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1. CONCEPT OF
PAIN

2. 2

3. CONCEPT OF COMFORT
▹ Keamanan adalah keadaan
bebas dari cedera fisik dan
psikologis atau bisa juga
keadaan aman dan tentram
(Potter& Perry, 2006).
KEBUTUHAN KESELAMATAN:
1. Keselamatan Fisik
2. Keselamatan psikologis
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4. ▹ Kolcaba (2005) mengungkapkan kenyamanan/rasa nyaman adalah suatu
keadaan telah terpenuhinya kebutuhan dasar manusia yaitu kebutuhan
akan ketentraman (suatu kepuasan yang meningkatkan penampilan
sehari-hari), kelegaan (kebutuhan telah terpenuhi), dan transenden
(keadaan tentang sesuatu yang melebihi masalah atau nyeri).
▹ Kenyamanan mesti dipandang secara holistik yang mencakup empat
aspek yaitu:
1. Fisik, berhubungan dengan sensasi tubuh.
2. Sosial, berhubungan dengan hubungan interpersonal, keluarga, dan sosial.
3. Psikospiritual, berhubungan dengan kewaspadaan internal dalam diri
sendiri yang meliputi harga diri, seksualitas, dan makna kehidupan).
4. Lingkungan, berhubungan dengan latar belakang pengalaman eksternal
manusia seperti cahaya, bunyi, temperatur, warna, dan unsur alamiah
lainnya.
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5. Comfort in Nursing
Perspective
▹ Increasing the need for comfort means that the
nurse has provided strength, hope,
entertainment, support, encouragement, and
assistance.
▹ In general, in its application the fulfillment of the need for
comfort is the need for comfort free from pain, and
hypo/hyperthermia.
▹ The condition of pain and hypo/hyperthermia are conditions
that affect the patient's feelings of discomfort as indicated
by the appearance of symptoms and signs in the patient.
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6. DEFINITON OF PAIN
▹ Mc. Coffery (1979), defines pain as a condition that affects a
person whose existence is known only if that person has
experienced it.
▹ Wolf Weitzel Feurst (1974), says that pain is a feeling of
suffering physically and mentally or a feeling that can cause
tension.
▹ Arthur C Curton (1983), said that pain is a production
mechanism of the body, arising when the tissue is being
damaged and causing the individual to react to eliminate
painful stimuli.
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7. OTHER DEFINITON
Pain: ’an unpleasant sensory and emotional experience associated with, or
resembling that associated with, actual or potential tissue damage’’ (IASP,
2020)
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8. NOW
WATCHING
THE VIDEO
OF
PHYSIOLOGIC
AL OF PAIN
https://www
.youtube.com
/watch?v=uO
aiaYDoUnA&t
=102s
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9. IN TWO OR THREE COLUMNS
In general, pain is
divided into 2
namely: acute pain
and chronic pain.
Acute pain is pain
that arises suddenly
and disappears
quickly, which does
not exceed 6
months and is
characterized by an
increase in muscle
tension.
Chronic pain is pain
that occurs slowly,
usually lasts for
quite a long time,
which is more than
6 months. Included
in this chronic pain
are terminal pain,
chronic pain
syndrome, and
psychosomatic
pain.
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10. 10 THE DIFFERENCES OF PAINS

11. PAIN THEORIES
Pattern Theory
Transmition and
InhibitionTheory
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Specificity Theory
Gate Control
Theory

12. Theory of Separation
(Specificity Theory)
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According to this theory, pain stimuli enter the spinal
cord through the dorsal horn which synapses in the
posterior region, then ascend to the tractus lissur and
cross the median line to the other side and end in the
sensory cortex where the pain stimulus is transmitted.

