Impaired Physical Mobility Research Articles

Implementasi Range Of Motion (ROM) Pasif Untuk Meningkatkan Mobilitas Fisik Pada Pasien Dengan Stroke Hemoragik Di Rumah Sakit Vita Insani Pematangsiantar

Stroke is a functional brain disorder in the form of death of neurological nerve cells due to disruption of blood flow in one part of the brain. Hemorrhagic stroke is a ruptured blood vessel in the brain which results in intracranial bleeding. The prevalence of stroke cases every year is 13.7 million and around 5.5 million deaths occur due to stroke. One of the nursing problems that arises in cases of hemorrhagic stroke is impaired physical mobility. Efforts that can be made to overcome physical mobility disorders are passive range of motion (ROM). This research design uses the Case Study method. The sampling method used is purposive sampling. The samples taken were 2 respondents, namely patients with hemorrhagic stroke who were hospitalized at Vita Insani Hospital, Pematangsiantar. The results showed that there was an increase in mobility experienced by hemorrhagic stroke patients, a decrease in muscle strength, Mr. U scales (3) to (4) and in Mr. S scales (2) to (3). Passive range of motion (ROM) is effective in cases of hemorrhagic stroke in increasing physical mobility. Nurses are expected to be able to accompany patients to apply passive range of motion (ROM) in an effort to increase physical mobility in hemorrhagic stroke patients.

Asuhan Keperawatan pada Tn. A dengan Diagnosa Medis Post Operasi Soft Tissue Tumor (STT) Flank Sinistra di Ruang Mawar 2 RSUD Dr. Soeselo Kabupaten Tegal

Tumor is a disease that is currently one of the health problems that causes death, soft tissue tumor or soft tissue tumor is an abnormal lump that is formed due to the growth of new cells (Irsal et al., 2020). The signs and symptoms in soft tissue tumor patients include pain due to the surgical process. The purpose of this writing is to find out and provide nursing care to Mr. A with a medical diagnosis post-operative soft tissue tumor (STT) left flank in the rose room 2 RSUD dr. Soeselo Tegal Regency in accordance with nursing standards. The methods used are descriptive methods and data collection methods. From the case review, it was found that Mr. A complains of pain. Three diagnoses were found, namely acute pain, impaired physical mobility and knowledge deficit. Interventions are prepared based on the theory of SDKI, SLKI and SIKI as well as on the client's condition and can be implemented.

Patient Care for Gout Arthritis with Physical Mobility Impairments Who Received Active Therapy Range of Motion (ROM) at Kandangsapi Health Center

Impaired physical mobility is a health problem where a person cannot move freely and regularly. In general, the problem of impaired physical mobility can occur in various age groups, one of which can occur in elderly sufferers. gout arthritis. Generally, sufferers of gout arthritis experience joint stiffness and pain when moved, making it difficult for sufferers to move their extremities. If physical mobility problems are not treated immediately, it can cause sufferers to have difficulty carrying out daily activities. Generally, sufferers of gout arthritis take medication to lower uric acid levels, but consuming too much medication can cause dependence, memory problems, kidney failure, and so on. Therapy range of motion can be a reference for overcoming physical mobility disorders that can be done anytime, anywhere, and do not cause side effects such as taking drugs. This case study aims to identify further changes in physical mobility experienced by sufferers of gout arthritis who experience physical mobility problems after therapy range of motion. This research method is a case study design where the patient is approached using the nursing process. In this case study, the author applies the therapy range of motion active in-patient Mrs. S for seven days. The results showed that on the seventh day, the nursing problem of impaired physical mobility was resolved, and this was proven by achieving all the outcome criteria for nursing goals. So, the therapy range of motion effectively overcame physical mobility disorders in patients with gout arthritis.

