Konsep Recovery
dalam Keperawatan
Jiwa
SHANTI WARDANINGSIH, NS.,M.KEP., SP.KEP.J., PH,D
Berapa Persen
Jumlah Pasien yang Relaps
dan Kembali dirawat?
Apakah Anda yakin
Pasien yang Anda rawat
bisa pulih?
ODS? after25% completely recover
10 years 25% much improved,
relatively independent
25% improved, but require
extensive support network
15% hospitalized, unimproved
10% dead (mostly suicide)
after
25% completely recover
30 years 35% much improved, relatively
independent
15% improved, but require
extensive support network
10% hospitalized, unimproved
15% dead (mostly suicide
Schizophrenia.c
om
Mental Health Challenges can
Affect An Individual’s
Social Relationships
Physical Health
Ability to engage in meaningful activity
Ability to work or attend school
Finance
Ability to see thir own potential
Pandangan Sejarah tentang Recovery
(Allot, P. Loganantan, L. Fulford, K.M.W-2002)
Institutionalization
Negative Perceptions
Mental Health System beliefs and
attitude had negative impact on
patients and their families
No nation of hope or recovery
Mental Health
Commission of Canada
Recovery (2010)
Recovery
Involves a process of growth
and transformation as the
person move beyond the acute
distress often associate with a
mental health problem or illness
and develop new-found strengths
and new ways of being
Language of Recovery
From focusing on deficits To working with peron’s
strengths
From doing for the person To working with the person
From focusing on disease To focusing on treatment
From the clinician as teacher To both person & clinician a
learner
From measuring set of specific To allowing person to
outcomes determine own goals & own
measures of success
Principles of Recovery
Recovery I about building a meaningful and
satisfying life, as defined by the person themselves,
whether or not there are ongoing or recurring
symptoms or problems.
Self-management is encouraged and
facilitated. The processes of self-management are
similar, but what works may be very different for each
individual. No “one size fits all”
Principles of Recovery
The helping relationship between clinicians and
patient moves
away from being
expert/patient to being coaches or partners on
a journey of discovery
People do not recover in isolation. Recovery is
closely associated with social inclusion and being
able to take on meaningful and satisfying
social role within local community
Recovery is about discovering – or
recovering – a sense of personal identity,
separate from illness or disability
Treatment
Recovery is described as a deeply personal, unique process of changing one’s
attitudes, values, feeling, goals, skills and/or roles. It is a way of living a satisfying, hopeful
and contributing life even with limitations caused by illness
Recovery involves the development of new meaning and purpose in one’s life
as one grow beyond the catastrophic effects of mental illness
Recovery approaches are viewed by the consumer movement as an
alternative to the medical model with its emphasis on pathology, deficits and
dependency. There is no single description or definition of recovery because
recovery is different for everyone
Providing education/guidance on medication options, including risks
Providing and benefits so consumer can make informed decisions
Assisting in identifying and achieving personal goals for safety and well-
Assisting being (symptom management, housing, financial security, healty
lifestyle activities)
Professional Facilitating
Facilitating fostering meaningful relationship, self empowerment, self
Expertise
esteem
Assisting in developing meaningful occupation and social/community
Assisting inclusion
Supporting Supporting peer relationship trough Peer Support Workers
A collaborative process which focused on
promoting well-being rather than simply
treating illness
Treatment in Professional staff are encouraged to
facilitate a service-user identifying,
Recovery developing, and working toward personally
meaningful goal for their well-being
As much as possible, the service user is the
ultimate decision-maker for how care is
directed
Characteristics of
recovery
a unique and personal journey
a normal human process
an ongoing experience and not the
same as an end point or cure
a journey rarely taken alone
nonlinear—frequently interspersed with
both achievement and setbacks.
Figure of Recovery
A series of concentric circles represents
the concept of recovery.
The innermost circle contains personal recovery characteristics
of resilience, strength, optimism and hope and
represents individuals with a lived experience.
the inner circle are recovery strategies such as advocacy,
treatment, support, connection, acceptance and
inclusion.
