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Showing posts with label News. Show all posts

Family Factors Influence On Childbehavior


The future is very dependent on the children at the time sekrang. If you want a better future than the present would be responsible for the present generation to provide the transfer of cultural and social values ​​to the next generation. Family held a prominent role in the achievement of the case because the elderly have a great answer tangung within the framework of the formation of behavior for their children.

Basic unit of society is the family unit and the birth of young children. In this unit most of the child's development needs are met. Most do not traditionally met the needs of a child by his father and mother as their parents. Urgent need for including nutrition, warmth, shade and protection from harm, provision within the framework of growth and development of physical, mental and social culture.
Initial interaction that occurs is between mother and baby, where is the satisfaction of basic physical and psychological. Dad also played an important role in growth and development of children. Its role is double, namely:
a. In the process of self identification (identity) of a child
b. Support and protection that will strengthen the role of the mother.
If one of the basic requirements are not met or are not adekuat amak dipenhuhi development will be blocked or disrupted. At the bottom there is a possibility if one failed to satisfy demand, then the other requirements will also be affected. Important elements for a successful development is given the love and security. Lack of it will cause serious problems in an individual.
Son of the heir of the norm values ​​held by a family. In terms of structural components of a unit will be called the family when in it consists of father, mother and child. A child will inherit genetic characteristics from both parents, where he will defend exsistensinya in the next life.
Worldwide training for child care checkers identical in some important gaps. In all the helpless infancy of society must be transformed into an adult who is responsible, to comply with the rules of society. Although such children are also affected by external environment, such as schools. This shows that there is universal in educating children CRA as desired, and position the child in the family.

1. How the structure and function of the family?
2. How social problems in the family?

A. Meaning
Behavior are all manifestations of the individual in interaction with biological environments, ranging from the most visible behavior that does not appear to reach, from which most do not feel up felt. b) view of behavior, there are five main approaches of behavior, namely: (1) neurobiologik approach, this approach focuses on the relationship between the behavior of the incident which took place in the body (brain and nerves) since the behavior is governed by the brain and nervous system activity, (2 ) behavioristic approach, this approach focuses on behavior that you see, the behavior can be formed by refraction and consolidation by conditioning the stimulus, (3) the cognitive approach, according to this approach, individuals not only receive a passive stimulus, but treats the behavior of the new stimulus, (4) view of psychoanalysis, according to this view of individual behavior is driven by instinct and a great amount of behavior is not realized, (5) humanistic view, individual behavior to be determined by the internal aspects of the individual. Mengaragkan behavior of individual and give color to the environment.