Tingkat Kemandirian Pasien Dengan Gangguan Mobilitas Fisik Dengan Berbagai Macam Penyakit

In Indonesia, 22.5 million people experience disabilities with the highest incidence occurring in those aged 60 years and over (elderly). Meanwhile, the most common impairment or limitation of function experienced by persons with disabilities in Indonesia is impaired walking (immobility). This mobility impairment can affect a person's independence in fulfilling their daily activities.This study aims to determine the level of independence of activity of daily living (ADL) in patients who experience impaired physical mobility. This research is quantitative research with a descriptive survey design. The sampling technique used purposive sampling technique with a total sample of 102 patients who experienced impaired physical mobility aged ≥ 60 years and domiciled in the Sukra Health Center work area. Measurement of ADL independence using the Katz Index questionnaire, which has been back translated and tested for construct validity with a calculated r value of 0.580-0.740 > r table 0.361 which means it is valid. Data were analyzed univariately and cross-tabulated. The results showed that the majority of patients with impaired physical mobility experienced total dependence in performing ADL (23.5%). Total dependence was more experienced by patients aged > 90 years (24.7%), female (26.1%), suffered a stroke (42.6%), lived with family (27.1%), usually assisted by other people (nurses/neighbors/helpers) (50%), and had been hospitalized less than 1 year ago (35%). Patients with impaired physical mobility are expected to be able to fulfill all activities daily living either independently or with the help of others.

Clinical validation of the nursing diagnosis "Fall risk in adults (00303)" in elderly people in the community-dwelling.

To identify the risk factors for the nursing diagnosis of fall risk in adults (00303) in elderly people in the community-dwelling. This is a methodological study, with a quantitative approach, carried out with elderly people living in the city of Ribeirão Preto, SP, Brazil, from February to December 2018. For data collection, the demographic profile, Mini-Mental State Examination, diseases self-reported, functional independence measure, Lawton and Brody scale, geriatric depression scale, and self-perception of gait instruments were used. Tests of accuracy and association of risk factors with p ≤ 0.05 were performed. A total of 262 elderly people, aged over 80 years (55.7%), 71% of which were female and 42.7% were widowed, were included in the sample. A total of 82.1% had vascular diseases, 72.1% had diabetes, and 20.6% had depression. The predominant risk factors were difficulty performing instrumental activities of daily living (58.8%), cognitive dysfunction (43.5%), and depressive symptoms (26.3%). Difficulty performing instrumental activities of daily living had a sensitivity greater than 60%. The positive and negative predictive values were mostly greater than 50%. In the regression analysis, it was found that the elderly have a higher risk of suffering a fall if they present anxiety (p=0.05), impaired physical mobility (p=0.02), and difficulty to perform instrumental activities of daily living as risk factors (p=0.03). It was possible to identify the presence of risk factors for the diagnosis fall risk in adults (00303) in the clinical context of the elderly in home settings and contribute to the clinical validation of the taxonomy, increase the evidence and importance of the diagnosis, and generate new knowledge for gerontological nursing. To help nurses identify risk factors that lead elderly people to suffer falls at home and to implement preventive actions in their community with the support of their families.

Pregnancy and Postpartum Experiences of Women with Impaired Physical Mobility Facing Challenges within Their Surrounding Physical and Social Contexts, Alongside Interventions from Occupational Therapy

Pregnancy and Postpartum Experiences of Women with Impaired Physical Mobility Facing Challenges within Their Surrounding Physical and Social Contexts, Alongside Interventions from Occupational Therapy

Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility.

To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation. A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus. Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient. The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs. These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes. In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.

Analisis Asuhan Keperawatan Pasien dengan Myasthenia Gravis pada Kehamilan

This study aims to analyze cases of myasthenia gravis (MG) in pregnancy using the Roy Adaptation model approach. The research method used a case study approach with a case of a patient experiencing MG-weighted flaccid tetraparesis during pregnancy. The research results showed that the nursing care plan used the Roy adaptation model. The main needs found are nutrition (swallowing disorders), mobility (impaired physical mobility), sensation (acute pain) and protection (risk of infection). Interventions provided include self-care assistance: eating, exercise promotion: muscle strength, pain management and infection control. In conclusion, Roy's adaptation model approach is useful in this case because it focuses on the patient's ability to adapt to his illness. The patient had a disease that had been going on for years and had worsened due to her pregnancy. Providing appropriate nursing care can speed up patient recovery so that the length of stay is shorter. Keywords: Roy Adaptation, Nursing Care, Myasthenia Gravis

