Tugas Individu

Diajukan untuk memenuhi salah satu tugas mata kuliah Riset Kulitatif

Dosen Pengampu

Dr. Blacius Dedi, SKM, M.Kep,

Oleh :

Salni Saharman

Sarwoko

PROGRAM STUDI MAGISTER KEPERAWATAN

PASCA SARJANA
UNIVERSITAS KARYA HUSADA SEMARANG
2021
REVIEW JURNAL RISET KUALITATIF 1
Nurses’ Reflections on Challenges and Barriers of Communication in The
Intensive Care Unit: A Phenomenology Study
Etika Emaliyawati, Restuning Widiasih, Titin Sutini, Ermiati, Urip Rahayu , 2020

1. Introduction
Communication among nurses, patients, and families takes an important role in the intensive
care unit in which the patients are in critical condition and unable to involve in two-way
communication. Research related to effective nurse-patient communication has been done
extensively, but the information regarding communication in intensive care unit is still
limited. This research aimed to explore nurses’ experiences in the intensive care units in
effective communication to patients/patient’s families.

2. Method
This study was a qualitative research project using a phenomenology approach, This
research aimed to explore nurses’ experiences in the intensive care units in effective
communication to patients/patient’s families.

3. Participants
The participants were ten nurses consisting of five men and five women selected by a
purposive sampling technique, Participants were selected with the assistance of the head
nurse (the manager of the nursing unit at each ward) using the nurse’s database as a
consideration of conformity with the inclusion criteria. Participation itself was voluntary.
The inclusion criteria include
1) nurses who have worked for more than 3 years,
2) Holds nursing education at least Diploma 3
3) ICU training certificates

4. Data Collection and Analysis

a. Data Collection
Data collection was done by in-depth interview, In this study, interview to 10
participants was conducted by the lead researchers who had experienced interviewing in
the qualitative study and had clinical experiences in critical care unit area including
intensive care unit for 16 years.
The interview was conducted in 60- 90 minutes with each participant, recorded
using a digital voice recorder and transcribed in Bahasa Indonesia. interview included:
developing trusts with participants and exploring nurse’s experience in communicating
with patients and families. The researcher paid attention to the principles of social skills
including friendly, empathy, polite, and showing open attitude in data interpretation and
reporting research results.

b. Data Analysis
Data analysis was undergone by using Colaizzi 1978 method
 1) Understanding the content of each transcript by listening to the recording and reading
transcripts at least 5-8 times.
2) marking the participants’ important expression related to nurse’s communication
with patients and families and separating the transcribe into a distinct file
3) formulating unit meaning reading file 1 then grouping the same ideas
4) reading file 2 and clustering it in the same themes, and they were put together into
the major theme
5) integrating all results into a very complete explanation of the them. (the researcher
narrated the major theme supported by data from the team cluster, files 1 and 2 and
discussed themes with the research team )
6) involves explaining the basic structure of the discovered phenomenon, using the full
description of the fifth stage. (the researchers identified the basic structure of
phenomena related to communication between nurses with patients and families in
intensive care unit)
7) validating the results of the analysis by returning to the participants to explain the
results of the sixth stage to ensure that it was in accordance with the nurse’s
experience when communicating with patients and families. Based on the analysis,
four major themes obtained are described in the results.

5. Results
a. Characteristics of participants
All participants in the study have the same education background, which is
Diploma III, with the average working period in ICU for 5 years with the maximum
working period of 8 years and the minimum of 3 years. All participants have
participated in various training related to life-saving and critical care.
b. Themes
1) Nurses’ dilemma of their professionalism and personal issues/matters,
As individuals, nurses also have problems at home, especially with families that
may affect the nurses’ emotional stability while working. They tried to put aside
their feelings, fatigue, and emotion due to personal problems so that despite the
problem, they can still perform well (smiling, being friendly, and answering
questions
2) Contextual factor affects selection of nurses’ communication n technique,
The nurses have to choose appropriate communication techniques based on the
characteristics of the family such as talking slowly, using simple-repetitive
language.
3) Barriers in effective communication: difficulties in accompanying families to
accept critical patient conditions, care and treatment procedures in the ICU which
were complicated, and misunderstanding between nurse-patient and family.
4) Compassion and patience are required in nurse-patient communication in ICU.
Patient’s critical conditions such as unconscious, weak and totally dependent state
on the health worker raised the nurses’ compassion to the patients and their
families. When performing interventions such as bathing, changing position and
suctioning the nurses empathized the patient’s condition. Thus, when the patients
 are unable to communicate verbally, the nurses may communicate non-verbally to
the patient by showing compassion