B. Structure and Function Family
a. Family Structure
- It is a basic unit of society
- The composition of families varies based on family forms, but usually one of a family head
- Have a purpose and beliefs and moral values ​​of its subscribers
- To carry out the role and framework to meet the needs of individuals and groups within the family
- Status of family members is determined by its position in relation to family social views.
b. Family Function
While the formal structure of the family remained unchanged, thus, its function has undergone a very extensive modifications. At one time the family is the unit of production and consumption, especially family sekrang a unit of consumption only. The most important function of the family, especially in a society with a lot of emotional tension is peace. As for the specific family functions are as follows:
• Reproduction
A group will grow to a large process in rangkan defend its existence and to make good in quality and large quantity. Preservation in order to improve conditions for the better.
This includes meeting the needs such as clothing, shelter, food and personal care, other family that also meets the needs of family members of other aspects such as: Social, psychological, emotional support. Protection against family members who are not mature until an individual has always given people grow into adults. In addition to being members of families of children also become part of the DRI community.
• Socialization
Child will adapt to cultural objects, habits and social situation in the development of behavior, aka tone of identity formation process in the child's relationship with other family members. Finally, children will learn to fit the type of role model and will seek to carry out kelaminnya what is their responsibility.
• Individual Growth
In individual families (children) will grow and develop into mature individuals (mature) and independent (Kontak).
• Education
The primary function of the family is the most important cultural norms of inheritance from one generation to another. For children still in care of elderly parents role in education can still mennjol.
• Religious (Religion and Faith)
Human right to profess the religion which he was born, w Even though later on at any given time there will be changes regarding religion and beliefs along with experienced adult life.
• Recreation
Families have recreational function at a time because the majority of recreational berdasr in the family, although now more common recreation outside the family.
• Health Care
Family is still the main unit where prevention and treatment of disease possible. Still very found kterlibatan and support the family without a case where this would be difficult rehabilitation process carried out in the family.
c. Social problems in the family
a. Family disorganization
Tiaks have families to escape from conflict, but each family has its own method for treating her. Most of the conflict comes from the marriage itself and has a direct effect on children. If a problem arises so that each pair will seek to solve it but if this is not possible then there will be divorce and separation
Divorce is a valid marriage settlement and influence children in many aspects and can interfere with the socialization of children, if still very young. Research shows that, boys that are less able to adjust to show that a higher percentage of divorce came from a divorced family, too.
Judgment in the care of mothers tend to entrust their children unless there is a strong reason for this menetang. Research shows that boys who grow up together without contact with the mother and father or without a role model male behavior so the child will have difficulty in determining its own role in later life
b. Families with single parents (single parent)
Single parent family with a very wide assortment of groups consisting of father or mother with children. In most families with single parents, parents are parents responsible for their children, many of whom are women who are divorced or abandoned her husband.
The influence of his parents abandoned children can vary, such as depression that settled, behavior disorders, personality anti sosialm failure in the educational process. In 1976, the Bureau issued a national children's survey results from a lack of research that children dibersarkan beruntungan paret single objects likely caused by poverty and therefore the accumulation of problems. Reported in 1974 and organized a number of comments, including special attention to women abandoned by her husband.
c. The loss of the mother and its influence
Bowlby (1965), states that the type of emotional relationship with her children in early childhood is very important and children need a sustainable ditegakkanya bond. When the bond is broken or this bond is not upheld memuaskam, the development of physical, intellectual, emotional and social will be affected.
The last study shows that the behavior of the bond is formed from several related components. Schaffer, studying infants reared in institutions that many staff will show a faster response verdict or reverse with the baby who was born in a little institutional staff.
Rutter (1972), allowing genetic and organic factors that are also involved, this is proved by that the children who grew up somewhere within and separated from his mother for a long time will have an effect on intellectual ability.
d. Persecution of children (child abuse)
Battered baby or child abuse syndrome diuraikamn the first time by a member of the radiology USA in 1946, but new in 1962, CH. Kempe, the first to use this term. There are many families who treat their children harshly, such as beatings and punishment. There is a tendency for the first or youngest child to get treatment as I, so also in infants with BBLR.
• Clinical picture of Persecution
- Son of late taken berobat generally not given information or evidence does not support the dideerita child injury
- Injury and multi-ganda and tipenya bermacan kinds, such as bruises and scratches
- Lllesi come in different levels, for example, are in various levels of healing
- Type of lesions including: Fracture (not common in infants, baker and tersenduh wounds, spots on the skin and cool conditions relating to the blue pad aekstremitas in relation to low-weight objects other than depression, emotional
- Place of injury, such as ear lobes petekhiepada (because trikan or pinch), a former ties around the neck (strangulation attempt), sundutan cigarettes are also specialized in eye injury, bleeding and tooth injury
• Attitudes and behaviors of children
Expression of the child should learn because it has great value in assessing the emotional status such as: fear, regret, complain, etc.
e. Pelecahan on Child Sexual
Sexual abuse in children is difficult to be evaluated, without the cooperation of family members. However there is an increase of awareness of action is sexual harassment. If pelecegahn sexual occurred then we should report on the bodies.
• general signs of sexual harassment:
- Can be obtained from the child's history of sexual assault or family member
- If you become pregnant or venerik disease in children aged 12 years or younger
- There is a history of genital trauma of conflict on children with

STRESS AND ADAPTATION


Every person has something called stress throughout life in this case a stress is positive and even necessary, however, too much stress can lead to poor adjustment, physical illness and inability to cope with coping with the problem. Hasn Selye developed a model of the biochemistry of stress known as the general adaptation syndrome (general adaptation syndrome (GAG). Which describes the physiological events during the stress response. Selye also introduced the concept of stressor that is internal or external stimuli that cause stress.
 The concept of stress
Stress and stressors
Stress is any situation where non-specific demands require an individual to respond or take action. Response or action, including physiological and psychological responses. Stress can cause negative feelings or the opposite of what is desired or threaten the emotional well-being. Stress can disrupt the way of thinking in general and the related person and a sense of belonging, other than that stress can impair a person's general outlook on life, brush aimed at loved ones and health status.
Perception or experience of the individual against big changes can cause stress. Stimuli that initiate or trigger the change is called a stressor. Stressors showed an unmet need and the needs of the bias are physiological needs, psychological, social development environment, spiritual or cultural needs. Stressors can generally be classified as internal or external. Internal stressors in a person comes from eg fever, conditions such as pregnancy or menopause or kejadaan emotions such as guilt. External stressors from outside oneself (eg, significant changes in ambient temperature, changes in family or social role or pressure from a partner.

 Stress
The term stress is often used incorrectly, used to designate the phenomenon of "side, not insane" in fact stress is a very neutral term, emunjuk the things that always experienced by humans in daily life. Simply put stress can be defined as a situation where individuals impaired balance. Stress is the result of external or internal situation which led to disruption and demand for adaptive berepson.
Stress is something inseparable from human life, even stress as a part of life itself. Every day we have to hurry up, pick up homework, forgot or did not get breakfast, ran after public transport, schools or through the activity, conflict with friends or anyone else, but ran out of money to buy daily necessities and so on. All of that led to stress.
Although quite often annoying, stress need not always be seen as a negative thing. In certain respects, stress has positive implications. Esutress is "stress in a positive sense". Which state that can motivate, had a beneficial impact. For example, there are people who when it is pressed for time, will suddenly awakened creativity. Some are feeling left behind, self-motivated and able to perform brilliantly.
Stress shows itself through various symptoms, such as increased anxiety, tension and anxiety, dihayatinya physical pain (headache, heartburn, hives, diarrhea), the kelelahyan, muscle tension, sleep disturbances, or increased blood pressure and heart rate. Stress can also appear in perubahgan on behavior: individual so impatient, more irritable, withdrawn or displaying dietary changes. Some individuals feel frustrated, helpless, become lethargic and have a judgment.

