tantangan/hambatan kesehatan dan penyembuhan; dapat dilakukan secara sendiri ataupun di komunitas penyembuhan
• Health : kondisi atau proses dimana individu (perawat, klien, keluarga, kelompok atau komunitas)memiliki pengalaman dalam kondisi sejahtera, harmonis, dan kesatuan dimana pengalaman individu tentang kesehatan, keyakinan kesehatan, dan nilai2 dihargai.
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• Health Promotion; aktifitas dan langkah-langkah pencegahan misal imunisasi, program kebugaran/latihan, pemeriksaan payudara sendiri, nutrisi yang sesuai, relaksasi, managemen stres, dukungan sosial, beribadah, meditasi, upacara penyembuhan, praktek budaya, dan promosi kesehatan lingkungan dan keamanan
• Holistic caring process ; proses yang menyeluruh meliputi 6 langkah yang muncul secara simultan. Meliputi; pengkajian, pola/tantangan, kebutuhan, outcomes, therapeutic care plan, implementasi, dan evaluasi
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• Holistic communication; pertukaran verbal dan nonverbal yang bebas antara orang2 dan makhluk yang signifikan seperti hewan peliharaan, alam, Tuhan/kekuatan hidup/mutlak/transendenyang menggali makna dan ide2 yang mengarah pada saling pengertian dan pertumbuhan
• Holistic nurse : seorang perawat yang mengenali dan mengintegrasikan prinsip dan modalitas tubuh-pikiran-semangat pada kehidupan sehari-hari dan praktek klinik; seseorang yang menciptakan ruang penyembuhan dalam dirinya sendiri/dirinya sendiri yang memungkinkan perawat untuk menjadi instrument penyembuhan untuk menolong orang lain menjadi aman dan harmonis; seseorang yang memberikan keaslian kehadiran yg tidak terkondisi untuk menghilangkan hambatan proses penyembuhan
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• Human caring process : kondisi moral yang mengantarkan perawat holistik secara menyeluruh kedalam hubungan secara umum atau signifikan yang menitikberatkan pada arti dan pengalaman sebagai sendiri dan kesatuan
• Patterns/challenges/needs: proses kehidupan aktual dan potensial seseorang yang berhubungan dengan kesehatan, penyakit, atau sakit dimana dapat atau tidak dapat berpengaruh terhadap kesejahteraan
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• Person ; individu, klien, pasien, keluarga, anggota, orang pendukung atau anggota komunitas yang memiliki kesempatan untuk berinteraksi dengan perawat holistik
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HOLISM
• NATURAL SYSTEMS THEORYSuatu cara memahami keterkaitan struktur alam di
dalam alam semesta.Struktur alam bervariasi dalam ukuran, mulai dari
tingkat partikel subatom (quark) hingga ke alam semesta, namun masing2 memiliki karakter yg spesifik pd sebuah struktur dan diatur oleh organisasi yg berprinsip sama
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Perubahan terhadap salah satu bagian hirarki dapat berakibat pada seluruh bagian yg lain
Perubahan dpt muncul pd seluruh level scr simultan; contoh efek adanya riak saat sebuah kerikil dilemparkan kedalam air maka permukaan akan mengalami perubahan, dan secara simultan akan mengubah permukaan air di atas maupun di bawah.
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Patterns of Natural Systems Components :
Person
SystemsOrgans TissuesCellsOrganellesMoleculesAtomsSubatomic particlesQuarks
Phys
ical
&
Biol
ogic
al sc
ienc
e
Trad
ition
al
Wes
tern
M
edic
ine
Universe Earth Human beingsCultureSubcultureCommunityFamily
Soci
al sc
ienc
e
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Traditional biomedical western biasanya memandang penyakit mulai dari tingkat sistem dan berakhir pada tingkat molekul.
Dari perspektif yang lebih tepat dari pendekatan sistem alam, penyakit dapat berasal dari gangguan pada setiap tingkat dari sub-atomik sampai suprapersonal, dan mungkin terjadi ketika kekuatan diganggu atau mengganggu struktur dari sistem alam itu sendiri.
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• BIO-PSYCHO-SOCIAL-SPIRITUAL MODELSemua penyakit memiliki komponen psikosomatik,
dan biologis, psikologis, social & spiritual selalu berkontribusi pada sypmtom, penyakit atau sakit pasien.
Dimensi spiritual dalam model bio-psycho-social-spiritual digabungkan dgn spiritual digunakan dlm konteks yg luas; nilai, arti dan tujuaan dalam hidup.
