CHAPTER 2

HOLISTIC APPROACH IN NURSING (System Theory)

1. Definition of Holistic Approach

Holistic (holism) is seeing humans and the environment as a whole in a single
system, Looking at the whole man: bio, psycho, social, spiritual nature with all the
essentials; have basic needs, and interpersonal needs; have a feeling; desire; and the
ability (Nursalam & Efendi)
Holistic is one of the underlying concepts of nursing actions that include the
dimensions of the physiological, psychological, socio-cultural, and spiritual. The
dimensions of a unified whole. If the one-dimensional disturbed affect other
dimensions. Related to the holistic well-being (Wellnes).
To prosper, there are five dimensions that influence each other, namely:
physical, emotional, intellectual, social and spiritual. To achieve these welfare, one
aspect that an individual must possess is the ability to adapt to the stimulus. Sister
Callista Roy's adaptation theory can be used.
It uses a dynamic approach, in which the role of nurses in providing nursing
care to facilitate the client's ability to adapt in the face of changing their basic needs.
Actions planned with the aim of changing the stimulus and focused on the
individual's ability to adapt to the stimulus. While the evaluation is done by looking
at the client's ability to adapt and prevent back problems ever experienced. This
adaptation capability covers all aspects of both the biological, psychological and
social (holistic). As a provider of nursing care, a holistic concept and this adaptation
is a concept that must be understood by the nurse in order to provide quality nursing
care to clients.
2. Definition of System Theory
The system is derived from the Latin (Systema) and Greek (sustema) is a unit
consisting of components or elements that are connected together to facilitate the
flow of information, materials or energy. The theory is the relationship some concept
or a conceptual framework, or a definition that gives a systematic view of the
symptoms or phenomena to determine the specific relationship between these
concepts with a view to elaborate, explain, predict or control the phenomenon.
Theory can be tested, modified or used as a guide in the study.
Nursing theory defined by Steven (1984), an attempt to describe and explain
various phenomena in nursing. Nursing theory plays a role in distinguishing nursing
with other disciplines and aims to describe, explain, predict and control the outcome
of care or nursing services performed. As for some understanding of the system
according to the experts is as follows:
a. L. James Havery : According to the system is a logical and rational
procedure for designing a circuit component associated with each other
with a view to serve as an entity in order to achieve a predetermined
goal.

b. John Mc Manama : According to the system is a conceptual structure

that is composed of functions that are interconnected to work as an
organic unity to achieve a desired result effectively and efficiently.
c. C.W. Churchman : According to the system is a set of parts that are
coordinated to carry out a set of objectives.
d. J.C. Hinggins : According to the system is a set of interrelated parts.
e. Edgar F Huse and James L. Bowdict : According to the system is a
series or a series of parts which are interconnected and dependent such
that the interaction and mutual influence of one part will affect the
overall
f. f. Jerry FithGerald : According to the system is a network of
procedures interconnected, gathered together to perform an activity or
solve a particular target.
The concept is a belief that complex to an object, objects, events or
phenomena based on experiences and perceptions of a person in the form of ideas,
views or beliefs. A collection of some of the concepts into a framework that can be
understood to form a model or conceptual framework. The concept can be analogized
as bricks and boards to build a home where houses are built likened to a conceptual
framework.
Feedback in the health care system may be the quality of health workers can also
make inputs are always increasing.

3. Characteristics of System Theory

Torrest (1985) and Chinn & Jacob (1983) asserts there are five basic
characteristics of nursing theory:
1. The theory identifies and defines nursing as the specific relationship of
nursing concepts such as the relationship between human concept, the
concept of health-illness, the concept of environment and nursing
2. The theory of scientific nursing, nursing theory means used by reason or
rational clear and developed using logical thinking
3. The theory is simple and general nursing, nursing theory means can be used
to issue simple or complex health problems according to the situation of
nursing practice
4. The theory of the nursing role in enriching the body of knowledge of nursing
is done through research
5. Theory of nursing to guide and contribute to improving the quality of nursing
practice

4. Component Systems Theory

1.

Input : Put in the nursing process is data or information derived from the
assessment of the client (for example, how the client relates to environmental
and physiological functions of the client).

2.

Results : The result is an end product of the system and in terms of the
nursing process is where the health status of client progress or remain stable as
a result of nursing care.
3. Feedback : Feedback plays a system to provide information on how the
system is functioning. For example, in the nursing process results illustrate the
client's responses to nursing interventions.
4. Fill : Content is the product and the information derived from the system. In
addition, the use of the nursing process as a sample, the content of the
information about nursing care for clients with specific health problems.