Models of stress
Nurses use the model to help clients overcome stress response that is not healthy, non-productive. With modifications, this model can help nurses respond in a way that shows care for the individualization of the client.

Model-based response
Models based on the response or responses associated circuitry specialize in a particular response that might indicate a stressor. Stress model of Selye (1976) is based on a model which defines the stress response as non-specific response of the body against any claim that was inflicted on him. Stress is indicated by a specific physiological reactions, GAG, so that one's response to physiological stress completely and never be modified to allow the influence of cognitive (MC Nett, 1989).

Models based on stimulation
The model focuses on the characteristics of stimulation by an annoying or disruptive in the environment. The model is based on stimulation of focusing on the following assumptions (Mc Nett. 1989).
1. Changes in life events is normal. And the change requires the type and duration of the same adjustment
2. Individuals are passive resipen of stress and their perceptions of events are not relevant
3. All people have the same stimulus amjbang and disease can occur at a point after the threshold is seetiap.
Nurses may experience difficulties when trying to use this model in the management of stress due to lack of keleluasannya for individual adaptation.

Models based on individual
Models based on looking at individual transactions in relation to environmental da dynamic, reciprocal and interactive (and Floknenan Lazarus, 1984). The model developed by lazarus and flokman, viewed as a stressor individual perceptual responses that stem from psychological and cognitive processes. Stress comes from relationships between individuals and the environment.

 The response to stress
When there is stress, a person using physiological and psychological energy to respond and adapt. Stress response is adaptive and prosektif, and the characteristics of this response is the result of integrated endocrine response of the neuron. Below will be explained more clearly in response to stress there are two, namely:
► physiological response
Classic research conducted by Selye (1946, 1976) has identified two physiological responses to stress: Okal adaptation syndrome (LAS) and the general adaptation syndrome (GAS), LAS is the response of tissues, organs or body parts to stress kjarena trauma, illness or change other physiological. GAS is the response of the whole body's defenses against stress.
LAS 
All forms of LAS has the following characteristics:
1. There is a local response, this response does not involve the whole body system
2. Adaptive response, meaning that the stressor is needed to stimulate.
3. Response is short term, there is a continuous response
4. Response is restorative, meaning that the LAS assist in restoring the homeostatic region / body part
As an example of the reflex response LAS pain and inflammatory responses. Reflection response of pain
Pain response is a reflection of the local response of the central nervous system to pain. This response is adaptive responses and protect tissues from further damage lanjuut
The inflammatory response
Distimuli inflammatory response to trauma or infection. Inflammatory response to this market, thereby inhibiting the spread of inflammation and promote healing. The inflammatory response includes the three phases.
• The first phase includes changes in the cells and the circulatory system
• The second phase is marked by the release of exudates from the wound
• Fffase last / third is the repair or regeneration of tissues by the formation of lung tissue.
 GAS
GAS is the physiological response of the whole body to stress. GAS consists flow peringata reaction, visislens stage, and stages of labor kenalisan. The following explanation:
 alarm reaction
Alarm reaction involves directing the defense mechanism of body and mind to face the stressor. During the alarm reaction of individuals exposed to specific stressors.
 Stage resistant
In the back of the body resistant stable stage, hormone levels, blood pressure, heart rate and cardiac output increased again to normal.

 Stage of exhaustion
Stage of exhaustion occurs when the body can no longer resist the stress and when the energy required to maintain the adaptation that has been thinned.
► Psychological Response
Psychologically adaptive behavior can be constructive or destructive. Constructive behavior helps individuals to accept the challenge to resolve the conflict. Even anxiety can be constructive: for example, anxiety may be a sign that there is a threat that someone can take action to reduce its severity. Adaptive behavior is also referred to as a psychological coping mechanism.
o Treatment of task-oriented
Task-oriented behaviors include the use of cognitive ability to reduce stress, solve problems, resolve conflicts and meet the needs. (Stuart and Sundeen).
o Defense mechanisms
Ego defense mechanisms whose purpose is to regulate the emotional distress and thus provide individual protection te4rhadap anxiety and stress. Ego defense mechanisms is a method of coping with stress are not unfamiliar.

NURSING PROCESS AND ADAPTATION TO STRESS
One's perception of the stressor is based on the beliefs and norms, experience and lifestyle, environmental factors, family structure and function, developmental stage, past experience with stress and coping mechanisms.
 Physiological Indicator
Physiological indicators of stress is the objective, is more easily identified and can generally be observed or measured. The relationship between psychological stress and disease is often called the mind body interactions. Research has shown that stress can affect patterns of disease and illness. Stressful situations can be divided into 3 sections:
 mild stress situation is a stressor that everyone faces on a regular basis, such as too much sleep, traffic congestion, criticism from superiors.
 ongoing stressful situation much longer, from several hours to several days
 The situation is a situation of chronic stress that can take several weeks to several years. Such as marital discord continuous, trouble finansional prolonged and long-term physical pendyakit.

