studi literature pengaruh pursed lip breathing …
TRANSCRIPT
STUDI LITERATURE PENGARUH PURSED LIP
BREATHING TERHADAP DISPNEA DAN PENINGKATAN
SATURASI OKSIGEN PADA PASIEN PENYAKIT PARU
OBSTRUKTIF KRONIS
SKRIPSI
Oleh :
MASAH ZAHIROH PUTRIYANA
201710420311172
PROGRAM STUDI ILMU KEPERAWATAN
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH MALANG
2021
STUDI LITERATURE PENGARUH PURSED LIP
BREATHING TERHADAP DISPNEA DAN PENINGKATAN
SATURASI OKSIGEN PADA PASIEN PENYAKIT PARU
OBSTRUKTIF KRONIS
SKRIPSI
Untuk Memenuhi Persyaratan Mencapai Derajat
Sarjana Keperawatan (S.Kep) pada Program Studi Ilmu Keperawatan
Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang
Oleh :
MASAH ZAHIROH PUTRIYANA
201710420311172
PROGRAM STUDI ILMU KEPERAWATAN
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH MALANG
2021
iii
KATA PENGANTAR
Puji dan syukur saya panjatkan kehadirat Allah SWT, berkat rahmat dan
bimbingan-Nya saya dapat menyelesaikan skripsi dengan judul “Studi Literature
Pengaruh Pursed Lip Breathing Terhadap Dispnea Dan Peningkatan Saturasi Oksigen
Pada Pasien Penyakit Paru Obstruktif Kronis”. Skripsi ini merupakan salah satu syarat
untuk memperoleh gelar sarjana keperawatan (S.Kep) pada Program Studi Ilmu
Keperawatan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.
Bersamaan dengan ini, maka perkenankanlah saya untuk mengucapkan
terimakasih yang sebesar-besarnya kepada :
1. Bapak Faqih Ruhyanuddin, M.Kep. Sp.Kep.MB selaku Dekan Fakultas
Ilmu Kesehatan Universitas Muhammadiyah Malang.
2. Ibu Nur Lailatul Masruroh, S.Kep.Ns. MNS selaku Ketua Program
Studi Ilmu Keperawatan.
3. Ibu Titik Agustyaningsih, S.Kep., Ns., M.Kep selaku Dosen
Pembimbing yang telah memberikan kontribusi yang sangat besar
selama penyusunan skripsi ini.
iv
4. Bapak Faqih Ruhyanudin, M.Kep. Sp.Kep.MB, Ibu Anis Ika Nur
Rohmah, M.Kep. Sp.Kep.MB, dan Ibu Indah Dwi Pratiwi, M.Ng
selaku penguji dalam hasil skripsi saya yang sudah memberi masukan
serta saran untuk hasil skripsi saya yang lebih baik lagi.
5. Kedua orang tua bunda Masnah dan ayah Misyanto yang tiada henti
memberikan support dan doa selama ini.
6. Adikku Miftahur Raihan Priyanto yang selalu mendoakan agar skripsi
ini lancar, serta Kakakku Hasni Nur Fariqoh atas motivasi yang
diberikan dan selalu menjadi penyemangat untuk saya dalam
menyelesaikan skripsi ini.
7. Teman-teman Squade Riza Nita H, Ellen Denada, M. Nur Alfian,
Ananda Rifqi F., Abiyosi Bayhaqi, dan M. Shilham Robith yang selalu
memberikan hiburan di kala penat.
8. Teman kos tercinta Tri Pemilu Wati, Laliyatul Maghfirah, Dzilfiyah, Lia
Novita Sari, dan Fatimatus Zahroh yang selalu ada di saat senang dan
sedih dalam menyelesaikan skripsi ini.