Asuhan Keperawatan Medikal Bedah dengan Intervensi Penerapan Slow Stroke Back Massage Therapy pada Pasien Stroke Non Hemoragik dengan Masalah Perfusi Serebral Tidak Efektif dan Gangguan Mobilittas Fisik di Ruang Flamboyan RSUD dr. T.C Hillers Maumere

Non-hemorrhagic stroke is a clinical sign of dysfunction or damage to brain tissue caused by lack of blood flow to the brain, thereby disrupting the need for blood and oxygen in brain tissue. Slow stroke back massage therapy is a non-pharmacological therapy to overcome problems in patients with stroke. This research aims to be able to carry out nursing care for clients with non-hemorrhagic stroke using slow stroke back massage therapy in the Flamboyan Room at RSUD dr. T.C Hillers Maumere. The research design used was a case study. The approach used is a nursing care approach which includes identifying data from assessment results, nursing diagnoses, planning, implementation and evaluation. Slow stroke back massage therapy is carried out for 3 days. Data collection techniques used a medical-surgical nursing care assessment format, observation and literature study. The results of the case study showed that clients were diagnosed with ineffective cerebral perfusion and impaired physical mobility. The application of slow stroke back massage therapy showed improvements or changes on the third day, which resulted in the client experiencing a decrease in blood pressure from 180/100 mmHg to 160/90mmHg, not complaining of dizziness, and the patient's right hand was starting to be able to move. The conclusion of this case study is that slow stroke back massage therapy is effective in reducing blood pressure and also helps in increasing physical mobility in non-hemorrhagic stroke patients.

Nursing Experience Using Art Therapy to Help Women With Breast Cancer Face Changes in Body Image

The subject in this study was a female professional painter who underwent bilateral mastectomy because of bilateral breast cancer, experienced postoperative wound scarring, and developed alopecia due to the side effects of chemotherapy, which caused the patient to lose body image confidence and the motivation to engage in artistic creativity. The patient had shed tears early in the intervention and complained of difficulties with body image adjustment due to her altered appearance. Mastectomy patients must not only undergo drug treatment but also adjust psychologically to body image changes to decrease negative emotions. This was the author's motivation for involvement in this case. The nursing period was from 23 September to 30 December 2021. Physical, mental, spiritual, social, and family data were collected using observations and interviews. These data were evaluated and the main problems were determined to be disturbed body image related to altered body perception post-surgery, alopecia caused by chemotherapy, impaired physical mobility due to upper limb mobility limitations post-surgery, and nausea due to chemotherapy. The patient was encouraged to paint again and to use artistic creativity to comfort herself. Moreover, she was guided to express her innermost thoughts to face the impact of her changes in appearance. In addition, a care consultation channel was provided to facilitate experience sharing with other breast cancer patients, thus assisting the patient to cope with the mental impact of her treatments and face subsequent cancer treatments with a more positive attitude. Art therapy embraces a diverse variety of methods, including drawing and music. Art therapy is a valuable tool that facilitates both physical and mental healing. Based on this experience, nurses should include patients' close relatives when performing art therapy to facilitate shared care to overcome difficulties. We hope this nursing experience provides a practical reference for nurses.

Embodying a self-avatar with a larger leg: its impacts on motor control and dynamic stability.

Several studies have shown that users of immersive virtual reality can feel high levels of embodiment in self-avatars that have different morphological proportions than those of their actual bodies. Deformed and unrealistic morphological modifications are accepted by embodied users, underlying the adaptability of one's mental map of their body (body schema) in response to incoming sensory feedback. Before initiating a motor action, the brain uses the body schema to plan and sequence the necessary movements. Therefore, embodiment in a self-avatar with a different morphology, such as one with deformed proportions, could lead to changes in motor planning and execution. In this study, we aimed to measure the effects on movement planning and execution of embodying a self-avatar with an enlarged lower leg on one side. Thirty participants embodied an avatar without any deformations, and with an enlarged dominant or non-dominant leg, in randomized order. Two different levels of embodiment were induced, using synchronous or asynchronous visuotactile stimuli. In each condition, participants performed a gait initiation task. Their center of mass and center of pressure were measured, and the margin of stability (MoS) was computed from these values. Their perceived level of embodiment was also measured, using a validated questionnaire. Results show no significant changes on the biomechenical variables related to dynamic stability. Embodiment scores decreased with asynchronous stimuli, without impacting the measures related to stability. The body schema may not have been impacted by the larger virtual leg. However, deforming the self-avatar's morphology could have important implications when addressing individuals with impaired physical mobility by subtly influencing action execution during a rehabilitation protocol.

Implementation of Nursing Education on Physical Exercise for Post-Section Caesarean Surgery Patients with Impaired Physical Mobility Problems in the Obstetrics Room at Lahat Regional Hospital

The problem of impaired physical mobility in post-cesarean section patients is caused by the presence of surgical scars which cause pain in the patient, so that the patient prefers to lie down and not move. The causes of caesarean section include fetal factors, maternal factors, and birth history. Research Objective: To determine the implementation of maternity nursing care with physical exercise education for post-cesarean section patients with physical mobility problems at Lahat Hospital 2023. Research Method: Descriptive in the form of a case study, with two post-SC clients who have physical mobility problems. The approach used is nursing care which includes assessment, nursing diagnosis, planning, implementation, evaluation and documentation. Research Results: After being given physical exercise education, namely patients 1 and 2, they were able to practice physical exercise independently. Conclusion: The implementation of nursing care with physical exercise education shows the effectiveness of reducing physical mobility disorders in post-SC patients. Exercises There is no charge, and each movement can be completed independently at home

MOBILISASI DINI DENGAN LATIHAN GERAKAN ROM (RANGE OF MOTION) KEKUATAN OTOT PASIEN PASCA STROKE ISKEMIK DI RUMAH SAKIT TK II PUTRI HIJAU MEDAN

Ischemic stroke is a condition of hypoxia or decreased oxygenation to brain tissue and is the result of poor blood supply, causing disability. The prevalence of stroke in Indonesia increases at ages > 75 years (50.3%). Objective: This study discusses nursing care for ischemic stroke patients at the Tk II Putri Hijau Kesdam I/BB Medan Hospital, with a focus on two patients who have the same diagnosis but different main complaints. Method: The first patient experienced impaired physical and neuromuscular mobility, with symptoms such as pain on the left side of the body, numbness, weakness, and difficulty sleeping. Meanwhile, other patients experience disorders in different body systems, requiring specific treatment to overcome these complaints. This study emphasizes that appropriate nursing care is needed in treating ischemic stroke patients. Result: Based on the assessment, planning and implementation of nursing actions, this research confirms the importance of correct nursing care in handling Ischemic Stroke at the Tk II Putri Hijau Kesdam I/BB Medan Hospital. This has the potential to increase the understanding and implementation of effective nursing practices for Ischemic Stroke patients.

Risk Factors and Predictive Models for Peripherally Inserted Central Catheter Unplanned Extubation in Patients With Cancer: Prospective, Machine Learning Study.