5. Application of System Theory

1.

Phase assessment
Assessment is a systematic approach to collecting data and analiyzed so
that can know the problems and needs the care of a patient.
The purpose of the assessment is to provide an overview continues about
the health of the patient, which allows teams of nurses plan nursing care to
patients on an individual basis.
1. Data collection
Data collection started since the client was hospitalized, as long as
the client was treated continuously and re-assessment can be done to
supplement and complement the existing data. Based on the data source,
data is differentiated assessment of primary data and secondary data:
Primary data is data obtained directly from the client however the
client's condition.
Secondary data is data obtained apart from the patient as nurses,
doctors, nutritionists, experts fisiotheraphy, family or relatives of
clients, nursing notes and the results of other investigations.
In general, there are several ways of data collection are:
o Interview namely through communication to get a response from the
patient face to face.
o Observations is to conduct visual observation or directly to the patient.
o Consultation is to consult the specialists the problematic parts.
o Through examination of such inspection (looking), palpation (feeling),
percussion (knock), auscultation and physical examination, such as
measurement of ECG.
2. Grouping the data
When finished collecting data, then the data collected are grouped, the
data can be shared on the basis of data and special data.
The data base consists of the data physiological / biological,
psychological the data, the data of social, spiritual and data about the
data tumbuhkembang clients.
Special Data is data that is specific bersipat. Eg fluid intake and output
reports during surgery, hematology test results, x-ray inspection and so
on.

In addition to the above data, based on the data collected are divided
into objective data and subjective data.
Objective data is data obtained a nurse based on the examination or
direct observation.
Subjective data is data obtained by the complaint or the words of the
client or his family.
3. Data analysis and formulation of Nursing Diagnosis
The last stage of the study is to analyze the data to determine the
nursing diagnoses. The nursing process is to connect the analysis of data
obtained with theoretical concepts, principles of nursing care that is
relevant to the patient's condition. Data analysis is done through validation
of data, grouping the data, comparing the data, determines the imbalances /
inequalities and make conclusions about the gap problem.
2.

Stage Diagnosis
Nursing diagnosis is a statement that describes the status / health issues
the actual / potential. The goal is to identify:
a. The actual problem is based on the client's response to the problem /
disease.
b. Factors contract / causing problems.
c. The client's ability to prevent / eliminate the problem.
Nursing diagnoses oriented to basic human needs, based on the basic
needs according to Abraham Maslow, shows the individual response / client
against the diseases and conditions that they experienced.

3. Planning Phase
After formulating nursing diagnoses it needs to make the planning of
nursing interventions and nursing activities. The purpose of planning is to
reduce, eliminate and prevent the problem of nursing clients.
Nursing planning stage are:
a. The process of determining priority
This process begins by making a priority nursing diagnoses, nursing
diagnosis indicates the priority order of the priority issues for nursing
intervention. However it does not mean that the diagnosis must be solved
first in total new work following diagnosis. Usually some nursing
diagnoses can be addressed simultaneously.
b. Setting goals and objectives
In this process done after the determination of the order of priority
nursing diagnoses. The targets are the results expected to reduce or
overcome the problem in accordance with the nursing diagnoses. While
the aim of describing the appearance, or behavior results associated with
the target client. Planning useful purpose in designing, implementing and
evaluating nursing care to clients.
c. Determination of evaluation criteria

Criteria are the standards used to evaluate penampialan clients. For

example, a client can mention four complications of diabetes mellitus.
Criteria required apabiala not specific purpose and can not be measured.
d. Intervention plan
Is the final part of the planning strategy, and decide where nurses nursing
interventions to be performed. Strategies and actions directed at the
etiology or contributing factors of nursing diagnoses.
4. The implementation phase
Implementation of a nursing planning implementation by nurses and clients. The
things that must be considered when implementing the intervention carried out
in accordance with the plan after validation, control, interpersonal skills,
intellectual, and a technical. Interventions must be done carefully and efficiently
in the right situation. Physical and psychological safety is protected and
documented in the form of recording and reporting of nursing.
There are three phases of implementation of nursing, namely:
a. The preparation phase, covering knowledge of the plan, validation plans,
knowledge and skills to implement the plan, the preparation of the client
and the environment.
b. Operational phase, is the top goal-oriented implementation of the
(intervention independent, dependent and interdependent).
c. Termination phase, a nurse with the client after the termination of the
implementation is done.
5. Phase evaluation
Things that are evaluated is the accuracy, completeness and quality of data,
whether the problem is resolved or the client, as well as the achievement of the
objectives and provisions of nursing interventions. Finally, the proper use of the
nursing process in nursing practice will benefit the client and the nurse. The
quality of nursing care is expected to be improved. Nurses can demonstrate
responsibility and gugatnya which is one characteristic of the profession and that
is very important is to ensure the efficiency and effectiveness of nursing care
provided to clients.
6. Phase documentation
Documentation of the nursing process is a recording method that is appropriate
for the nursing process systematic decision-making. Documentation of the
nursing process includes assessment, documentation problems, planning, action.

