Data Special The analgesic effect of in20Eur20J20 Pain.pdf .
2013 was recorded incidence Sectio Caesarea deliveries on average each
month in 38 patients. This increase is allegedly due to
improved techniques and facilities, the operation lasted more aseptic, anesthetic
techniques improved, comfort pasectio caesarea higher operating, and the length
of the short growing and can choose the date of birth as you wish Roeshadi,
2006. Nevertheless Caesarea operation pharmacological nursing activities that
can assist in the relief of pain. One of them is progressive relaxation, non-
pharmacological methods of pain relief that has a very low risk. Although such
action is not a substitute for drugs, such action is necessary to shorten episodes
of pain that lasts only a few seconds or minutes.
Based on the above description researchers interested in conducting
does not mean free of risks or problems. research on
“The Influence Of Research by Hillan about pain post
Sectio known that on days 1-2 clients still experiencing pain in the wound, and
even almost half of women lasts until they return home, and even about 32
of patients who performed the cesarean is still experiencing pain in injuries, and
often pain in the wound after returning gain weight thus requiring analgesics.
Steer, 2004 stated that relaxation is a method of transfer of non-
pharmacological pain that is often used in the UK. Steer in the study reported
that as many as 34 women using relaxation, by induction of relaxation for
15 minutes can significantly reduce the sensory component of pain. Pillips
added that the emotional component of pain is also reduced so that the effect of
exacerbating anxiety was also reduced due to the impact of the relaxation
Mander, 2004. Relaxation can be used in episodes of acute and chronic pain to
reduce pain. Usually it takes 5-10 training sessions before a client can
effectively minimize pain. Patients who already know about the relaxation
techniques may just need to be reminded to use such techniques to reduce or
prevent the pain. The basic aim of relaxation is to help people to relax, and
thus improve the various aspects of physical health. Besides, there are also
some other benefits, which lead to inner peace, reduced anxiety, lower heart rate,
reduce blood pressure, a greater resistance to disease, mental health
getting better and better memory.
Many patients and health teams tend to view drugs as the only method to
relieve pain, but many non-
512 Progressive Relaxation To Decrease
Pain For Patients Of Sectio Caesarea Surgery In The First And Second Day”
in the Maternity Room of the District General Hospital Kediri.
Formulation of the Problem
Based on the description of the background of the problem, it can be
formulated research problem, namely “Is there a The Influence Of Progressive
Relaxation To Decrease Pain For Patients Of Sectio Caesarea Surgery In
The First And Second Day in the Maternity Room of the District General
Hospital Kediri?”
Purpose 1. General Purpose
To determine differences in the level of pain in patients with postoperative
Sectio Caesarea before and after being given the progressive
relaxation technique in Maternity Room General Hospital of Kediri.
2. Special Purpose a. Identify the level of pain before
the progressive relaxation in patients with postoperative sectio
caesarea in the first and second day.
b. Identify the level of pain after doing the progressive relaxation
in patients with postoperative sectio caesarea in the first and
second day.
c. Analyzing the influence of progressive relaxation to decrease
postoperative pain in patients
Code Scale Pain
1 5
2 4
3 4
4 4
5 3
6 7
7 5
8 3
9 7
Mean 4,67
Median 4
Modus 4
Stand. Dev
1,5 3
4 4
5 5
5 6
7 7
6 8
5 9
7 Mean
5,66 Median
6 Modus
6 stand. Dev
1
Code Pain Scale
1 6
2 6
sectio caesarea in the first and second day.
Research Design
The research design used in this research is the design of pre-
experimental design One group pretest- posttest, which in this design there is no
comparison group control, but most do not already made the first observation
pre-test that allows researchers can test changes occurred after the experiment.
Based on the table shows that out of 9 respondents surveyed 11.11 or 1
Pre test test
01
Treatment
X
Post
02
respondent experienced pain with pain scale 4, 33.33 or 3 respondents
experiencing pain with pain scale 5, 33.33 or 3 respondents experiencing
pain with pain scale 6 and 22.22 or 2
The independent variable in this study is a progressive relaxation. The
dependent variable in this study is the reduction of postoperative pain in
patients Sectio Caesarea.
The study population was 38 patients with postoperative sectio
caesarea experiencing pain in the first and second day. In this study, samples
taken part sectio caesarea postoperative mothers who experience pain in the first
and second day as many as 9 respondents. In this study, the sampling
technique used was purposive sampling, where the technique of determination of
sample by choosing among a population sample in accordance with the desired
researchers in accordance with the criteria. The data analysis was done
through descriptive analysis, the observation of the frequency table.
Frequency table consists of a column - a column that contains frequencies and
percentages for each category.