Cancer indeed represents a significant public health challenge, and unplanned extubation of peripherally inserted central catheter (PICC-UE) is a critical concern in patient safety. Identifying independent risk factors and implementing high-quality assessment tools for early detection in high-risk populations can play a crucial role in reducing the incidence of PICC-UE among patients with cancer. Precise prevention and treatment strategies are essential to improve patient outcomes and safety in clinical settings. This study aims to identify the independent risk factors associated with PICC-UE in patients with cancer and to construct a predictive model tailored to this group, offering a theoretical framework for anticipating and preventing PICC-UE in these patients. Prospective data were gathered from January to December 2022, encompassing patients with cancer with PICC at Xiangya Hospital, Central South University. Each patient underwent continuous monitoring until the catheter's removal. The patients were categorized into 2 groups: the UE group (n=3107) and the non-UE group (n=284). Independent risk factors were identified through univariate analysis, the least absolute shrinkage and selection operator (LASSO) algorithm, and multivariate analysis. Subsequently, the 3391 patients were classified into a train set and a test set in a 7:3 ratio. Utilizing the identified predictors, 3 predictive models were constructed using the logistic regression, support vector machine, and random forest algorithms. The ultimate model was selected based on the receiver operating characteristic (ROC) curve and TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) synthesis analysis. To further validate the model, we gathered prospective data from 600 patients with cancer at the Affiliated Hospital of Qinghai University and Hainan Provincial People's Hospital from June to December 2022. We assessed the model's performance using the area under the curve of the ROC to evaluate differentiation, the calibration curve for calibration capability, and decision curve analysis (DCA) to gauge the model's clinical applicability. Independent risk factors for PICC-UE in patients with cancer were identified, including impaired physical mobility (odds ratio [OR] 2.775, 95% CI 1.951-3.946), diabetes (OR 1.754, 95% CI 1.134-2.712), surgical history (OR 1.734, 95% CI 1.313-2.290), elevated D-dimer concentration (OR 2.376, 95% CI 1.778-3.176), targeted therapy (OR 1.441, 95% CI 1.104-1.881), surgical treatment (OR 1.543, 95% CI 1.152-2.066), and more than 1 catheter puncture (OR 1.715, 95% CI 1.121-2.624). Protective factors were normal BMI (OR 0.449, 95% CI 0.342-0.590), polyurethane catheter material (OR 0.305, 95% CI 0.228-0.408), and valved catheter (OR 0.639, 95% CI 0.480-0.851). The TOPSIS synthesis analysis results showed that in the train set, the composite index (Ci) values were 0.00 for the logistic model, 0.82 for the support vector machine model, and 0.85 for the random forest model. In the test set, the Ci values were 0.00 for the logistic model, 1.00 for the support vector machine model, and 0.81 for the random forest model. The optimal model, constructed based on the support vector machine, was obtained and validated externally. The ROC curve, calibration curve, and DCA curve demonstrated that the model exhibited excellent accuracy, stability, generalizability, and clinical applicability. In summary, this study identified 10 independent risk factors for PICC-UE in patients with cancer. The predictive model developed using the support vector machine algorithm demonstrated excellent clinical applicability and was validated externally, providing valuable support for the early prediction of PICC-UE in patients with cancer.

Maternity care and occupational therapy support for women with impaired physical mobility during pregnancy, childbirth, and the postpartum period in Estonia

Maternity care and occupational therapy support for women with impaired physical mobility during pregnancy, childbirth, and the postpartum period in Estonia

Prevalence of Impaired Physical Mobility in Dialysis Patients: A Single-Centre Cross-Sectional Study.

Impaired physical mobility in hemodialysis (HD) patients is considered an important modifiable risk factor of increased all-cause morbidity and mortality. To our knowledge, no study to date has determined the overall burden of limited physical mobility in prevalent HD patients. The aim of this research is to investigate impaired physical mobility and its clinical correlates. We conducted a cross-sectional observational study in all patients of the Centre for Acute and Complicated Dialysis at the University Medical Centre of Ljubljana, where the most complex patients receive HD on average three times per week. The data were collected through interviews based on a prepared questionnaire and medical history review. A total of 205 patients were included in this study (63.9 ± 15.4 years). Sixty percent (122/205) of the patients had little or no physical mobility impairment, and others were categorized with a minor or severe mobility limitation. A minor mobility impairment was found in 21% (43/205) of patients: 10 patients (5%) used a mobility aid in the form of a crutch, 9 patients (4%) were dependent on two crutches or a walker, and 24 patients (12%) were temporarily dependent on the assistance of a third person. Severe mobility limitations were observed in 22% (40/205) of patients, ranging from being confined to bed (19/205, 9%), confined to bed but able to perform some movements (19/205, 9%), and ambulatory but dependent on the assistance of a third person for locomotion (2/205, 1%). The most common causes of the limitation of mobility were neurological (19/40, 47.5%), cardiovascular (9/40, 22.5%), musculoskeletal (8/40, 20%), and other causes (4/40, 10%). A significant, moderate positive correlation was observed between mobility problems and the age of the participants (r = 0.36, p < 0.001), while a significant, small positive correlation was obtained between the mobility problems and C-reactive protein (r = 0.15, p = 0.044). Moreover, mobility problems had a small but significant negative correlation with albumin levels (r = -0.15, p = 0.042). When controlling for age, results yield no significant correlations, and, in regression analysis, only the age (p < 0.001) and male gender (p = 0.007) of the participants were independent predictors of mobility impairment. We conclude that impaired mobility has a high overall prevalence among chronic HD patients. Strategies to prevent and improve mobility limitations are strongly needed.

Experiences of women with impaired physical mobility during pregnancy, childbirth and postpartum: A case study.