9. Dan semua pihak yang telah membantu penyelesaian skripsi ini.
Malang, 4 Februari 2021
Penulis
v
DAFTAR ISI
LEMBAR PENGESAHAN ............................................................................................... i
LEMBAR PENGESAHAN ..............................................................................................ii
SURAT PERNYATAAN KEASLIAN PENELITIAN ........................................... iii
KATA PENGANTAR ....................................................................................................... iv
ABSTRAK ............................................................................................................................. vi
DAFTAR ISI ...................................................................................................................... viii
DAFTAR GAMBAR ......................................................................................................... xii
DAFTAR TABEL............................................................................................................. xiii
DAFTAR LAMPIRAN ................................................................................................... xiv
BAB I ...................................................................................................................................... 1
PENDAHULUAN .............................................................................................................. 1
1.1 Latar Belakang ........................................................................................................ 1
1.2 Rumusan Masalah .................................................................................................. 5
1.3 Tujuan ..................................................................................................................... 6
1.4 Manfaat ................................................................................................................... 6
1.5 Keaslian Penelitian ................................................................................................ 7
BAB II ................................................................................................................................... 11
TINJAUAN PUSTAKA ................................................................................................... 11
2.1 Konsep Dasar PPOK ......................................................................................... 11
2.1.1 Pengertian PPOK ............................................................................................ 11
2.1.2 Etiologi PPOK ................................................................................................ 11
2.1.3 Klasifikasi PPOK ............................................................................................ 13
2.1.4 Patofisiologi ...................................................................................................... 15
2.1.5 Faktor Risiko .................................................................................................... 15
vi
2.1.6 Manifestasi Klinis ............................................................................................ 16
2.1.7 Komplikasi ....................................................................................................... 17
2.2 Konsep Saturasi Oksigen ................................................................................... 18
2.2.1 Pengertian saturasi oksigen ............................................................................ 18
2.2.2 Penyebab penurunan saturasi oksigen pada pasien PPOK ....................... 19
2.3 Konsep dyspnea ................................................................................................... 20
2.3.1 Pengertian dyspnea ............................................................................................ 20
2.3.2 Penyebab dyspnea pada pasien PPOK ........................................................... 20
2.4 Konsep Pursed Lip Breathing ........................................................................... 21
2.4.1 Pengertian pursed lip breathing .......................................................................... 21
2.4.2 Teknik ............................................................................................................... 21
2.5 Pengaruh pursed lip breathing terhadap dyspnea dan peningkatan saturasi
oksigen pada pasien PPOK ............................................................................................ 23
BAB III ................................................................................................................................. 25
METODE PENELITIAN ............................................................................................. 25
3.1 Desain Penelitian ................................................................................................. 25
3.2 Tahapan Studi Literature .................................................................................... 25
3.2.1 Protokol dan Registrasi ................................................................................... 25
3.3 Identifikasi Masalah ............................................................................................. 27
3.4 Pencarian Database ............................................................................................. 27
3.5 Screening ............................................................................................................... 27
3.5.1 Kata Kunci ....................................................................................................... 27
3.5.2 Kriteria Inklusi dan Eksklusi ......................................................................... 28
3.6 Penilaian Kualitas ................................................................................................ 29
3.6.1 Hasil Pencarian dan Penilaian Kualitas ........................................................ 29
