Journal Nursing Care and Biomolecular
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Analisis Praktik Residensi Keperawatan Medikal Bedah Pada Pasien Penyakit Jantung Koroner Dengan Pendekatan Teori Model Adaptasi Roy Dan Program Rehabilitasi Jantung Fase 1 Di Ruang Pamenang RSUD Gambiran Kota Kediri
Get PDFPendahuluan: Penyakit jantung koroner (PJK) merupakan penyebab utama penyakit kardiovaskular yang menyebabkan kematian manusia. Dampak negatif dari aspek fisik, antara lain nyeri dada, sesak napas, kelelahan, dan keterbatasan aktivitas fisik. Penelitian ini bertujuan untuk mendeskripsikan praktik keperawatan medikal bedah residensi pasien PJK dengan pendekatan teori model adaptasi Roy dan program rehabilitasi jantung fase 1 di Ruang Pamenang RSUD Gambiran Kota Kediri dalam melaksanakan peran pemberian asuhan keperawatan dengan adaptasi Roy. pendekatan teori, dan implementasi inovasi program rehabilitasi jantung fase 1 keperawatan berbasis bukti. Metode: Metode asuhan keperawatan profesional tim (MAKP) merupakan model MAKP yang diterapkan di Ruang Pamenang RSUD Gambiran Kota Kediri. Analisis SWOT untuk menentukan prioritas masalah. Inovasi dan praktik berdasarkan bukti Teori Model Adaptasi Roy dan rehabilitasi jantung fase 1. Hasil : Hasil analisis SWOT Ruang Pamenang ditemukan prioritas masalah : Discharge Planning, Babak Keperawatan, Dokumentasi Keperawatan, M3-METODE (MAKP), M1 (Ketenagakerjaan), M2 (Fasilitas dan Prasarana), Pengawasan, Penimbangan, dan Sentralisasi Obat . Hasil pengkajian keperawatan pasien PJK ditemukan lima diagnosa keperawatan yaitu nyeri akut, penurunan curah jantung, pola nafas tidak efektif, intoleransi aktivitas, dan kecemasan. Diskusi: Teori model adaptasi Roy efektif memberikan asuhan keperawatan pada pasien PJK. Teori model ini memungkinkan perawat untuk memberikan asuhan keperawatan yang komprehensif dalam meningkatkan kemampuan beradaptasi terhadap perubahan lingkungan internal dan eksternal. Intervensi program rehabilitasi jantung fase 1 efektif dalam tindakan pencegahan sekunder dan meningkatkan kualitas hidup pasien PJ
PENGARUH HEALTH EDUCATION TENTANG PERKEMBANGAN PSIKOSOSIAL TERHADAP UPAYA PENCEGAHAN PERILAKU PHUBBING PADA GENERASI ALPHA DI SDN PUCANGSARI 1 PURWOSARI
Get PDFPendahuluan: Generasi alpha merupakan generasi yang lahir antara tahun 2011 sampai tahun 2025, generasi alpha ini yang paling akrab dengan teknologi digital dan generasi ini diklaim paling cerdas dibandingkan generasi generasi sebelumnya. Generasi Alpha tidak lepas dari gadget, kurang bersosialisasi, kurang daya kreativitas dan bersikap individualis. Generasi alpha menginginkan hal-hal yang instan dan kurang menghargai proses, keasyikan mereka dengan gadget membuat mereka teralienasi secara social sehingga membuat tanpa sadar telah melakukan perbuatan phubbing. Metode: Desain penelitian mengunakan desain observasi analitik dengan pendekatan Quasy Experimen. Populasi penelitian sebanyak 100 siswa siswi dan sampel diambil sesuai dengan kriteria inklusi dan ekslusi, ditentukan dengan teknik simple random sampling yaitu sebanyak 80 siswa. Penggumpulan data menggunakan instrumen lembar kuesioner pada anxiety level menggunakan Kuesioner General sacale of phubbing (GSP) dan memberikan perlakuan edukasi kesehatan tentang Perilaku Phubbing dan telah dilakukan uji validitas dengan menggunakan Pearson Product Moment (r). Berdasarkan hasil uji reabilitas untuk kuesioner General sacale of phubbing (GSP) nilainya 0,998, sehingga dinyatakan reliabel untuk penelitian. Hasil: Hasil uji paired sample t-test didapatkan nilai Sig (2-tailed)=0,000 (α< 0,05) yaitu ada Pengaruh Health Education Tentang Perkembangan Psikososial Terhadap Upaya Pencegahan Perilaku Phubbing Pada generasi Alpha di SDN Pucangsari 1 Purwosari. Pembahasan: Perilaku phubbing merupakan hal baru yang berkembang pesat di masyarakat. Anak dapat menggunakan. Dalam konteks keterikatan dengan smartphone, anak kerap kali menggunakannya di waktu yang kurang tepat. Seperti halnya perilaku phubbing, yang mendefinisikan sebagai individu yang cenderung lebih sering fokus terhadap ponselnya dari pada lawan bicara. Anak akan lebih konsisten pada smartphonenya dibandingkan dengan lawan bicaranya. Karena itu, semakin penting bagi ilmuan psikologi dan sosial untuk lebih memperhatikan dampak dan kualitas kehidupan yang ditimbulkan dari perilaku phubbing yang kian menjadi kewajaran ini