Research Result 1. Respondents pain scale before action
is taken progressive relaxation techniques
513 respondents experiencing pain with pain
scale 7. the mean 5.67, median 6, 6 mode and standard deviation 1.
2. Pain scale respondents action after progressive relaxation techniques
Based on the table shows that out of 9 respondents surveyed 22.22 or 2
respondents experiencing pain with pain scale 3, 33.33 or 3 respondents
experiencing pain with pain scale 4, 22.22 or 2 respondents experiencing
pain with pain scale 5 and 22.22 or 2 respondents experiencing pain with pain
scale 7. The Mean Value 4.6, 4 Median,
Resp. Number
Before After
Decrease pain scale
1 6
5 1
2 6
4 2
3 4
4 Tetap
4 5
4 1
5 5
3 2
6 7
7 Tetap
7 6
5 1
8 5
3 2
9 7
7 Tetap
Mean 5,66
4,67 1,5
Median 6
4 1,5
Modus 6
4 1
Stand. dev.
1 1,5
0,54 mode 4 and the Standard deviation of
1.5. 3. Analysis of the effect of progressive
relaxation in patients with postoperative sectio caesarea in
Maternity Room General Hospital District Kediri.
Based on the results of research conducted it appears that there is a
decrease pain scale by the respondents, the descriptive statistical tests obtained
prior to action relaxation techniques mean value of 5.66, the median value of
6.00, the value of 6:00 mode, and standard deviation of 1. After the action
is obtained the mean 4.67, median values of 4.00, 4.00 value mode, and
standard deviation of 1.5. Value indicates a decrease in the mean value of
1.5, the median value of 1.5, the value of mode 1 and a standard deviation of 0.54
so that H0 is rejected and H1 accepted. It showed no effect of relaxation
techniques on a scale decrease postoperative pain in patients sectio
caesarea on the first day and the second in the Maternity Room General Hospital
of Kediri.
514
Discussion 1. Pain scale before the patient is given
the actions of progressive relaxation techniques.
Pain scale before being given a progressive relaxation technique that
measures of 9 respondents surveyed in the last 2 weeks Mean pain scale
score was 5.6, median 6, 6 mode and standard deviation 1.
Pain is an uncomfortable feeling, whether mild or severe. Pain
is defined as a condition that affects a persons existence is unknown and if
someone ever experienced Tamsuri, 2007. According to the International
Association for the Study of Pain IASP, pain is an emotional
experience unpleasant feelings as a result of actual or potential damage,
or describe the condition of the occurrence of damage.
According to the researcher scale of perceived pain patients in the
Maternity Room District General Hospital Kediri is influenced by
several things including the age and experience of sectio caesarea
operation. Showed that of the majority of respondents aged 20-30
years and 2 respondents had never undergone surgery sectio caesarea. It
can be concluded that the different scale of perceived pain patients due
to surgery sectio caesarea experience before.
2. Pain scale after the patient is given the actions of progressive relaxation
techniques. The scale of the pain that is
felt after the patient is given the actions of progressive relaxation
techniques, decreased pain skla into Mean Value 4.6, 4 Median, Mode 4,
the standard deviation is 1.5.
Progressive relaxation technique is to focus on a muscle
activity by identifying the tense muscles then lowers the tension by
doing relaxation techniques to get a feeling of relaxation Murphy, 1996.
It is also based on the theory of the
gate control, explaining that the pain that occurs in a person due to certain
stimuli such as surgery can be blocked when the interaction
between the pain stimulus and the stimulus to the fibers that transmit
sensations of pain blocked on the circuit gate resistor, this reversal can
be done through distraction or by the action of relaxation Sutherland,
2005.
According to researchers pain scale decline in respondents
influenced surgery sectio caesarea experience and capabilities of
different respondent in conducting different respondents in performing
relaxation techniques are taught, so the impact on respondents perceived
pain scale. So the difference in results or the effect of relaxation
techniques performed in this study indicate that the need for health
workers to improve the ability to analyze the factors that affect pain
scale and improve skills in using the techniques of progressive relaxation
as one alternative to reduce the pain scale for patients other than use
drugs.
Conclusion
progressive relaxation techniques are taught. So with relaxation techniques
is expected patients assisted by nurses can use it as an action to lower
the scale of pain experienced, in addition to using the drug.
3. Progressive relaxation influence on reducing postoperative pain in
patients sectio caesarea on the first day and the second in the Maternity
Room General Hospital District Kediri.
Based on the results of the study showed a decrease in the pain
scale sixth respondent after given action relaxation techniques, to
obtain penurunkan mean values of 1.5, 1.5 median, mode 1, and
standard deviation of 0.54 means that there is a decrease in the pain scale of
respondents.
The factors that affect pain scale include age, gender, culture,
anxiety and past experiences and 1.
2.