 Indicator development
Prolonged stress can affect the ability to complete development tasks. Prolonged stress can interfere with or impede the smooth finish that stage of development. In the form of existential, prolonged stress can lead to a crisis of maturity.
 baby or small child in the home generally face the stressor
 school-age children typically develop a sense of adequacy
 Teens usually develop a strong sense of identity but at the same time need to be accepted by their peers.
 Young adults in transition from adolescence to the experience of adult responsibilities
 middle age are usually involved in building a family, creating a stable career and the possibility of caring for their parents.
Age  elderly generally face change adaptation in the family and the possibility of the death of a spouse or a friend of his life.


 Indicator emotional behavior
Individual personalities include complex relationships diatara many factors, it is a reaction to prolonged stress determined by examining the client's lifestyle and the last stressor, previous experience with the stressor, coping mechanisms that work in the past, the role function, self-concept and fortitude that is a combination of three personality characteristics are thought to be the media to stress

 Indicator intellectual
Prolonged stress can manifest in the intellectual dimension and has indicator that can be observed

 Social Indicator
Assess stressors and coping resources in the social dimension covers the court with clients on the size, type and quality of social interactions that exist. Family stressors can sign menimbuilkan effect. Dysfunction affecting the client or the overall keluiarga (Reis and Heppner, 1993).

 spiritual Indicator
People using spiritual resources to adapt to stress in many ways, but stress can also manifest in the spiritual dimension

 Improving health
The nurse must first establish a severe help, create mutual trust comfortable environment serves as the basis for any changes in behavior. When helping clients reduce stress, nurses reduce stressful situations, reduce the physiological response to stress and improve emotional and behavioral responses to stress.

► Reduce stressful situations
Nurses can reduce some stressors and thereby giving the client a greater sense of control. There are several methods that help in reducing stress.
 Structure
 Management of time
 environmental modification
► Reduce the physiological response to stress
In general, stress management techniques include the usual health promotion can reduce the impact of stress on physical and mental health. General requirement for penalataksanaan stress including
Exercise regularly 
 Humor
 Nutrition and diet
 Rest
 relaxation techniques
 Spirituality
► Improved behavioral and emotional responses to stress
Behavioral and emotional responses to stress can be bridged by using a system support, crisis intervention and improved self-esteem.
 System supporters
 crisis intervention
Is a therapeutic crisis intervention techniques to help clients solve specific problems due to stress that just happened. There are crisis intervention, namely:
1) Crisis
2) The crisis situation
3) the development crisis
 Increase self-esteem

► Improve stress management for care
Most of the nurses experienced stress in their work environment is stressful jobs often lead to a condition called fatigue

CORE CONCEPT
- The mechanism is controlled by physiological adaptis through oblongata, and reticular formation of the pituitary gland
- Prolonged Stress lowers the body's adaptive capacity
- Stress is a physiological or psychological stress that can affect any or all of the human dimension
- A person may encounter environmental stressors in the internal / external
- Stressors require changes / adaptations so that the state can be maintained akuilibriuym
- A person's response to stress is influenced by the intensity, duration and scope of the stressor and the magnitude of stressors that occur at specific times
- A man facing stresdengan using sources in the physical and developmental, emotional, intellectual, social and spiritual
- Ekedua form of physiological response to stress is the local adaptation syndrome and the general adaptation syndrome
- Sinmdrom common adaptations include physiological responses, to stress mulktisistem
- The three stages of the syndrome is common adaptasdi warning reaction, resistance phase and exhaustion stages
- Psychological Response to strestermasuk firmly oriented behavior and mechanisms of ego resilience
- Ego defense mechanisms are unconscious behavior that gives a person protection from stressful feelings or events that
- Stress has an impact on the onset, travel and outcome of disease.
- Prolonged stress lose the ability to adapt to stress and have someone in keldima dimension
- People generally learn to use a strategy of short-term and long term to cope with stress.
- Stress management techniques include peningkatn habit habits health crisis intervention
- And the improvement of health, crisis intervention and methods of work stress reduction.

In individuals, the source of the stressor can be:
1. Environment
1. Environmental attitudes: The form of the demand, positive and negative views on the success of acceptable work
b. Kelduarga demands and attitudes, for example, must get a job, the desire for parental choice to work
c. Ppperkembangan science and technology (Science and Technology), the more quickly obtain information and future trend if it works for something to be desired
2. Yourself
1. Psychological needs of the lust that must be achieved against the cool them.
b. Internalization process itself, namely the absorption of the continually desired in accordance with its development
3. Mind
1. Associated with an individual assessment of the environmental and pendgaruhnya on perceptions of self and the environment
b. Related to the way self-assessment on how the adjustment can be done by the individual concerned.

Negative assessment of the individual mind both current and foreseeable future to give a more severe effect. For example:
- Anxiety entrance exams work
- Fear not pass the entrance exams work
- In doubt follow from work

STRESS IN DAILY LIFE
The onset of stress and personality factors
In action and alert yourself to face a danger, the individual often can not distinguish whether the danger tersebuit concrete / real or merely the perception / anticipation mere shadow, depending on the individual unconscious attitudes toward the stressor. Anticipation of negative emotional reactions may aggravate or extend more and reasonable. Also can arise in reaction to something that actually never happened. Psychological stress can accumulate and affect health.
Personality and behavior patterns of individuals to determine the pattern of reaction to a situation or event. Attitudes, and habits that kuranglugas tatanilai and anticipatory fear of going to things that are not yet known, impatient, angry, anxious and so can lead to nerve stimulation and the same biochemical reactions in the face of stressors such as concrete and cause unnecessary stress.
Two cardiologists, M. Friedman and R. Rosenman developed the following classification: type A personalities who tend to be excited: very conscious of time, impatience, stress.

Changes in lifestyle
Lifestyle changes can be a challenge that brings stresoir nTo take risks and adapt. The better the health status of a person going the better the ability to cope with these changes. TH Holmes and RH Rahe created a scale of social adjustment by making the weighting score required by the person to change or adjust to the changing situation perbagai life: More than 300 in one year means that the risk of falling ill in 80% of individuals: 150 299 30% reduced risk ; and less than 150 means that the risk lightly.
Other experts argue that external events are not enough to cause interference, but the combination of experience and genetic factors must exist for the sick. Personality and ability to cope with life changes that determine how well the reaction in such a life change.

Achievement demands
We are making progress with challenges and stress of physical feats and skills. This is a healthy thing as long as we remain confident, and able to use the energy and tension arising from these additional demands. Certain emotional states can also be a secondary stressor; boredom with the lack of stimulation or interest in the work, unemployed or retired may cause derpesi, apathy and stress. Doubts about whether it was needed or appreciated may lead to poor self-image and sense of alienation often.
Grief or loss of a spouse with divorce, separation or death can influence the prolonged menimbulakn. And if it does not resolve your grief can trigger mental or physical illness.
WHAT STRESS ON OUR BODIES
Stress is a natural response of our body and soul when subjected to environmental stresses. The impact of diverse strespun, can affect mental and physical health but also have a positive impact (eustress). Here are the effects of stress that you know sebainya
The positive impact of waged spirit!
Effects of stress on this one it is very important to balance the body. Eustress is a positive impact of stress that makes you become discouraged when faced with a case or issue a challenge. Your creativity can testimuylasi. For example, when deswainer must complete a rancangtan already approaching deadline, he will devote all its capabilities and creativity to design the perfect finish.

Chronic stress triggers extreme measures
Prolonged stress will lead to tensions and worries constantly. According to the psychological term, prolonged stress is called chronic stress. Nature of chronic stress undermines and destroys the body, and the whole life of his suffering pikir5an slowly. As a result, the patient will continue to feel depressed and lose hope.
No wonder people with chronic stress eventually took the decision to commit suicide or die of a heart attack, stroke, cancer or high blood pressure. So observe yourself, if you include people who like to let the matter without a positive way out? Be careful of the consequences that you will face!

The stress is more sensitive
People who are stressed will be more sensitive than people who are not in conditions of stress. Therefore, someone who stressed esring misrepresenting what happened to him. Could be one of perception, one read and interpret a situation, opinion or judgment, criticism, advice, and even the behavior of others.
In addition, the stress tends to associate everything with him. As a result he has more to withdraw from the environment, no longer follow the usual activities and easy emotion. No wonder the result of this attitude they are shunned by her friends. Negative response will further add to the burden that he suffered because of the perception that during the time he thought was right.

Influence to health
• Triggering heart disease
In the long term, uncontrolled stress would trigger a rise in blood pressure so that the risk of heart attack meningkatl. Stress can also raise blood cholesterol levels. These conditions are made so that the clogged arteries of patients susceptible to heart attack or stroke are familiar with our usual
• Causes the body easily tired and limp
This is because the hormones serotonin and melatonin is disrupted when the body is stressed. Need and know, both these hormones play a major role to help us sleep well. Sleeping conditions will trigger a rise in cortisol hormone in the body. As a result, eye brows screwed hard imsomnia
• Cause gastric disorders like heartburn
Heartburn arises because the production of excess stomach acid. Well, when you are stressed, your body will produce gastric acids in amounts higher than normal and also erode the stomach lining, or mucosa, which in turn cause the pain that we know as heartburn.

As for how DEALING WITH STRESS
First you must learn to recognize stress. Gejkala-stress symptoms include mental, social and physical. These include fatigue, loss of or increase in appetite, headaches, crying, sleeplessness, and oversleeping, break away from alcohol, drugs or other compulsive behavior are often indications of feelings of stress symptoms of anxiety, frustration or kelelusan can accompany stress.
What can you do to manage your stress? What strategies are there?
1. Consider the environment around you might see something that you really can you change or control in such situations.
2. keep yourself from stressful situations, your situation, give yourself a chance to rest
3. learn the best way to relax yourself and, meditation and breathing exercises have been proven effective in controlling stress. Practice to clear your mind of disturbing thoughts.
4. Determine realistic goals for yourself. By reducing the number of events that happen in your life, you will be able to reduce the burden of excessive
5. Do not be concerned about trivial things, try to prioritize a few things that really matter and let the others follow
6. Do not overload yourself with too much you are complaining about your entire workload. Handle each task as where it should, or deal selectively with respect to some priority.
7. Get enough sleep, lack of rest just aggravates stress. Use a good weekends, particularly for self memajatkan and out of the daily routine
8. Open, not buried our problems alone. With a variety of stories to people who we believe we will force the load is lighter and does not settle in the mind.
9. Levels of sense of humor, humor can be used clinically to relieve stress. Humor is needed so that nerves are not too tight and the body can relax.
As with individuals, family groups may be beradaptsi to stressors. Aedalah family adaptation process in which the family maintains a balance so that families can meet the goals and tasks to cope with stress and enhance the growth of individual members.