KESIAGAAN MASA DARURAT COVID-19 MELALUI SKRENING MANDIRI COVID-19 TERHADAP STIGMA PENDERITA
No full textIntroduction: The Covid-19 has infected all countries in the world, including Indonesia. This condition affects the emergence of stigma to everyone because Covid-19 is a disease with rapid transmission. The stigma drives individuals to obscure unhealthy conditions and be reluctant to perform immediate health care. Therefore, it is essential to conduct COVID-19 self-screening actions. This study intended to determine the relationship between COVID-19 self-screening and the patients’stigma during the COVID-19 emergency. Methods: The research adopted a non-experimental descriptive with a correlational analytic method in which the researcher analyzes the COVID-19 self-screening with the patients' stigma. The instrument used a COVID-19 self-screening questionnaire and the stigma of COVID-19 patients. The sample was selected by total sampling with 45 respondents according to the inclusion and exclusion criteria. Result and analysis: The statistical test result of the Spearman Rho correlation test obtained a p-value = 0.000 (p-value <0.05). In conclusion, the result revealed a relationship between COVID-19 self-screening and the patients’ stigma during the Covid-19 emergency.
Key words: stigma, screening, covid-19Introduction: The Covid-19 has infected all countries in the world, including Indonesia. This condition affects the emergence of stigma to everyone because Covid-19 is a disease with rapid transmission. The stigma drives individuals to obscure unhealthy conditions and be reluctant to perform immediate health care. Therefore, it is essential to conduct COVID-19 self-screening actions. This study intended to determine the relationship between COVID-19 self-screening and the patients’stigma during the COVID-19 emergency. Methods: The research adopted a non-experimental descriptive with a correlational analytic method in which the researcher analyzes the COVID-19 self-screening with the patients' stigma. The instrument used a COVID-19 self-screening questionnaire and the stigma of COVID-19 patients. The sample was selected by total sampling with 45 respondents according to the inclusion and exclusion criteria. Result and analysis: The statistical test result of the Spearman Rho correlation test obtained a p-value = 0.000 (p-value <0.05). In conclusion, the result revealed a relationship between COVID-19 self-screening and the patients’ stigma during the Covid-19 emergency.
Key words: stigma, screening, covid-1
APLIKASI FPE (FAMILY PSYCHOEDUCATION) MOBILE DALAM MENURUNKAN STRES KELUARGA ORANG DENGAN GANGGUAN JIWA
No full textIntroduction: Mental health treatment has moved from hospital-based to community-based psychiatric services. Mental illness often has a 'ripple effect' on families, creating tension, uncertainty, stress, and sometimes significant changes in how people live their lives. The study aims to determine the effect of FPE mobile application to decrease stress level of families living with mental illness. Method: A quasi experiment pre-post test with control group designed apply to this study. A purposive sampling technique carried out in Centered-public health of Bantur. The intervention group with 6 trained cadres give 30 families. Both, pre and posttest measured of stress level. Result and analysis: Pre and posttest measured of stress level. Statistically, a significant mean values difference of stress (p=0.001), as significance as p<0.05. Discussion: Statistically, FPE has a positive effect on the stress level of families living with mental illness. A positive-benefits on the psychological aspect, especially in reducing stress on caregivers for families living with mental illness, but no clinically significant effect on the stress scores of families living with mental illness in relation to high family burdens. Conclusion: FPE has a significance positive effect on the stress level of families living with mental illness, but no clinically significant effect on the stress scores of families living with mental illness.