vii
3.6.2 Penilaian Kualitas ............................................................................................ 30
3.7 Ekstraksi Data ...................................................................................................... 30
BAB IV ................................................................................................................................. 31
HASIL PENELITIAN .................................................................................................... 31
4.1 Deskripsi Jurnal yang di Review ........................................................................ 31
4.1.1 Karakteristik Jurnal Penelitian ....................................................................... 31
4.1.2 Karakteristik Peserta ....................................................................................... 32
4.1.3 Demografi Wilayah ......................................................................................... 32
4.2 Deskripsi Jurnal yang Di Review ....................................................................... 32
4.2.1 Pengaruh Pursed Lips Breathing Terhadap Dispnea ...................................... 33
4.2.2 Pengaruh Pursed Lips Breathing Terhadap Saturasi Oksigen ....................... 35
4.2.3 Pengaruh Pursed Lip Breathing Terhadap Dyspnea dan Saturasi Oksigen ... 37
4.3 Analisa Data ......................................................................................................... 38
4.3.1 Memahami Data .............................................................................................. 38
BAB V ................................................................................................................................... 39
PEMBAHASAN ................................................................................................................ 39
5.1 Pengaruh Pursed Lip Breathing terhadap Dispnea ........................................ 39
5.2 Pengaruh Pursed Lip Breathing terhadap Peningkatan Saturasi Oksigen ... 42
5.3 Pengaruh Pursed Lips Breathing Terhadap Dispnea dan Saturasi Oksigen
pada Pasien PPOK .......................................................................................................... 45
BAB VI ................................................................................................................................. 48
KESIMPULAN DAN SARAN ...................................................................................... 48
6.1 Kesimpulan ........................................................................................................... 48
6.2 Saran ...................................................................................................................... 48
6.2.1 Bagi Institusi ..................................................................................................... 48
viii
6.2.2 Bagi Peneliti Selanjutnya ................................................................................. 48
DAFTAR PUSTAKA ........................................................................................................ 50
Lampiran .............................................................................................................................. 59
ix
DAFTAR GAMBAR
Gambar 2.1. Teknik Pursed Lip Breathing (Leskovsek et al., 2014) ............................. 23
Gambar 3.2 Alur Pencarian Data (PRISMA) .......................................................... 26
x
DAFTAR TABEL
Tabel 3.5.1 Kata Kunci Literature Review Berbahasa Indonesia dan Bahasa Inggris ... 27
Tabel 3.5.2 Format PICOS dalam Literature Review .................................................. 29
xi
DAFTAR LAMPIRAN
Lampiran 1. Proses Pencarian ................................................................................. 59
Lampiran 2. Instrumen JBI ..................................................................................... 61
Lampiran 3. Pencarian Database............................................................................. 65
Lampiran 4. Penulisan JBI ...................................................................................... 65
Lampiran 5. Ekstraksi Data .................................................................................... 68
50
DAFTAR PUSTAKA
Agustina Tuk Jiron. (2020). Asuhan Keperawatan Klien Penyakit Paru Obstruktif
Kronik (Ppok) Dengan Ketidakefektifan Pola Nafas. Journal Of Chemical
Information And Modeling, 53(9), 1689–1699.
Amira Permata S T, J. (2018). Pernafasan Pursed Lip Breathing Meningkatkan Saturasi
Oksigen Penderita Penyakit Paru Obstruktif Kronis (Ppok) Derajat Ii. Jurnal
Keperawatan Indonesia, 1(2), 39–46.
Astriani, N. M. D. Y., Dewi, P. I. S., & Yanti, K. H. (2020). Relaksasi Pernafasan
Dengan Teknik Ballon Blowing Terhadap Peningkatan Saturasi Oksigen Pada
Pasien Ppok. Jurnal Keperawatan Silampari, 3(2018), 426–435.
Babu, B., Ealias, J., & Venunathan, A. (2016). Pursed Lip Breathing Exercise – A Self-
Management Approach Anveshana International Journalof Research In
Pharmacy And Life Sciences Pursed Lip Breathing Exercise – A Self-
Management Approach Towards Shortness Of Breath. Anveshana International
Journalof Research In Pharmacy And Life Sciences, 1(1), 41–45.
Belinda B Hammond, Polly Gerber Zimmermann, R. M. M. C. (2013). Sheehy’s
Emergency And Disaster Nursing - 1st Indonesian Edition (A. K. Triyasni (Ed.)).
Elseiver Singapore Pte. Ltd.
Berry, Michael J, K. L. S. (2018). Comparison Of Effects Of Endurance And Strength
Training Programs In Patients With Copd. Journal Of Chronic Obstructive Pulmonary
Disease, 15(2), 192–199.
Bharadwaj, T. A., Jiandani, M. P., & Mehta, A. (2016). Pursed Lip Breathing Increases
Unsupported Upper Extremity Exercise Endurance And Reduces Desaturation In Copd
Exercițiile Executate Cu Membrele Superioare Și Reduce Desaturația , În Bpoc Result In
Abnormal Breathing Patterns During Common Daily Activitie. 22(38), 5–14.