The research deals with a little-studied topic in Estonia: the experiences of women with impaired physical mobility (IPM) during pregnancy, childbirth, and in the postpartum period. Women with IPM, a vulnerable group, have a higher risk of complications and a higher probability of missing out on comprehensive maternity care. The method of the present research is qualitative. It is a case study of three women with IPM with whom semi-structured interviews were conducted. It was found that women with IPM encountered several obstacles and problems during pregnancy, childbirth, and the postpartum period; despite this, women's experiences with maternity care were mostly positive. Furthermore, there are several areas for improvement to ensure more comprehensive maternity care. Women with IPM need more support and help, and midwives are expected to have additional knowledge regarding the specifics or limitations resulting from mobility impairments. In the future, the topic needs greater attention and improvement in the Estonian context to ensure more comprehensive maternity care for women with IPM. It is important to provide midwives the knowledge and skills to assist women with IPM during pregnancy, childbirth, and the postpartum period.

Nursing Care Of Type Ii Diabetes Mellitus Patients

Background: Type II Diabetes Mellitus is a chronic disease with a high prevalence in Indonesia. As nursing care providers, nurses have an essential role in managing patients with type II Diabetes Mellitus. Purpose: Get an overview of the implementation of nursing care in patients with Type II Diabetes Mellitus. Methodology: A case study was conducted on Mrs. D in Dahlia Room RSUD Ciamis on 27 - 30 June 2022. Results: The results of the nursing evaluation obtained: ineffective peripheral perfusion, acute pain, nutritional deficits, impaired skin integrity, unstable blood glucose levels, impaired physical mobility, and disturbed sleep patterns are partially resolved, and the risk of hypovolemia has been determined. Conclusion: Nursing care carried out can overcome the problems experienced by patients.

Pengembangan Clinical Pathway Stroke Hemoragik Berbasis 3S (SDKI, SLKI, SIKI)

This study aims to develop a clinical pathway for hemorrhagic stroke patients based on the 3S (SDKI, SLKI, SIKI). The method used is Research and Development with stages including literature study, observation evaluation, validity and reliability testing, and Focus Group Discussion (FGD). The research results show that developing a 3S-based hemorrhagic stroke clinical pathway is by clinical practice guidelines and service quality. The results of Pearson's product-moment correlation test are &lt;0.514, and the reliability of the Cronbach alpha test is 0.906. Conclusion: The development of a 3S-based hemorrhagic stroke clinical pathway was prepared with nursing diagnoses, including ineffective airway clearance, decreased intracranial adaptive capacity, acute pain, impaired physical mobility, and risk of fluid imbalance. The development of a 3S-based hemorrhagic stroke clinical pathway is generally in good categories in terms of Functionality, Efficiency, and Usability so that it can be recommended for use by nurses and can improve the quality of hospital services.&#x0D; Keywords: Clinical Pathway, SDKI, SIKI, SLKI, Hemorrhagic Stroke

Nursing Diagnosis in Perioperative Cataract and Comorbidity

Nurses are essential in providing nursing care to patients for pre, intra, and postoperative cataracts. An appropriate nursing diagnosis can help clients achieve optimal health. The purpose of the study was to identify nursing diagnoses in pre,intra, and postoperative cataracts. The design of the study used qualitative descriptive research design. The population of all patients undergoing surgery was 30, and data was collected through interviews and observations. The results of the study: preoperative nursing diagnosis consisted of sensory perception and anxiety disorders 30 (100%), impaired physical mobility, activity intolerance, and risk of falling 3 (10%), knowledge deficit 2(6,7%), body image disorders 1 (3,3%). Intraoperative nursing diagnosis: impaired tissue integrity 30 (100%), acute pain 7(23,3%), hypothermia 4 (13%), hypothermia risk 3 (10%). Postoperative nursing diagnosis, all participants experienced sensory perception disorders 30 (100%), acute pain 7(23.3%), infection risk 5(16,7%), impaired physical mobility, activity intolerance and fall risk 3 (10%), knowledge deficit 2(6.7%). Comorbidity affects the enforcement of nursing diagnoses. The correct nursing diagnosis is a reference for nurses in providing continuous intervention so that quality nursing services are obtained