Keyword: Family stress, FPE Mobile, PsychoeducationIntroduction: Mental health treatment has moved from hospital-based to community-based psychiatric services. Mental illness often has a 'ripple effect' on families, creating tension, uncertainty, stress, and sometimes significant changes in how people live their lives. The study aims to determine the effect of FPE mobile application to decrease stress level of families living with mental illness. Method: A quasi experiment pre-post test with control group designed apply to this study. A purposive sampling technique carried out in Centered-public health of Bantur. The intervention group with 6 trained cadres give 30 families. Both, pre and posttest measured of stress level. Result and analysis: Pre and posttest measured of stress level. Statistically, a significant mean values difference of stress (p=0.001), as significance as p<0.05. Discussion: Statistically, FPE has a positive effect on the stress level of families living with mental illness. A positive-benefits on the psychological aspect, especially in reducing stress on caregivers for families living with mental illness, but no clinically significant effect on the stress scores of families living with mental illness in relation to high family burdens. Conclusion: FPE has a significance positive effect on the stress level of families living with mental illness, but no clinically significant effect on the stress scores of families living with mental illness.
Keyword: Family stress, FPE Mobile, Psychoeducatio
METODE PENGELOLAAN SAMPAH RUMAH TANGGA: SURVEY KEPERAWATAN KESEHATAN KOMUNITAS DI AREA PEDESAAN KABUPATEN PROBOLINGGO JAWA TIMUR
No full textIntroduction: Waste management is still a problem in the community. The results of the study found that the largest waste recycling sorting was household waste and 90.47% did not provide a place for garbage collection in the house and waste management has not been carried out properly. The main factors related to waste management are the lack of alternative waste disposal options, household attitudes, and lack of awareness. The main challenge for poor waste management from both local governments and households is that bad waste management practices require policies related to waste management. Objective: The purpose of this study was to determine the method of household waste management in rural areas of Probolinggo Regency. Methods: This research is descriptive research using a survey method with an action research approach, the population of this research is all heads of families in Sentong Village, Probolinggo Regency, sampling technique using random sampling with a sample of 777 families. The instrument used was an environmental health questionnaire in the community nursing assessment and observation format. Results and analysis: The data analysis in this study uses descriptive statistics of trends and graphics to see the pattern of people's habits in waste disposal and management. The study findings show that the community waste disposal method is mostly burned by as many as 404 families (51.9) % and waste disposal to the Got is 447 families (44.7%) and waste management is mostly indiscriminate by as many as 542 families (69.7%). Discussion: This study shows that most people have not managed household waste properly, so this study recommends the importance of facilitating proper waste management so that the community commits to implementing environmental health programs.
Keywords: Waste Management, Household, Community HealthIntroduction: Waste management is still a problem in the community. The results of the study found that the largest waste recycling sorting was household waste and 90.47% did not provide a place for garbage collection in the house and waste management has not been carried out properly. The main factors related to waste management are the lack of alternative waste disposal options, household attitudes, and lack of awareness. The main challenge for poor waste management from both local governments and households is that bad waste management practices require policies related to waste management. Objective: The purpose of this study was to determine the method of household waste management in rural areas of Probolinggo Regency. Methods: This research is descriptive research using a survey method with an action research approach, the population of this research is all heads of families in Sentong Village, Probolinggo Regency, sampling technique using random sampling with a sample of 777 families. The instrument used was an environmental health questionnaire in the community nursing assessment and observation format. Results and analysis: The data analysis in this study uses descriptive statistics of trends and graphics to see the pattern of people's habits in waste disposal and management. The study findings show that the community waste disposal method is mostly burned by as many as 404 families (51.9) % and waste disposal to the Got is 447 families (44.7%) and waste management is mostly indiscriminate by as many as 542 families (69.7%). Discussion: This study shows that most people have not managed household waste properly, so this study recommends the importance of facilitating proper waste management so that the community commits to implementing environmental health programs.