The outermost circle contains support networks such as
services, practitioners, peer specialists, community,
friends and family
Process of personal recovery
(Andresen, Oades and Caputi; 2003, 2006 dan 2011)
Finding and maintaining hope—believing in oneself; having a
sense of personal agency; optimistic about the future
Re-establishment of positive identity—incorporates mental
health issues or mental illness, but retains a positive sense of self
Building a meaningful life—making sense of illness or emotional
distress; finding a meaning in life beyond illness; engaged in life
Taking responsibility and control—feeling in control of illness
and distress and in control of life.
Process of personal recovery (Glover,
2012))
Glover's model reflects the efforts that people undertake in their personal recovery journeys
through a set of five processes.
From passive to active sense of self—moving from the passive position of being a
recipient of services to reclaiming one's strengths, attributes and abilities to restore recovery
From hopelessness and despair to hope—moving from hopelessness and despair to
one of hope
From others' control to personal control and responsibility —moving from others taking
responsibility for recovery to the person taking, holding and retaining responsibility
From alienation to discovery—'finding meaning and purpose in the journey; doing more
of what works and less of what does not work; learning from past experiences and
incorporating that lesson into the present; acknowledging that journeys always have
something to teach us and contribute to our sense of discovery'
From disconnectedness to connectedness—moving from an identity of illness or
disability to an appreciation of personal roles and responsibilities and to 'participating in life
as a full citizen and not through the powerlessness of illness'.
TIM PELAKSANAAN KESEHATAN JIWA MASYARAKAT
(TPKJM)
KECAMATAN KASIHAN
Penasehat PEMBINA
Kepala Kecamatan Dinkes Bantul
RS Grhasia DIY
Tim Kesehatan Jiwa UMY
Kasi Kesejahteraan
Masyarakat
Sekretaris : Kec.Kasihan
Programer Kesehatan Bendahara
Jiwa Ketua Bagian Keuangan
PKM Kasihan 1 dan Sekretaris Camat Kecamatan
Kasihan 2
ANGGOTA
UPT PPD
KUA&Depa Puskesmas Kecamat Ketua
g
Kasihan I & II an Karang
Kecamatan
Kasihan Kasihan Taruna
Kec.Kasihan
Babinsa
Polsek
PKK Desa Koramil
Kesra Desa
Babinkamtibma PLKB/PKH Kecamatan
s Desa (4 Desa) (4 Desa) (4 Desa)
Kec Kasihan Kasihan
PEMBENTUKAN TPKJM
CAPACITY BUILDING
PELATIHAN DAN KOORDINASI
TPKJM
Pelatihan Kecamatan Siaga Sehat
Jiwa
Pelatihan Kegawatdaruratan Psikiatri
untuk Tim
PELAKSANAAN KEGIATAN
TKSK
KADER
NAKES:
PERAWAT+DOKTER
SIAPA?
Community Based Rehabilitation
(Puspitasari &Wardaningsih, 2019)
Pharmacotherapy
Psychoeducation
Social skill training
Occupational Therapy
Sesi 1: Definisi Sesi 2: Gejala
Skizofrenia Skizofrenia
PSYCHOEDUCATION Sesi 3: Sesi 4:
Manajemen Pemulihan
Skizofrenia Dan Kambuh
Sesi 6 :
Sesi 5: Peran
Manajemen
Keluarga
Stres
Psychoeducation
Individual Group
Sesi 1: Keterampilan Memulai Percakapan
Sesi 2: Keterampilan Mendengarkan Aktif
Sesi 3: Menyampaikan Keterampilan
KETRAMPILA Permintaan
N SOSIAL Sesi 4: Memberikan Keterampilan Perasaan
Senang
Sesi 5: Memberikan Keterampilan Perasaan
Tidak Menyenangkan
Sesi 6: Mengakhiri Keterampilan
Percakapan
Occupational Therapy
Penanggung Jawab Kegiatan
Kriteria ODGJ
Jenis Ketrampilan
Occupational Therapy
Membuat Telur Asin
Bermain Hadroh
Bercocok Tanam
Usaha Buah
Penghargaan bagi Bhabinkamtibmas
Publication
• Improving
Quality of Life
of People
with
Schizophrenia
• Decreasing
Score of
PANS
The personal view
of recovery is
viewed as a
journey that is a
unique and
personal
experience for
each individual