CHAPTER 3
CONCLUSION

3.1. Conclusions
In the most general sense, a system is a set of tools that have a relationship
between them. The system can be simply defined as the unity of the various elements
or parts that have functional relationships and interact dynamically to achieve the
expected results. Thus nursing, can be interpreted as an overall work of human
formed from parts that have functional relationships in order to achieve the ultimate
goal.
In the system there are inputs (input), process, outputs (results / Output) and
feedback. The systems approach is one way of looking at nursing thoroughly and
systematically, not partial and Fragmentis.
As a system, the nursing process has components, which include Input (derived from
client / human), results (the client's health status), Feedback (Response clients) and
Content (nursing products).

3.2. Suggestions
1. Preferably as a nurse, prior to performing health care, nurses must learn in
advance what is the priority of providing health care so as to avoid things that
are detrimental to the patient.
2. Nurses must learn the system and the changes that exist in a patient without
comparing the economic status of the patient so as not to cause dissent.
3. Confront any changes with calm and humor (be sure that the change is a
difficult thing, and become agents of renewal will be more difficult).

CHAPTER 1
INTRODUCION
1.1. Background
If the terms of the historical development of administrative science, systems
theory can indeed be said to be relatively new. This theory appears as a positive
reaction to the classical administration overemphasize the division of tasks in
implementing a program. Realizing that an organization is essentially formed by a
group of people interacting with each other, then comes the human relations theory
and the theory of behavior that is the basis of System Theory.

Systems theory is very important in the world of nursing, because in theory

this system we can learn a framework relating to all aspects of human social,
structural organizational problems, as well as changes in internal relations and the
surrounding environment.
The success of a health care system that exists on the nurse, doctor or other
health care team will work perfectly when there is mutual support in the practice of
nursing. These systems will provide quality health care that is effective to look at the
values that exist in society. In health care, nursing is an important part of health care.
The nurse is also expected to provide services quality so that people will feel
supported and cared in improving health, so there is no disagreement that will occur
between the nurse and patient. In addition to applying the principles of the nurse
changes must apply together do not discriminate, must be comprehensive (holistic).
One of the progress made today is progress in the development of information
systems in general and in particular in the field of health which is known as the
Health Information System is an integrated system to provide information to support
the operations function of management and decision making in healthcare
organizations. The information system receives input data and instructions, process
the data according to the instructions and remove the results. The basic model system
in the form of input, processing and output is suitable for a case of the simplest
information. Therefore, knowledge of the system and basic systems approach to
studying the health information system is absolutely necessary.

1.2. Purpose
1.2.1.
1.2.2.
1.2.3.
1.2.4.

To understanding of definition system teory

To understanding of characteristic system theory
To understanding of component system theory
To understanding of application system theory

REFERENCE
Anonim. 2008. Perubahan Dalam Keperawatan. Wikipedia. Jakarta.
Anonim. 2010. Aplikasi Teori Adaptasi Dalam Kasus Discectomi. Wikipedia. Jakarta.
Arifiyanto, Dafid. 2008. Konsep Berubah. Wikipedia. Jakarta.

Forewords
Assalamu'alaikum Wr. Wb.
Praise and gratitude to Allah SWT authors say over abundance of His mercy and
grace, I can finish a paper, entitled " System Theory of Holistic Approach". This paper aims
to fulfill one of the tasks of fundamental nursing 1 Course Lecturer Ns. Esthika Ariany,
S.kep, M.Kep.
The paper was written by various sources related to the material, as well as
information from various media relating to such materials.

The authors hope this paper can add insight regarding fundamental nursing 1 on
nursing process. And the authors hope for readers to be able to provide criticism and
suggestions for this paper to be more perfect.
Wassalamu'alaikum Wr. Wb.

Padang, august 2015-08-18

The writer team