Keywords: Waste Management, Household, Community Healt
PENGARUH LAMA PEMBERIAN ASI TERHADAP TINGKAT KEJADIAN ISPA PADA ANAK USIA 2 – 5 TAHUNDI PMB ANUGERAH KABUPATEN MALANG
Get PDFOne of the factors that cause acute respiratory tract infections in toddlers is a history of exclusive breastfeeding. Exclusive breastfeeding in Indonesia for the last 5 years has not met the national target of 80% so that it can increase the risk of acute respiratory infections by 15-23%. Breastfeeding, especially exclusive breastfeeding, is very beneficial for children to prevent infectious diseases because breast milk has protective substances or immune substances. The purpose of this study was to determine the effect between breastfeeding duration and the incidence of ISPA in children aged 2-5 years. This study used a correlative design with a cross sectional approach with purposive sampling. The data analysis used was Rho Spearman analysis. The results of the analysis are the significance value or sig (2-tailed) of 0.001 so that the value of sig (2-tailed) < 0.01 and a positive value of 0.712, namely there is a strong and unidirectional significant relationship between the duration of breastfeeding and the incidence of ISPA, meaning that the more The longer breastfeeding, the lighter the incidence of ISPA in children aged 2-5 years. Efforts to provide breastfeeding to children can be done through commitment from breastfeeding mothers and support from husbands, families and health workers
REAKSI PSIKOLOGIS DENGAN PENILAIAN QUALITY OF LIFE PASIEN GAGAL GINJAL KRONIS YANG MENJALANI HEMODIALISA PADA MASA PANDEMI
No full textThe COVID-19 pandemic started from the city of Wuhan, precisely in China and spread quickly to all countries in the world. Chronic diseases infected with COVID-19 will affect health conditions and have an impact on the low quality of life for chronic kidney failure. If the quality of life is getting lower then this can have an impact on the patient's psychological reaction, this psychological reaction can be depression, anxiety, and stress. The focus of this study was to determine the relationship between the Quality of Life Assessment of Chronic Failed Patients undergoing hemodialysis and I at Waluya Hospital Malang. This study uses an analytical observation design with a cross sectional approach. The sample according to the inclusion and exclusion criteria, was determined by incidental sampling technique as many as 36 chronic disease patients. Data collection uses the WHOQOL-BREF questionnaire for Quality of Life and Psychological Reactions and has been tested for validity and reliability. The analysis was carried out univariately to see the statistics of the research data and bivariate analysis with spreadaman rank correlation using the SPSS version 16 application. The bivariate test showed that anxiety (r = 0.921, P = 0.000), depression (r = 0.949, P = 0.000), and stress (r=0.949, P=0.000) was positively related to quality of life. There is a relationship between anxiety, stress and depression. Anxiety is the dominant factor related to the quality of life of chronic failure patients undergoing hemodialysis.
Keywords: Quality Of Life, Chronic Disease, Psychological Reaction.The COVID-19 pandemic started from the city of Wuhan, precisely in China and spread quickly to all countries in the world. Chronic diseases infected with COVID-19 will affect health conditions and have an impact on the low quality of life for chronic kidney failure. If the quality of life is getting lower then this can have an impact on the patient's psychological reaction, this psychological reaction can be depression, anxiety, and stress. The focus of this study was to determine the relationship between the Quality of Life Assessment of Chronic Failed Patients undergoing hemodialysis and I at Waluya Hospital Malang. This study uses an analytical observation design with a cross sectional approach. The sample according to the inclusion and exclusion criteria, was determined by incidental sampling technique as many as 36 chronic disease patients. Data collection uses the WHOQOL-BREF questionnaire for Quality of Life and Psychological Reactions and has been tested for validity and reliability. The analysis was carried out univariately to see the statistics of the research data and bivariate analysis with spreadaman rank correlation using the SPSS version 16 application. The bivariate test showed that anxiety (r = 0.921, P = 0.000), depression (r = 0.949, P = 0.000), and stress (r=0.949, P=0.000) was positively related to quality of life. There is a relationship between anxiety, stress and depression. Anxiety is the dominant factor related to the quality of life of chronic failure patients undergoing hemodialysis.