51
Budiono, B., Mustayah, M., & Aindrianingsih, A. (2017). The Effect Of Pursed Lips
Breathing In Increasing Oxygen Saturation In Patients With Chronic Obstructive
Pulmonary Disease In Internal Ward 2 Of The General Hospital Of Dr. R.
Soedarsono Pasuruan. Public Health Of Indonesia, 3(3), 117–123.
Https://Doi.Org/10.36685/Phi.V3i3.132
Cabral, L. F., D’elia, T. D. C., Marins, D. D. S., Zin, W. A., & Guimarães, F. S. (2015).
Pursed Lip Breathing Improves Exercise Tolerance In Copd: A Randomized
Crossover Study. European Journal Of Physical And Rehabilitation Medicine, 51(1), 79–
88. Http://Www.Ncbi.Nlm.Nih.Gov/Pubmed/24691248
Chorostowska-Wynimko, J. (2016). Disease Modification In Emphysema Related To
Alpha-1 Antitrypsin Deficiency. Copd: Journal Of Chronic Obstructive Pulmonary
Disease, 13(6), 807–815. Https://Doi.Org/10.1080/15412555.2016.1178224
Enie Novieastari, Kusman Ibrahim, Sri Ramdaniati, D. D. (2020). Fundamentals Of
Nursing Vol 1- 9th Indonesian Edition. Elseiver Singapore Pte. Ltd.
Global Initiative For Chronic Obstructive Lung Disease. (2020). Gold 2020. Global
Initiative For Chronic Obstructive Lung Disease, 141. Https://Goldcopd.Org/Wp-
Content/Uploads/2019/12/Gold-2020-Final-Ver1.2-03dec19_Wmv.Pdf
Handayani, M. (2019). Metodologi Penelitian Akuntansi (Bagi Pendidikan Vokasi). Poliban
Press.
Harun Ain, Ririn Anantasari, M. F. N. F. (2019). Pernafasan Diafragma Meningkatkan
Saturasi Oksigen Pada Pasien Ppok Di Rsud Soedarsono Pasuruan. Prosiding
Seminar Nasional Hasil Penelitian Dan Pengabdian Masyarakat Seri Ke-3 Tahun 2019,
53–61.
Heriyanto. (2018). Thematic Analysis Sebagai Metode Menganalisa Data Untuk Penelitian
Kualitatif. 2(3), 317–324.
52
Hidayati, A. N. (2018). Gawat Darurat Medis Dan Bedah. Airlangga University Press
(Aup).
Huriah, T. (2018). Metode Student Center Learning Aplikasi Pada Pendidikan Keperawatan
Edisi Pertama. Prenada Media Grup.
Huriah, T., & Wulandari Ningtias, D. (2017). Pengaruh Active Cycle Of Breathing
Technique Terhadap Peningkatan Nilai Vep1, Jumlah Sputum, Dan Mobilisasi
Sangkar Thoraks Pasien Ppok. Indonesian Journal Of Nursing Practices, 1(2), 44–54.
Https://Doi.Org/10.18196/Ijnp.1260
Irfanuddin. (2019). Cara Sistematis Berlatih Meneliti Merangkai Sistematika Penelitian
Kedokteran Dan Kesehatan. Pt Rayyana Komunikasindo.
Ismail, L., Sahrudin, S., & Ibrahim, K. (2017). Analisis Faktor Risiko Kejadian Penyakit
Paru Obtruktif Kronik (Ppok) Di Wilayah Kerja Puskesmas Lepo- Lepo Kota
Kendari Tahun 2017. Jurnal Ilmiah Mahasiswa Kesehatan Masyarakat Unsyiah, 2(6),
198210.
Isnainy, U. C. A. S., & Tias, S. A. (2019). Pengaruh Posisi Condong Kedepan Dan
Terapi Pursed Lips Breathing Terhadap Derajat Sesak Napas Penderita Penyakit
Paru Obstruktif Kronik (Ppok). Holistik Jurnal Kesehatan, Volume 13, 389–395.