6. Conclusion
The themes were new insights in the research related to nursing and patient
communication in ICU. The themes are also important as knowledge of the nurses and
family communication, especially health services in Indonesia which might be different
from other countries. It is important for nurses to improve their clinical performance,
knowledge, and effective communication skills to enhance the verbal communication
effectiveness, as well as nonverbal communication between nurses and patients. Training
and assistance in effective communication in the intensive care unit can be the way to
improve nurses’ communication skills
REVIEW JURNAL RISET KUALITATIF 2

Patients Experience and Perception in Preventing Tuberculosis Transmission in Rural

Areas:
A Qualitative Research
R Endro Sulistyono, Tantut Susanto, Rr Dian Tristiana, 2020

7. Introduction
The global tuberculosis report 2019 stated that Indonesia was ranked third (8%) with the
most TB sufferers after India (27%) and China (9%). However, efforts to prevent TB
transmission from TB patients’ perspectives, especially in the rural area, are not well
documented. This study aimed to explore the efforts made by TB patients in preventing
transmission to the community

8. Method
This research was qualitative research with a phenomenological approach..

9. Participants
The participants of this study were TB patients who received treatment with a duration of
treatment of six months, lived in a Pandalungan area, were native to the Pandalangan, were
at least 18 years old, and could speak Indonesian or Local (Madura).

10. Data Collection and Analysis

c. Data Collection
Qualitative data was collected through in-depth interview method. Interviews
were conducted using the local language of participants and Indonesian for
approximately 30–45 minutes per participant. using a recorder and recorded in the note
field during the interview process.
d. Data Analysis
All data were transcribed verbatim and analyzed thematically include
identification, coding, analysis, and clustering.

11. Results
c. Characteristics of participants
The sample in this study amounted to 12 participants The total participants in this
study were male of 8 participants and four female participants. Almost all participants
were educated in junior high school (9 participants). Two participants were educated
in high school, and one participant was studying
d. Themes
environmental modification, adhering to treatment, limiting interactions with others,
and increasing food intake. Knowledge and awareness of TB patients are still an issue
in preventing the transmission of TB in the community. Immediate intervention needs
to be made regarding increasing knowledge and awareness of TB patients and the
supervision of health workers regularly in handling TB disease in the community
1) Knowledge and Participant Perception of TB disease
Most participants stated that TB was an infectious disease and could be
cured. Participants said that the TB disease they suffered could recover if they
adhered to treatment. Almost all participants said that TB disease is a contagious
disease. Some participants stated that TB was transmitted through the airborne,
but most interpreted TB transmission with incorrect perceptions.

2) Performing Alternative Treatment

Some participants stated that they performing alternative therapy,
(Traditional Healer), and drank traditional medicine as an effort to recover while
still taking the medication in health services.

3) Using personal protective equipment

Using personal protective equipment Some participants said using
personal protective equipment such as masks or closing with their hands when
coughing to prevent transmission of TB to others. Another participant said that
they were only wearing a mask when they go to the public health center because
of fearful that health professional workers would be angry because they did not
comply with the order to wear a mask.

4) Environmental Modification
a) Adequate ventilation
Participants stated that improving ventilation in the home environment is one
of the efforts to prevent transmission of TB disease
b) Sputum Disposal
Participants said several different ways related to sputum disposal. Sputum
disposal is carried out in the toilet, in the trash and wrapped in cloth, and then
thrown into the river or burned.

5) Adhering with treatment

Some participants stated that they tried to take anti-TB drugs on a regular
basis despite causing discomfort due to high motivation from themselves to
recover.

6) Limit interactions with others

The interaction limitation is in the form of separating the bedroom from the
family and partner and limiting the interaction outside the home with the
neighbors.

7) Increase food intake

Some participants stated that they increased the number of food portions to
prevent worsening of TB disease suffered
12. Conclusion
Most of the participants interpreted TB transmission with incorrect perceptions,
even though TB patients in this study conduct care in community health centers and
contact with health workers, Incorrect perceptions about TB is an issue that needs to be
addressed because it can lead to a false understanding of TB that can hamper efforts to
control and prevent TB in the community. this finding can be one of the considerations to
include a traditional healer as one of the means of health promotion, especially in TB
sufferers to continue to follow the treatment until completion.
Some participants have carried out the ethics of coughing and using masks to prevent
transmission of the disease.

TB patients in rural areas have made efforts to prevent transmission of TB in the

community. Some TB patients have done the right way, and some still lack understanding
regarding TB disease. Health workers need to educate and increase awareness of TB
patients to be involved in preventing the transmission of TB in the community. The self-
management ability of TB patients should be increased. This intervention also needs to be
accompanied by supervision in the community with cross-sector collaboration or
involving health cadres in supervising compliance and preventing TB transmission
behavior in the community. Funding:This study was funded by Universitas Jember
Indonesia.