Keywords: Quality Of Life, Chronic Disease, Psychological Reaction
STUDI FAKTOR PENYEBAB TINGKAT STRES PADA PASIEN GAGAL GINJAL KRONIS YANG MENJALANI HEMODIALISIS DI RUMAH SAKIT GAMBIRAN KEDIRI
No full textIntroduction: Chronic non-communicable diseases such as cardiovascular disease, hypertension, diabetes mellitus, and chronic kidney disease, have replaced infectious diseases as a major public health problem.. The purpose of this study was to explore the study of factors that cause stress levels in chronic kidney failure patients undergoing hemodialysis at Gambiran Hospital, Kediri. Method: This study used an Qualitative case study approach that describes and explores the study of factors that cause stress levels in chronic kidney failure patients undergoing hemodialysis at Gambiran Hospital, Kediri. The sampling technique was purposive sampling, with inclusion and exclusion criteria. The researcher uses the credibility test to test the validity of the data. Result and analysis: The results of the thematic analysis, obtained four major themes, namely diet of patients with chronic kidney failure undergoing hemodialysis, family support for patients undergoing hemodialysis, hemodialysis services for patients with chronic kidney failure undergoing hemodialysis, and Genetics of patients with chronic kidney failure undergoing hemodialysis at Gambiran Hospital, Kediri. Discussion: The diet of patients with chronic kidney failure undergoing hemodialysis at Gambiran Hospital Kediri has decreased, family support for patients undergoing hemodialysis has received good support from their families, hemodialysis services for patients with chronic kidney failure undergoing hemodialysis are very good, families of patients with kidney failure are very good, suffering from diabetes and high blood
Keyword: Stress, Chronic Kidney Failure, HemodialysisIntroduction: Chronic non-communicable diseases such as cardiovascular disease, hypertension, diabetes mellitus, and chronic kidney disease, have replaced infectious diseases as a major public health problem.. The purpose of this study was to explore the study of factors that cause stress levels in chronic kidney failure patients undergoing hemodialysis at Gambiran Hospital, Kediri. Method: This study used an Qualitative case study approach that describes and explores the study of factors that cause stress levels in chronic kidney failure patients undergoing hemodialysis at Gambiran Hospital, Kediri. The sampling technique was purposive sampling, with inclusion and exclusion criteria. The researcher uses the credibility test to test the validity of the data. Result and analysis: The results of the thematic analysis, obtained four major themes, namely diet of patients with chronic kidney failure undergoing hemodialysis, family support for patients undergoing hemodialysis, hemodialysis services for patients with chronic kidney failure undergoing hemodialysis, and Genetics of patients with chronic kidney failure undergoing hemodialysis at Gambiran Hospital, Kediri. Discussion: The diet of patients with chronic kidney failure undergoing hemodialysis at Gambiran Hospital Kediri has decreased, family support for patients undergoing hemodialysis has received good support from their families, hemodialysis services for patients with chronic kidney failure undergoing hemodialysis are very good, families of patients with kidney failure are very good, suffering from diabetes and high blood
Keyword: Stress, Chronic Kidney Failure, Hemodialysi
KAJIAN BURNOUT DARI STATUS GIZI PEKERJA DEWASA MADYA
No full textIntoduction: Many middle-aged workers experience burnout. Prolonged burnout resulted in negative impact, from the point of view of health and work productivity. The purpose of the study was to determine the relationship between nutritional status and burnout among middle-aged workers at University X in Malang. Method: This is a descriptive correlation study with a cross-sectional design. The population is all middle-aged employees at University X, within a total of 84 people. The sample were 42 staff from University X who are middle-aged adults in Malang, which were taken by accidental sampling technique. The independent variable in this study was nutritional status, while the dependent variable was burnout syndrome. The burnout questionnaire used as study instrument which combined burnout questionnaire and the Body Mass Index observation sheet. Data analysis using Spearmen-rank test with SPSS software version 18. Results :showed as many as 42.9% of middle-aged workers have an ideal body mass index and the rest are overweight; while as many as 45.2% of each worker had a moderate and high level of burnout. Discussion: More over, results showed that there was no relationship between nutritional status (BMI) and burnout syndrome (p-value 0.676). It is recommended for further researchers to examine the Health Belief Model on burnout syndrome analysis among middle-aged workers.