Isnainy, U. C. A. S., & Tias, S. A. (2020). Pengaruh Posisi Condong Kedepan Dan
Terapi Pursed Lips Breathing Terhadap Derajat Sesak Napas Penderita Penyakit
Paru Obstruktif Kronik (Ppok). Holistik Jurnal Kesehatan, 13(4), 389–395.
Https://Doi.Org/10.33024/Hjk.V13i4.1670
Jackson. (2014). Keperawatan Medikal Bedah Edisi I. Rapha Publishing.
Junaidin, J., Syam, Y., & Irwan, A. M. (2019). Pengaruh Pursed Lip Breathing Dan
Meniup Balon Terhadap Kekuatan Otot Pernapasan, Saturasi Oksigen Dan
Respiratory Rate Pada Pasien Ppok. Jurnal Ilmiah Keperawatan (Scientific Journal Of
53
Nursing), 5(1), 31–39. Https://Doi.Org/10.33023/Jikep.V5i1.211
Kemenkes. (2013). Riset Kesehatan Dasar, Hasil Riskesdas. Kemenkes Ri.
Kemenkes. (2014). Menkes Ungkap Dampak Rokok Terhadap Kesehatan Dan Ekonomi. Hal
1. Jakarta.
Khasanah, S., & Maryoto, M. (2015). Efektifitas Posisi Condong Ke Depan Dan Pursed Lips
Breathing ( Plb ) Terhadap Peningkatan Saturasi Oksigen Pasien Penyakit Paru Obstruktif
Kronik Effectiveness Of Position Thrust Forward And Pursed Lips Breathing ( Plb ) To
Improvement Oxygen Saturation. Vii(1), 25–36.
Kristiningrum, E. (2019). Farmakoterapi Penyakit Paru Obstruksi Kronik ( Ppok ).
Cermin Dunia Kedokteran, 46(4), 262–271.
Kusumawardani, N., Rahajeng, E., & Mubasyiroh, R. (2017). Hubungan Antara
Keterpajanan Asap Rokok Dan Riwayat Penyakit Paru Obstruktif Kronik ( Ppok ) Di
Indonesia Associationof Cigarrete Smoke Expossure And Chronic Obstructive Pulmonary
Disease ( Copd ) In Indonesia. 160–166.
Laily Widya Astuti. (2014). Pengaruh Pursed Lips Breathing Terhadap Pola Pernapasan
Pada Pasien Dengan Emfisema Di Rumah Sakit Paru Dr. Ario Wirawan Salatiga.
Program Studi Ilmu Keperawatan. Sekolah Tinggi Ilmu Kesehatan Ngudi Waluyo Ungaran.
Lee, W. J., Govind, S., Singh, K., & Wah, Y. C. (2019). A Comparative Study Between
Breathing Control And Pursed Lip A Comparative Study Between Breathing Control And
Pursed Lip Breathing Among Bronchial Asthma. December.
Lemone, P. (2016). Buku Ajar Keperawatan Medikal Bedah Vol. 3.
Leskovsek, M., Pušenjak, N., Lasic, A., & Ravnik, D. (2014). Breathing Television: A
Breathing Controlled Multimedia Player For Reducing Breathing Rate. Open
Journal Of Respiratory Diseases, 04(04), 111–118.
Https://Doi.Org/10.4236/Ojrd.2014.44015
54
Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., Wei, G. X., & Li,
Y. F. (2017). The Effect Of Diaphragmatic Breathing On Attention, Negative
Affect And Stress In Healthy Adults. Frontiers In Psychology, 8(Jun), 1–12.
Https://Doi.Org/10.3389/Fpsyg.2017.00874
Mahler D. A, Fierro-Carrion, J. C. B. (2017). Evaluation Of Dyspnea In The Elderly.
Clinics In Geriatric Medicine, 19(1), 19–33.
Mary A Nies, M. M. (2015). Community And Familly Health Nursing - 1st Indonesian Edition
(N. M. R. Junaiti Sahar, Agus Setiawan (Ed.); 6th Editio). Elseiver Singapore Pte.
Ltd.
Maryoto, S. K. M. (2015). Efektifitas Posisi Condong Ke Depan Dan Pursed Lips
Breathing (Plb) