The prevalence of HIV cases increases significantly in the vulnerable population; it is Transvestite. The high prevalence of HIV in transgenders requires treatment and treatment services. However, until now the transgender community is a group that is often not served in various health facilities. Transvestite identity intersections produce unique life experiences, such as multiple identities and spiritual identities. The purpose of the study was to explore the experience of transgender HIV patients when hospitalized in fulfilling spiritual needs. Research method with qualitative design phenomenology study approach. This study involved 12 transvestite participants who had been hospitalized because of HIV positive. Retrieving data using in-depth interviews, data analysis using Colaizzi. The results of the study found four themes namely (1) Spiritual according to HIV patients transvestites means believing in the existence of God; (2) Be grateful for the conditions they have; (3) get closer to God by doing good things; (4) Poor nurse services for transgender HIV patients.

Each interacts with the environment and gives a different response, namely a positive response and even a negative response because he considers that changing conditions is a pressure that causes stress and encourages individuals to respond to coping. The research objective was to determine the effectiveness of coping and stress management training in increasing the perception of stress in health levels before and after the intervention was given. The design used one group pre-post design. The population was 30 health cadres, and the sampling technique used total sampling. Before the activity, the respondents were given a questionnaire to determine stress levels, followed by training. The respondents applied stress management techniques within one month, after which a post-test was carried out. The instrument used the Perceived Stress Scale. The results showed that the mean stress adaptation of respondents before the intervention was 20.73, and the mean stress adaptation after the intervention was 7.83. Further analysis using a paired t-test showed a significant difference in stress adaptation between stress adaptations to health cadres before and after the intervention (p-value=0.001; α<0.05). Coping training and stress management effectively reduce stress levels to improve the quality of human life that is physically and mentally healthy.

Introduction: The novel coronavirus disease 2019 (COVID-19) is a virus that attacks the respiratory tract with rapid spread and high mortality. Initial reports that COVID-19 associated with critical care due to the severity of the disease requiring mechanical assistive devices in its treatment. The purpose to identify the nursing diagnosis related to respiratory and circulatory problems of COVID-19 in the critical care unit. Method: An integrative review highlights the issue that nursing problems related to respiratory and circulatory in COVID-19 patients admitted to the Intensive Care Unit (ICU). This study focuses on papers published from 2020 to 2021 using the keyword "clinical manifestation of COVID-19" which was accessed through the Pubmed database. Result: The results showed that findings in articles that were reviewed and integrated with the SDKI. Nursing diagnosis related to respiratory problems such as 1) Ineffective airway clearance; 2) Dysfunctional ventilatory weaning response; 3) Impaired gas exchange; 4) Impaired spontaneous ventilation. Nursing diagnosis related to circulatory problems such as 1) Risk / decreased cardiac output; 2) Risk for bleeding; 3) Risk for effective renal perfusion; 4) Risk for ineffective cerebral perfusion. Conclusion: Critical care nurses carry out a series of treatments based on the nursing process stages, one of which is the enforcement of a nursing diagnosis. The nursing diagnosis is needed to develop nursing plans and strategies for implementation so that the goals of nursing care are achieved. Keywords: covid-19, nursing diagnosis, intensive care unit

Background: Cardiac rehabilitation is an evidence-based intervention that includes physical exercise, health education, and modification of health behavior in patients with cardiovascular disease. Cardiac rehabilitation is considered as secondary prevention after acute coronary syndrome and improves treatment outcomes in patients with coronary heart disease. This literature review aimed to evaluate the effectiveness of cardiac rehabilitation in coronary heart disease patients. Methods: This present study was a literature review discussing cardiac rehabilitation for coronary heart disease patients. Results: The result showed that the functional capacity of the CR group was more increased compared to non-CR (p <0.001; α <0.05), left ventricular ejection fraction (LVEF) significantly increased in the CR group (p < 0.05; α <0.05), the medical cost of CR group was lower significantly (p=0.042; α <0.05), and the risk of recurrence rate was significantly lower in CR group (p=0.004; α <0.05). Conclusions: Cardiac rehabilitation is known to increase functional capacity, increase left ventricular ejection fraction (LVEF), reduce medical costs, and reduce the recurrence rate of patients with CHD.

ABSTRACT   GRANTING OF EDUCATION STRUCTURED NUTRITION AND ELECTROLYTE (ESNE) ON CHANGING INTERDIALYTIC WEIGHT GAIN IN CHRONIC CALCULATION FAILURE PATIENTS By Lutfi Wahyuni, Ika Ainur rofiah, Mochammad Achwandi Chronic kidney disease is a condition when kidney function begins to decline gradually. The condition of the decline in kidney function occurs due to many factors, one of which is because the kidney damage that has occurred intensely for many years. Patients with chronic renal failure need a management or hemodialysis therapy, which is the cleansing process of blood from waste substances, through a screening process outside the body using an artificial kidney in the form of a dialysis machine. Hemodialysis therapy is needed in the management of patients with chronic renal failure who cannot be treated again (terminal). The success of hemodialysis is based on various elements, one of which is compliance with fluid restrictions. Limitation of fluid intake in patients with chronic renal failure is very important. The provision of structured education can be given to patients with chronic kidney failure who are undergoing hemodialysis therapy. Education structured nutrition and electrolyte (ESNE) is a structured health education on nutrition and electrolyte management for chronic renal failure patients undergoing hemodialysis. ESNE is done to improve patients' understanding of diet and electrolyte compliance to prevent an increase in IDWG and to improve patient compliance with fluid restrictions. The stages of service activities that have been carried out are to explain fluid requirements and fluid restriction in patients with chronic renal failure using the Education structured nutrition and electrolyte (ESNE) method, the next recourse is an evaluation after continuous or ESNE administration of respondents given treatment and respondents who were not treated. Keywords: Diet, Chronic Kidney Disease, Hemodialysis