Merefleksikan sifat manusia thd caring, love, honesty, wisdom, & imagination
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HOLISTIC NURSING
2 tantangan keperawatan di abad 22 :a. Mengintegrasikan konsep technology, mind,
and spirit kedalam praktik keperawatanb. Membuat dan mengintegrasikan model bagi
perawatan kesehatan sebagai pedoman penyembuhan diri sendiri dan orang lain
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ERAS OF MEDICINE
• “Doing” and “Being” TherapiesHolistic nursing use both “doing” & “being” therapies.Doing therapies include almost all forms of modern
medicine, such as medication, procedures, dietary manipulations, radiation, and acupuncture.
Being therapies do not employ things, but instead use state of consciousness ; imagery, prayer, meditation & quiet contemplation, as well as the presence & intention of the nurse.
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• Rational vs Paradoxal HealingRational healing experiences include those
therapies or events that make sense to our linear, intellectual thought process, whereas paradoxical healing experiences include healing events that may seem absurd or cantradictory but are, in fact true.
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Continuum of Rational & Paradoxical Healing :
Paradoxical healing
Miracles
Prayer
Placebo effects
Biofeedback
Psychological counseling
Drugs
Irradiation
Surgery
Rational healing
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• Complementary and Alternative Therapy (CAM)
Defined as those interventions neither taught widely in medical schools nor generally available in U.S hospitals. Or a broad set of health care practices (already available to the public), that are not readily integrated into the dominant health care model because they challenge diverse societal beliefs & practices (cultural, economic, scientific, medical & educational)
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Classification of CAM Therapies Defined By The national Center for Complementary and Alternative Medicine (NCCAM)
1. Alternative Medical Systemsbuilt upon complete systems of theory & practice. Examples ;AcupunctureAnthroposophic medicineAyurvedaEnvironmental medicineHomeopathic medicineNatural productsShamanism Tibetan medicineTraditional chinese medicine
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2. Biologically Based Therapies use substances found in nature, such as herbs, foods, and
vitamins. Examples ;Antioxidizing agentsCell treatmentChelation therapyMetabolic therapyOxidizing agents (ozone, hydrogen peroxide)Macrobiotics and other therapeutic diet programsMegavitaminsNutritional supplementsBotanical medicine
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3. Manipulative and Body-Based Methodsbased on manipulation and/or movement of one or more parts
of the body. Example ;AcupressureAlexander techniqueBiofield therapeuticsChiropractic medicineFeldenkrais methodMassage therapyOsteopathic manipulationReflexologyTrager methodZone therapy
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4. Energy Therapiesthe use of energy fields. They are 2 types ; biofield therapies are
intended to affect energy fields that purportedly surround and penetrate the human body. The existence of such fields has not yet been scientifically proven. Some forms of energy therapy manipulate biofields by applying pressure and/or manipulating the body by placing the hands in, or through, these fields.
Examples ;Qi gongReikiTherapeutic touchHealing touch …………………..continue
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Bioelectromagnetic-based therapies involve the unconventional use of electromagnetic fields such as pulsed fields, magnetic fields, or alternating current or direct current fields
Examples ;ElectroacupunctureElectromagnetic fieldsElectrostimulation and neuromagnetic stimulation devicesMagnetoresonance spectroscopyMagnets/ magnetic fieldsQi gongReikiTherapeutic touchHealing touch
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5. Mind – Body Interventionuses a variety of techniques designed to enhance the mind’s
capacity to affect bodily function and symptoms. Some techniques that were considered CAM in the past have become mainstream (for example, patient support groups and cognitive-behavioural therapy).
Other mind-body techniques are still considered CAM, including meditation, prayer, mental healing and therapies that use creative outlets such as art, music, or dance
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• Art therapy• Biofeedback• Counseling• Dance therapy• Guided imagery• Humor therapy• Hypnotherapy• Meditation• Music therapy• Prayer• Psychotherapy• Relaxation techniques• Support groups• Tai chi• yoga
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Additional Intervention frequently Used by Holistic Nurses :AromatherapyAutogenicsBreathing exercisesCognitive therapyCommunity-based health care practicesExercise and movementGoal setting and contractingHealing presenceHealing touch modalitiesHolistic self-assessmentsJournalingNutrition counseling …………………..continue
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• Play therapy• Self- care intervention• Self-reflection• Smoking cessation• Weight management
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RELATIONSHIP-CENTERED CARE
• PATIENT-PRACTITIONER RELATIONSHIP
• COMMUNITY-PRACTITIONER RELATIONSHIP
• PRACTITIONER-PRACTITIONER RELATIONSHIP