ADAPTATION
Adaptation is the outcome of coping efforts, adapting response characteristics are:
- Able to maintain a balance
- Adaptation takes time
- The ability of adaptation is different for each individual
- Adaptation to the laborious and need help from others.

ADAPTATION to stressors
Adaptation is the process by which the physiological and psychosocial dimensions of change in responding to stress. An adaptive process occurs when the stimulus of internal and external environment causes deviations balance of organisms. With dmeikian adaptation is an attempt to maintain optimal function. Melibgatkan adaptation reflex, an automatic mechanism for the protection of coping mechanisms, and may lead to adjustments idelany1., Mastery of the situation (Selye, 1976). Mosen. Floyd and Brookman 1992). Short term such as fever, long term, such as paralysis of the limbs of the body.
In order to function optimally, one must be able to respond to and adapt to the demands stresir or needed changes, adaptation requires an active response from all individuals.

ADAPTATION
Physiological adaptation to stress is the body's ability to maintain a state of relative balance. This adaptive capability is a form of dynamic equilibrium of the body's internal environment. Internal environment is constantly changing and adaptive mechanisms of the body is continuously working to adapt to these changes and to maintain equilibrium or homeostasis.
Homeostasis is maintained by a physiological mechanism that controls body functions and organs of the body to monitor most of these mechanisms are controlled by the nervous and endocrine system and do not include the behavior of the body sasdar make adjustments in heart rate. Frekeunsi breathing, blood pressure, body temperature, fluid balance and elektrolis, hormone secretion and levels of consciousness are all shown to maintain adaptation.

Physiological ADAPTATION MECHANISM
Physiological mechanisms of adaptation to function through a negative feedback mechanism is a process by which a state of abnormal control feel like a drop in body temperature and makes an adaptive response, such as starts to shiver to generate body heat
Medulla oblongata, medulla oblongata is a vital control functions needed to maintain these functions including heart rate, blood pressure and respiration.
Reticular formation is a small group of neurons in the spinal cord and batng optak. This group also controls the vital functions and continuously monitor the physiological status of the body via connections with sensory and motoriks tract. For example, certain cells in the reticular formation can cause a sleeping person awake or increase awareness tingkt when the need arises.

MODEL ADAPTATION
Ability to adapt, stress, the first factor usually depends on one's experience with similar stressors. System support and overall perceptions, the second factor relating to the practice of individual and peer group norms. These responses can help clients adapt to stress or respond to simple circuitry to adjust to the behavior of a group of peers.
The third factor is the impact of social environment in helping an individual to adapt to the stressor. Last factor includes resources that can be used to cope with the stressor.

The Concept Of Culture And Health Community Hospital


Mutant contains a lot of healthy term kulturan, social and professional understanding of the diverse. First from the point of view of medicine, health is closely associated with pain and disease. In fact it is not that simple, healthy should be viewed from various aspects. WHO (1981): Health is a state of complete physical, mental and social well being, and not merely the absence of disease or infirmity. 

WHO defines a healthy sense as a perfectly good physical condition, rohami, as well as one's social welfare. What extent one can be considered complete physical? By health experts, medical anthropology is seen as a discipline biobudaya pays attention to those aspects of biological and social culture of human behavior, especially about the ways of interaction between the two throughout the history of human life that affect health and disease. Disease itself is determined by culture: this is because the disease is the social recognition that the person can not afford to run its normal role of natural causes. Way of life and human life style is a phenomenon that can be associated circuitry emergence of various diseases, in addition to the results of different cultures can also cause disease.

Community and traditional healers are two concepts embrace the cause of pain is: Naturalistic and personalistic. Naturalistic is the cause of a person suffering from pain due to environmental influences, the food (one meal), living habits, imbalance in the body, including the trust as a cold chills and congenital diseases. Embraced the concept of healthy pain medicine tradisiolan (Battra) similar to that adopted by the local community, which is a condition associated with a state agency or state body disorders and symptoms are healthy for a person means a state of normal Yuang, face, comfortable and can perform daily activities with passion. While the illness is considered as a state agency that is less fun, even perceived as a punishment that causes a person can not afford to run their daily activities as well as healthy individuals (7). While the personalistic concept considers the emergence of disease (illness) is caused by the intervention of an active agent which can be either non-human creatures (ghosts, spirits, ancestors or evil spirits), or human beings (witches, fortune-teller). Tracing the cultural values, such as the introduction of leprosy and treatment. Leprosy has been known by the ethnic Makasar long time. The existence of the term kaddala sikuyu (leprosy crab) and kaddala massolong (leprosy is melted) is an expression of support that leprosy is endemic have been in a long time in the midst of the community. 

