ANALISIS LAPORAN KASUS SERIAL PASIEN STEMI DENGAN PENDEKATAN TEORI ADAPTASI ROY DI PUSAT JANTUNG TERPADU RSUP Dr. WAHIDIN SUDIROHUSODO = ANALYSIS OF CASE REPORTS OF STEMI PATIENTS SERIALLY USING ROY'S ADAPTATION THEORY APPROACH AT THE INTEGRATED HEART CENTER OF Dr. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL

ABSTRAK INGGRIS Title: Analysis of Serial Case Reports of STEMI Patients Using the Roy Adaptation Theory Approach at the Integrated Heart Center of Dr. Wahidin Sudirohusodo Hospital Background: ST-Segment Elevation Myocardial Infarction (STEMI) is a cardiovascular emergency with high mortality requiring rapid and comprehensive management. Theory-based holistic nursing care is crucial for optimizing patient adaptation; however, in-depth analysis of its application in serial case reports remains limited. Objective: To analyze the clinical characteristics and the application of nursing care based on the Roy Adaptation Theory in serial case reports of STEMI patients at the Integrated Heart Center of Dr. Wahidin Sudirohusodo Hospital. Methods: This study employed a descriptive-quantitative serial case study design with an analytical approach. A total of 10 purposively selected STEMI cases were included. Data were collected from nursing documentation and analyzed using the Roy Adaptation Model Documentation Assessment Scale (RAM-DAS) instrument to evaluate the application of the theory across four adaptive modes (physiological, self-concept, role function, and interdependence). Descriptive and inferential statistical analyses were performed using IBM SPSS Statistics version 26. Results: The majority of patients were middle-aged males (mean age 55.2 years) with dominant risk factors of smoking (90%) and dyslipidemia (100%). Primary PCI with stenting was performed in 80% of patients. The application of the Roy Adaptation Theory was well-documented in 90% of cases. RAM-DAS assessment revealed high scores in the assessment dimension (93.75%) and stimuli identification (91.67%), while the dimensions of intervention appropriateness (75%) and adaptation evaluation (83.33%) require further improvement. The dominant evidence-based nursing intervention was video-based education (50%), which effectively reduced patient anxiety scores post-intervention. Conclusion: This analysis of serial case reports demonstrates that a holistic approach based on the Roy Adaptation Theory has been comprehensively applied, particularly in the assessment aspect. However, there is room for optimization in intervention appropriateness and evaluation of adaptation outcomes, especially in the physiological and role transition aspects. Recommendations include strengthening integrated nursing care protocols and developing more standardized evaluation instruments.

Keyword : Case Series Analysis, STEMI, Roy Adaptation Theory, Holistic Nursing Care, RAM-DAS.