Objective To determine the impact of palliative care (PC) on end-of-life (EoL) care and the place of death (PoD) in children, adolescents, and young adults with life-limiting conditions. Method Eight online databases (PubMed, Medline, EMBASE, Cochrane Library, CINAHL, Airiti, GARUDA Garba Rujukan Digital, and OpenGrey) from 2010 to February 5, 2020 were searched for studies investigating EoL care and the PoD for pediatric patients receiving and not receiving PC. Results Of the 6,468 citations identified, 14 cohort studies and one case series were included. An evidence base of mainly adequate- and strong-quality studies shows that inpatient hospital PC, either with or without the provision of home and community PC, was found to be associated with a decrease in intensive care use and high-intensity EoL care. Conflicting evidence was found for the association between PC and hospital admissions, length of stay in hospital, resuscitation at the time of death, and the proportion of hospital and home deaths. Significance of results Current evidence suggests that specialist, multidisciplinary involvement, and continuity of PC are required to reduce the intensity of EoL care. Careful attention should be paid to the need for a longer length of stay in a medical setting late in life, and earlier EoL care discussion should take place with patients/caregivers, especially in regard to attempting resuscitation in toddlers, adolescents, and the young adult population. A lack of robust evidence has identified a gap in rigorous multisite prospective studies utilizing data collection.

Pendahuluan: Kecamatan Cerme merupakan salah satu kecamatan di Kabupaten Gresik dengan angka kejadian kecelakaan yang cukup tinggi dibandingkan dengan daerah lain. Kecelakaan ini memerlukan bantuan dan penanganan awal yang bisa dilakukan oleh orang awam, termasuk siswa SMU untuk mengurangi angka kecacatan dan kematian. SMU Muhammadiyah 8 dan SMK Muhammadiyah 3 berlokasi di tepi jalan raya dimana kecelakaan lalu lintas tersebut sering terjadi, namun pihak sekolah mengungkapkan belum bisa memberikan bantuan karena kurangnya pengetahuan dan ketrampilan dalam memberikan pertolongan pertama. Dengan demikian diperlukan suatu strategi untuk memberdayakan masyarakat dalam memberikan bantuan atau pertolongan pertama, yaitu melalui pengabdian masyarakat dalam rangka peningkatan kemampuan siswa SMU di Kabupaten Gresik dalam memberikan bantuan hidup dasar. Metode: Kegiatan pengabdian masyarakat dilakukan melalui pemberian edukasi melalui simulasi dan bermain peran (role play) kepada para siswa. Alasan dari pemilihan metode ini adalah karena siswa SMU pada dasarnya lebih menyukai pembelajaran partisipatif dibandingkan dengan ceramah. Pembelajaran simulasi akan memberi siswa kesempatan untuk belajar secara langsung melalui melihat, mempraktikkan, serta bermain peran cara melakukan pertolongan pertama pada kecelakaan atau memberikan bantuan hidup dasar. Dengan demikian diharapkan para siswa akan mengalami peningkatan pengetahuan, sikap dan tindakan dalam penanganan kecelakaan. Hasil: Kegiatan pengabdian masyarakat menghasilkan perubahan yang sesuai dengan target luaran yang telah ditetapkan yaitu peningkatan pengetahuan siswa tentang pertolongan pertama pada korban kecelakaan, meliputi tindakan bantuan hidup dasar, bebat bidai, dan transportasi khusus untuk orang awam. Kesimpulan: Pemberian edukasi melalui simulasi dan bermain peran dalam pengabdian masyarakat pada siswa SMU di Wilayah Kabupaten Gresik meningkatkan pengetahuan dan ketrampilan siswa akan pemberian pertolongan pertama pada korban kecelakaan.

Introduction: Foot ulcers cause women in Indonesia to lose opportunities to participate in religious and cultural activities due to the inability to wear certain footwear. This study examined body image as a mediator in the relationship between gender and quality of life (QoL) among patients with diabetic foot ulcer (DFU) in Indonesia. Method: A cross-sectional design with convenience sampling was used to recruit participants at the Surgical Outpatient Department and Wound Care Clinic in Bali, Indonesia. The Diabetic Foot Ulcer Scale–Short Form and the body image domain of the Body Investment Scale were administered. Results: We found gender differences in participants’ ( n = 201) QoL and body image ( p < .05). Body image fully mediated the effect of the relationship between gender and QoL (B = 6.68; 95% confidence interval [3.14, 10.52]) and explained 39.13% of the variance. Discussion: Health care providers should consider patients’ religious beliefs in DFU education and consider women’s body image issues. Diabetes foot ulcer may prevent women from performing religious rituals, thus, influencing their QoL. Protective strategies to prevent DFU among women in Indonesia warrant further development.

Abstract-In Indonesia, traditional healing, as it is known asSangkal Putung (SP) has been an alternative for fracture treatment. People with fracture at any age, anywhere and any case went to SP even there was a general hospital with surgery service. SP, where was the study taken is located in rural area where is approximately 40 km from Surabaya, the capital city of East Java Province. The study aimed to explore patient's experience of fracture healing at SP. The method and methodology were Hermeneutic Phenomenological study that used deep interviews. The participant was taken by purposive sampling, adult aged 25 to 55-years old and were at the second or more of healing series. Data originated from seven participants and 13 interviews. Interviews were recorded, transcribed verbatim and analysis. The findings showed that previous close friends, relatives and family's experience of SP were the main issued of decision-making process. Participants with several SP experience had different views of SP; they seemed that SP today is more convenient than before. Most of them stated that safety and comfort was the priority for the fracture healing. The concept of culture in the behavioral alteration of fracture healing can have on the participants.