The results of qualitative research and nkuantitatif on cultural values ​​in the District Soppeng, in relation to leprosy (kaddala, BGS) in Bugis society shows that arise and are strictly diamalkanya leprophobia because according to one cultural figures, in marriage counsel older people there , said kaddala come covered in it. Mentioned that in the event of a violation to have sex when she is menstruating, they (the bride) will be cursed and suffer from leprosy / kaddala. The idea of ​​aiming for a great moral being created in the new family, growing comply with the communication process in society and became a leper as a stage concept of sin. Understanding the patient as a result of the sins of the mother-father is suffering from early leprophobia. Low self-esteem of people with low self-esteem begins to feel tainted family when one family member suffering from leprosy. Accused of sin to have sex when she is menstruating for a fanatical Islam is perceived as psychosomatic traumna burden is very heavy. (8). 

Parents, the family is refusing her son was diagnosed leprosy. In the present study the use of Health Services. In the province of East Nusa Kalimanta Western Landmark (1990), the results of group discussions in East Kalimantan showed that the children expressed pain when mengangis continues, the body sweats, not eating, not sleeping, cranky, skinny. For adults, a declared sick when it's not working, can not walk, malaise, chills, dizziness, weakness, anemia, cough, nausea, diarrhea. While the results of group discussions at the World Medical Nusa Tenggara No Mirror. 149, 2005 50 

West suggests that the sick child be seen from the physical state of the body and behavior yaitujika show symptoms such as fever, cough runny nose, diarrhea, vomiting, itching, sores, abscessed tooth, yellow body, leg and abdominal swelling. A traditional healers who also accept the view of modern medicine, has an interesting knowledge about ill-health problems. For him, the meaning of illness are as follows: bodily pain means no signs of disease in the body such as high fever, weak eyesight, is not strong work, it is difficult to eat, sleep disturbances, and weakness or pain, lie down or rest it wants. Inner Padapenyakit no signs on his body, but can be known by asking the supernatural. In healthy people, movements agile, strong, working, normal body temperature, and then the normal sleep, visions bright, bright eyes, do not complain of lethargy, weakness or body aches (9). 

Based on the range of healthy-sick, then the paradigm of nursing in the health-illness concept, the paradigm of nursing in the concept of healthy-looking sore that forms keperawtan services to be provided over a range of healthy and sick, will advance the health status in a healthy range, pain, whether its status in setanggah stage illness, pain or chronic pain, so it will dikethaui levels of nursing care to be provided and the objectives to be expected in improving health status. Range where it can be drawn from the hospital a half sick, skait, chronic pain and death ended circuitry, while the healthy range can dgigambarkan from normal healthy, very healthy and prosperous as the highest health status. 

This range is a measurement tool in assessing the status kesehaqtan that is dynamic and always changing in every time. Through this range can be known limitation of nurses in nursing practice clearly.

The phenomenon of ill health


Ill health science is the study of the interrelationships between health factors and environmental factors. Health regarding all aspects of life are very wide-reaching scope, one of the meter to go through the health status of a region is the morbidity that shows the health status in society. People with this component memandnag that it is a form of nursing care given to sick people in a healthy range

Many factors affect the health of the business mentioned above, the physical factors that affect the health of the business. Factors that affect the health of business environment factors can be physical / chemical. Biological environment or social environment, economic, cultural and physiological conditions of human beings can cause disease.
Currently it is now recognized that the health aspects of health and illness due to environmental and development process is not limited to environmental pollution directly tetapiu must remember also about environmental pollution indirectly.
Thus it is recommended to provide nursing services to the community in a healthy or sick factors arising from the various aspects of life.

Clinical Picture of Pertussis


Period of 7-14 days of shoots, the disease can last up to 6 weeks or more and is divided into three stages, namely:

Kataralis Stadium: The duration of 1-2 weeks. At the beginning only a mild cough, especially at night. These coughing grew worse and occur day and night. Other symptoms are runny nose, hoarseness and anorexia. This stage resembles regular influenza.

Spasmodic stage: 2-4 weeks duration. At the end of the week of increasingly severe coughing and going proksismal a typical cough. The patient was sweating, neck and facial blood vessels to widen. The patient cough up so heavy tread agitated with a red face and cyanotic. Long bouts of coughing, there is no such inspirium and ends with a whoop (a long, deep breath-pitched sounds). Often accompanied by vomiting and a lot of thick sputum. Children can be terberak-stools and peed. Activities such as laughing and crying can cause coughing.

Konvalensi Stadium: The length is approximately 2 weeks to heal. In the fourth week the number and severity of attacks was reduced coughing, vomiting also reduced as well, my appetite back. Diffuse crackles found in spasmodic stage begin to disappear. A kind of common cold infections can cause coughing attacks again. When encountered a patient with cough has long been given the drug and no improvement. Moreover, there are complaints of cough with vomiting at the longer end of the cough and high-pitched voice can be presumed that the patient has pertussis.