3. Pain scale measures a patient prior
to relaxation techniques obtained a mean value of 5.6, the median 6, 6
mode and standard deviation 1.
The scale of the patients pain after the relaxation techniques
implemented measures showed that the mean value of 4.6 median value
of 4.00 mode value of 4.00 and a standard deviation of 1.5.
Patient pain scale before and after the implemented measures showed
a decrease in mean values of 1.5 median value of 1.5 mode value of
1 and a standard deviation of 0.54. There dilakukanya influence action
relaxation techniques to decrease pain scale figures on maternal
postoperative sectio caesarea in Maternity Room General Hospital
District Kediri.
progressive relaxation techniques. Suggestion
Progressive relaxation is an effective way to rest the muscles through an
appropriate manner, followed by mental relaxation and mind Davis,
2005.
According to researchers, the differences decrease pain scale on
each individual is different. That is because many factors ranging from
differences in age, experience sectio caesarea operations, and the ability of
515 1.
2. For health agencies
Progressive relaxation technique is one of the nursing treatment that is
easy and inexpensive can be selected to be applied to nursing
actions for clients with problems of pain.
For educational institutions Relaxation techniques are one
option for clients with problems of
pain, so it can be entered into the Farrer,
Hellen. 2001.Pearawatan laboratory skills of students in the
achievement of competence. Maternitas.Edisi
ECG.Jakarta 2 :
3. For the general public
Mothers with post Sectio Caesarea expected to apply relaxation
techniques as a non- pharmacological therapies that are
Astuti, Puji. 2010, cermin Dunia Kebidanan. www.cermin
dunia kebidanan.com download
safe and easy to reduce pain. Notoatmojo,
soekidjo. 2003. Metodologi
Penelitian 4.
For further research This study can be used as a source
of information for further research Kesehatan. Jakarta : PT
Rineka Cipta. pengembangkan. Future studies
Notoatmojo, soekidjo. 2005.
may consider factors that affect Metodologi
Penelitian pain scale such as age, experience
sectio caesarea operations and the ability of respondents to do
relaxation techniques taught.
Reference
Potter, P.A Perry, A.G.2005 Kesehatan. Jakarta : PT
Rineka Cipta. Notoatmodjo, S. 2010. Metodologi
Penelitian Kesehatan , Ed.Rev 1 .Jakarta : PT
Rineka Cipta
Fundamental Keperawatan Konsep, Proses Dan
Praktik, Jakarta: EGC Nursalam.
2003. Konsep dan Penerapan Metodologi
Keperawatan. Jakarta : Salemba Medika
Smeltzer, S. C, Bare.2001. Buku Ajar Keperawatan Medikal
Bedah. Jakarta. EGC Smeltzer, S. C, Bare.2002. Buku
Ajar Keperawatan Medikal Bedah. Jakarta. EGC
Torrance, C Serginson. E 1997. Surgical Nursing.
Bridgend, Midglanmorgan:WBC
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Jakarta
516
THE INFLUECING OUTCOME FACTORS OF CAESAREA SECTIO PATIENTS IN PREPARATION FOR THE CLINICAL PATHWAYS COSTING OF DRGS AT PARE
– KEDIRI HOSPITAL
Suryono
Akademi Keperawatan Pamenang Pare, Jl. Mahakan No. 05 Pare- Kediri, Email
suryono.sanjayagmail.com Abstract
Clinical Pathway is a concept of comprehensive service to plan the patient that are using standard of medical service and Nursing care during hospitalization. Research design is correlational approach
observation with secondary input variables including Hb, age, class of service, indication, medicine, wound care, and nutrition. The output variables are LOS Length of Stay, cost, wound, mobilization,
and complication using statistical analysis with multiple linear regression. Populations in this study were all patients hospitalized with caesarean section at Pare Hospital, Kediri, east Java, Indonesia.
Multiple linear regression analysis showed that Hb variable positive correlate to the LOSr=0,136. Antibiotic variables also showed positive correlation with the hospital cost p=0,041. From multiple
logistic regression analysis, wound care is more influenced B=161,98 to wound healing process, mobilization and complications more than another variables. This result can be used for early basic to
arranged clinical pathway at caesarean section patient with some consideration such as age, infant indications, nutrition, antibiotic combinations, wound care, diabetic mellitus, prolonged delivery, and
hypertension with complications.
Key words : Clinical pathway, caesarean section
Background
On July 1st, 2007 the Ministry of Health of Indonesia has introduced Diagnosis Related
Groups DRGs INA which will be used as the basis for a claim payment insurance patient
mobilization and complications of caesarean sectio patients at Delivery Room Pare Kediri
Hospital. The benefits of this research can be used as the initial data for the hospital to
arrange Clinical Pathway.
hospital. But the government in implementing