13. Pattern Theory
Pain stimuli enter through the dorsal root ganglion
to the spinal cord and stimulate T cell activity. This
results in a stimulating response to a higher part,
namely the cerebral cortex, and contraction causes
perception and muscles contract causing pain.
Perception is affected by the modality of the T-cell
reaction.
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14. Gate Control Theory
According to this theory, pain depends on the action of large and small nerve fibers, both of
which are located in the dorsal root ganglion. Stimulation of the large nerve fibers will
increase the activity of the substantia gelatinosa which results in the closing of the mechanism
door so that T cell activity is inhibited and causes the conduction of stimuli to be also
inhibited. Large fiber stimulation can directly stimulate the cerebral cortex. The results of this
perception will be returned to the spinal cord via efferent fibers and their reactions affect T
cell activity. Stimulation of small fibers will inhibit the activity of the substantia gelatinosa.
and opens the mechanism door, thereby stimulating T cell activity which will then deliver pain
stimuli.
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15. Transmission and Inhibition
Theory
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The presence of a stimulus on the nociceptor starts the transmission of nerve
impulses, so that the transmission of pain impulses becomes effective by specific
neurotransmitters. Then inhibition of pain impulses becomes effective by impulses in
large fibers blocking impulses in sluggish fibers and endogenous opiate suppressive
systems.

16. Factors Affecting Pain
1. Meaning of pain
The meaning of pain for a person has
many differences and most of the
meaning of pain is a negative
meaning, such as endangering,
destroying, and so on. This situation is
influenced by various factors, such as
age, gender, socio-cultural
background, and experience.
2. Pain perception
Perception of pain is a very subjective
assessment of its place in the cortex
(in cognitive evaluative function). This
perception is influenced by factors
that can trigger nociceptor stimuli.
3. Pain tolerance
This tolerance is closely related to
pain intensity which can affect a
person's ability to withstand pain.
Factors that can affect the increase in
pain tolerance include: alcohol, drugs,
hypnosis, and others. Meanwhile,
factors that can reduce pain tolerance
include: fatigue, anger, boredom,
anxiety, pain that does not go away,
illness, and others.
4. Reaction to pain
Reaction to pain is a form of a
person's response to pain, such as
fear, anxiety, anxiety, crying, and
screaming. All of these are forms of
pain response that can be
influenced by several factors such
as the meaning of pain, level of pain
perception, past experiences,
cultural values, social expectations,
physical and mental health, fear,
anxiety, age and others.
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17. 17 NURSING CARE IN PAIN

18. 18 ASSESSMENT
On safety needs, the assessment shows the grouping of data that
identifies the client as having actual or potential security risks.
While the assessment of pain problems such as location of pain, pain
intensity, quality and time of attack.
The assessment can be carried out by means of PQRST:
PROVOKE/PROBLEM: factors that affect the severity / lightness of pain
QUALITY: from pain, such as a sharp, dull or cut feeling
REGION: the area of travel pain
SEVERITY: the severity or intensity of pain
TIME: duration/time of attack or frequency of pain.p or software projects
using these gadget templates.

19. 19 TOOLS FOR ASSESS PAIN

20. 20 NURSING DIAGNOSIS
OPEN YOUR 3S

21. 21 INTERVENTION
To provide client comfort, the interventions carried out are:
a. reducing and limiting factors that increase pain;
b. using various non-invasive techniques to modify the pain experienced;
c. using ways to reduce pain optimally, such as giving analgesics according
to the specified program.

22. IMPLEMENTATION
▹ Implementation of pain is performed to
reduce factors that can increase pain,
such as distrust, misunderstanding, fear,
fatigue and boredom.
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23. EVALUATION
▹ Evaluation of pain is carried out by
assessing the ability to respond to pain
stimuli, including the loss of feeling of pain,
decreased pain intensity, the existence of a
good physiological response and the
patient is able to carry out daily activities
without complaints of pain.
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24. TASK
▹ Ny. W umur 13 tahun pekerjaan pelajar, keluhan utama nyeri ulu hati,
dialami sejak 3 hari yang lalu, terus-menerus, nyeri dirasakan memberat
jika terlambat makan, perut terasa kembung dan sering merasa mual,
sering makan tidak teratur, memiliki BB:43 kg, TB: 148 cm, IMT: 19,63
kg/m2 TD:120/70, HR:92x/i, RR:20x/I, T:36,5oC, konjungtiva anemis (-),
sklera ikterus (-), bibir sianosis (-), massa tekan (-), nyeri tekan (+), udema
(+).
▹ Dari kasus di atas lakukan pengkajian PQRST
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THANKS!
Any questions?
You can find me at
▹ +62 857 3939 8949
▹ Newratna.rosyida@gmail.co
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