Diagnostic Examination of Pertussis
At the beginning of the stadium and stadium kataralis spasmodic rising sometimes to the number of leukocytes per mm3 with limfosis 15000-45000, diagnosis can be confirmed by isolating the bacteria from the airway secretions are released when coughing. In the laboratory diagnosis of pertussis can be determined berdasrkan bacteria in culture or by examination imunofluresen.

Complications and Prevention of Pertussis


Complications
Complications of pertussis are as follows:
Respirator
Otitis media may occur (often in infants), bronchitis, bronchopneumonia, atelectasis caused by mucus blockage, emphysema (mediastinal emphysema may occur, neck, severe skin kaswus) bronkrektasis whereas pre-existing tuberculosis can become more severe.








Digestion Tool
Severe vomiting that can lead to emasiasi (the child becomes very thin) or hernia prolapsed rectum that may arise due to intra-abdominal pressure tingginyua, ulcers on the tip of the tongue because it rubbed on the teeth or coughing attacks tergigik time, also stomatitis.

Nervous System
Seizures may occur due to electrolyte imbalance due to vomiting. Sometimes there is congestion and edema in the brain, brain bleeding may also occur.

Prevention
Prevention can be done in 2 ways:
1.      Actively, by giving the pertussis vaccine in a total of 12 units divided by the dose interval of 8 weeks.
2.      Passively, prevention can be done by giving chemoprophylaxis.

Pharmacology Of Hypertension Drugs


Drugs commonly used include the class of diuretics, beta blockers, calcium channel blockers, ACE inhibitors, angiotensin II receptor blockers, alpha blockers, adrenergic inhibitors and vasodilators

Use of ACE inhibitor therapy is a safe and conventional therapy. Although the drug is effective and used as the primary option, but these drugs often cause side effects cough is very annoying. This led to the selection of drugs known as angiotensin II receptor blocker as an alternative therapy.



Here are a few examples of drugs known as angiotensin II receptor blocker:
A.    Valsartan (generic name)
Trade name in Indonesia
Diovan ® from Novartis

Indication: Treatment of hypertension, heart failure and post myocardial infarction

Contraindications
Pregnancy and lactation, severe liver damage, hypersensitivity to valsartan or its constituent components.

Dosage form, dosage, and the rules of use.
Diovan dosage forms of tablets 40 mg, 80 mg, 160 mg and 320 mg. 
1.      The initial dose for heart failure is 40 mg 2x a day, and the maximum dose of 320 mg / day.
2.      The initial dose for heart failure is 40 mg 2x a day and a maximum dose of 320 mg / day
3.      The dose for post-myocardial infarction, the initial dose of 20 mg 2x a day.

Side effects
Drugs can cause unwanted effects and adverse side effects, although not all of this happen. If there are side effects that occurred then it should immediately consult a medical. Here are some side effects that may occur in the use of valsartan as an antihypertensive:

Dizziness (7%), fatigue (19%), fatigue (3%), headache, vertigo (1%), diarrhea (5%), abdominal pain (2%), nausea (1%), neutropenia (2% ), hyperkalemia (2%), cough and upper respiratory tract infection (1%).

Special Risks
  1.  In pregnant women: dangerous on the second and third trimester and may cause fetal death.
  2. In renal failure this drug should be used carefully, renal function and potassium concentrations should be monitored especially for use in elderly patients. And also need a dose adjustment.
  3. In hepatic disorders secar this drug should be used carefully because it can enhance the effect of valsartan. This is because the elimination of time, so the use of liver disorders should be done on dose adjustment.

 B.     Irbesartan (generic name)
Trade name in Indonesia
Aprovel ® from Sanofi Aventif, Irentensa ® of Fahrenheit

Indication
Essential hypertension (hypertension of unknown origin)

Contraindications
Pregnancy and lactation, hypersensitivity to irbesartan or its constituent components

Dosage form, dosage, and the rules of use
Dosage forms of tablets aprovel ® is 150 mg and 300 mg while the iretensi ® 150 mg tablets
  1. Initial and maintenance dose for hypertension 150 once a day, can be increased to 300 mg or plus other classes of antihypertensive drugs
  2. The initial dose for renal impairment in hemodialysis 75 mg


Side effects
They can cause undesirable effects and adverse side effects, although not all of this happen. If there are side effects that occurred then it should immediately see a doctor. Here are some side effects that may occur in the use of irbesartan as an antihypertensive:

Hiperkalmia (19%), hypotension (5%), fatigue (4%), fatigue 10%), diarrhea (3%), upper respiratory tract infections (9%), cough (2.8%).

Special Risks:
  1. In pregnant women: berbahay on the second and third trimester and may cause fetal death.
  2. In renal failure this drug should be used carefully, renal function and potassium concentrations should be monitored especially for use in elderly patients. And also need a dose adjustment.
  3. In the liver disorder medication should be used cautiously because it may enhance the effects of irbesartan. This is because of elimination in a long time, so the use of the kelaianan hepatic dose adjustment should be done.

 
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