Most of the patients in intensive care units (ICU) are intubated. These conditions can affect the psychological, social and spirituality condition of the patients. The nurse's role in terms of providing spiritual care is still not optimal. Many feel the urge to reach out to their patients and offer spiritual support, but they do not know how to do it. However, the procedure or intervention needed for providing spiritual care is still little known about. This study aimed to explain the nursing interventions that could be applied for promoting spiritual care based on the existing literature. The systematic review was guided by the PRISMA protocol. A comprehensive search was carried out on a selection of databases; PubMed (Medline), CINAHL, Scopus, Springerlink, ProQuest, EBSCOHost, Web of Science Clarivate Analytic and Science Direct. The searching of published studies was done comprehensively using several keywords: "spiritual nursing care" OR "spiritual care in ICU" OR "spiritual intervention" OR "spiritual AND nurse" OR "spiritual AND critically ill patients" OR "implement spiritual intervention". The searches were limited to publications in English with the year of publication being from 2009 up to February 2019. Ten studies were included in the review. This review confirmed some of the ways to promote spiritual nursing care in the ICU. Nurses, in promoting spiritual nursing, need the ability to communicate effectively and also to collaborate with the patient's family and/or chaplain. It is hoped that this review could be a reference for nurses to allow them to provide spiritual nursing care in the ICU.

Introduction: Haemodialysis (HD) is one of therapies to sustain life for people with End Stage Renal Disease (ESRD). HD and ESRD are the source of the stressor for the patients. The purpose of this study was to gain insight about the life experiences of patients suffering from ESRD and coping that they used in dealing with stressors.Methods: This study employed hermeneutic phenomenological study as methodology. Samples were taken at RSU Dr. Soedono Madiun in December 2010–May 2011 using purposive sampling. Participants in this study amounted to 9 people who all male and had suffered kidney failure and undergoing HD for more than 2 years. Data were processed and analysed through the nine stages data interpretation according collaizi.Results: Client's life experiences with HD and coping strategies they used to cope with critical situations have been identified and grouped into several themes. The first theme was the reaction of participants when receiving the diagnosis should undergo HD including: sad, rejection, fear, shock and feelings of resignation and hope. The second theme was perceived to critical situations by clients include shortness of breath, weakness, body swelling, itching, diarrhea and could not urinate. Last theme was the meaning of life in hemodialysis derived from attitudinal values (the values to be) and experiential values (the values of appreciation).Conclusion: Ways in which clients address critical situations were quite diverse. Emotional informational, instrumental supports from spouse or significant other were needed by participants to overcome the critical situation. This study suggests that nurse should perform therapeutic communication to HD patients so that patients may cope with the disease more positively.

Background: Injury isa condition causes the body getting damage by physical pressure or chemical.The breakdance community members need to know the ability of the first injury handling. Objective: The purpose of this study is to analyze the influence of health education with explicit instruction method towards the injury handling behavior in Surabaya breakdance community.Methods: This study used quasy experimental design with pre-test and post-test in two groups. It comprised 13 treatment group and 13 control group respondents. This study used purposive sampling. The data were analyzed by Wilcoxon Signed Rank Test, Mann Whitney Test and Chi Square Test significance p<0,05. Results: The Wilcoxon Signed Rank Test result of the treatment group respondents showed knowledge (p = 0.001) and action (p = 0.001). The control group respondents showed the knowledge(p= 0.102) and action (p = 1,000). The Mann Whitney Test result between the treatment and control group were obtained knowledge(p = 0.000) and action (p = 0.000). For the Chi Square Testgot the attitude (p=0.047).Conclusion: This research shows the health education with explicit instruction method influences the breakdance community member’s behavior in injury handling. It suggests for further research to undertake the health education by using other methods.

Pendahuluan: Tersedak merupakan kondisi kegawatan pernapasan yang harus cepat ditangani. Bayi dan anak – anak adalah kelompok umur yang paling berpotensi untuk mengalami tersedak disebabkan oleh tidak dikunyahnya makanan dengan sempurna, makan terlalu banyak pada satu waktu dan memasukkan benda-benda padat kecil ke dalam mulut.Tujuan:Melakukan pemberdayaan masyarakat dalam hal ini guru, care giver/bunda KB (kelompok bermain) dan orang tua siswa KB-TK Khadijah Surabaya dalam penanganan kasus tersedak pada anak dan bayi. Metode:Metode yang digunakan dalam pengabdian masyarakat ini adalah ceramah, diskusi, simulasi/demonstrasi oleh fasilitator yang kemudian dilanjutkan dengan  redemonstrasi oleh peserta/audience sebagai evaluasi.Hasil:Setelah dilakukan pengabdian kepada masyarakat terdapat peningkatan kemampuan peserta yang ditunjukkan oleh peningkatan pengetahuan dan efikasi diri sebelum dan sesudah kegiatan pengabdian masyarakat. Para guru dan orang tua juga dapat melakukan redemonstrasi secara benar setelah dilakukan pengabdian masyarakat ini. Diskusi:Pengetahuan terjadi setelah orang melakukan penginderaan terhadap suatu objek tertentu. Metode simulasi/demonstrasi mempermudah guru dan  orang tua untuk mengetahui cara penanganan tersedak melalui indera mata dan telinga, sehingga mudah untuk dipahami. Pengetahuan kognitif merupakan domain yang sangat penting dalam membentuk tindakan seseorang.Simpulan:Pengabdian masyarakat melalui pemberdayaan masyarakat dapat meningkatkan pengetahuan dan efikasi diri terhadap penanganan kasus tersedak pada anak dan bayi. Kata kunci :tersedak, pemberdayaan masyarakat, pengetahuan, efikasi diri