Keywords: activity; burnout; middle-aged workers; nutritional statusIntoduction: Many middle-aged workers experience burnout. Prolonged burnout resulted in negative impact, from the point of view of health and work productivity. The purpose of the study was to determine the relationship between nutritional status and burnout among middle-aged workers at University X in Malang. Method: This is a descriptive correlation study with a cross-sectional design. The population is all middle-aged employees at University X, within a total of 84 people. The sample were 42 staff from University X who are middle-aged adults in Malang, which were taken by accidental sampling technique. The independent variable in this study was nutritional status, while the dependent variable was burnout syndrome. The burnout questionnaire used as study instrument which combined burnout questionnaire and the Body Mass Index observation sheet. Data analysis using Spearmen-rank test with SPSS software version 18. Results :showed as many as 42.9% of middle-aged workers have an ideal body mass index and the rest are overweight; while as many as 45.2% of each worker had a moderate and high level of burnout. Discussion: More over, results showed that there was no relationship between nutritional status (BMI) and burnout syndrome (p-value 0.676). It is recommended for further researchers to examine the Health Belief Model on burnout syndrome analysis among middle-aged workers.
Keywords: activity; burnout; middle-aged workers; nutritional statu
MODEL ASUHAN KEPERAWATAN PROFESINAL DI RUANG PAMENANG RSUD GAMBIRAN KOTA KEDIRI
No full textIntroduction: The strategy to increase the role and function of nurses in providing nursing services is to evamp nursing management, so that optimal management factors can be used as an effort to improve nursing service delivery and ensure patient satisfaction. This study aims to describe the practice of nursing residency management towards improving nursing care service efforts, and the implementation of innovations about nursing management strategies for the implementation of professional nursing care (MAKP) TIM in the Pamenang room of Gambiran Hospital, Kediri. Method: The team's MAKP method was applied in the Pamenang Room of Gambiran Hospital, Kediri City. SWOT analysis to determine the priority of the problem. Result: The results of the Pamenang Room SWOT analysis found priority issues: Discharge Planning, Nursing Round, Nursing Documentation, M3-METHOD (MAKP), M1 (Employment), M2 (Facilities and Infrastructure), Supervision, Weighing in, and Drug Centralization. Discussion: Inadequate discharge planning in the room, Unavailability of patient leaflets when returning home, Not yet optimal health education for patients/families, Nursing Rounds cannot be carried out in the treatment room, Characteristics of staff who meet qualifications are not evenly distributed, MAKP has not been implemented optimally, Number of staff is not balanced with the number of patient dependence levels, There is no standardized format for nursing interventions, There is no computerized documentation system, Some employees have unclear job descriptions, MAKP has not been implemented properly, Supervision has not been carried out, Implementation of the team model is not appropriate, Nurses manage all patients, Nursing rounds has not been implemented, facilities and infrastructure for maintenance actions are available in sufficient and good condition but insufficient.
Keywords: Coronary Heart Disease, Phase 1 Cardiac Rehabilitation Program, Roy Adaptation Model TheoryIntroduction: The strategy to increase the role and function of nurses in providing nursing services is to evamp nursing management, so that optimal management factors can be used as an effort to improve nursing service delivery and ensure patient satisfaction. This study aims to describe the practice of nursing residency management towards improving nursing care service efforts, and the implementation of innovations about nursing management strategies for the implementation of professional nursing care (MAKP) TIM in the Pamenang room of Gambiran Hospital, Kediri. Method: The team's MAKP method was applied in the Pamenang Room of Gambiran Hospital, Kediri City. SWOT analysis to determine the priority of the problem. Result: The results of the Pamenang Room SWOT analysis found priority issues: Discharge Planning, Nursing Round, Nursing Documentation, M3-METHOD (MAKP), M1 (Employment), M2 (Facilities and Infrastructure), Supervision, Weighing in, and Drug Centralization. Discussion: Inadequate discharge planning in the room, Unavailability of patient leaflets when returning home, Not yet optimal health education for patients/families, Nursing Rounds cannot be carried out in the treatment room, Characteristics of staff who meet qualifications are not evenly distributed, MAKP has not been implemented optimally, Number of staff is not balanced with the number of patient dependence levels, There is no standardized format for nursing interventions, There is no computerized documentation system, Some employees have unclear job descriptions, MAKP has not been implemented properly, Supervision has not been carried out, Implementation of the team model is not appropriate, Nurses manage all patients, Nursing rounds has not been implemented, facilities and infrastructure for maintenance actions are available in sufficient and good condition but insufficient.
Keywords: Coronary Heart Disease, Phase 1 Cardiac Rehabilitation Program, Roy Adaptation Model Theor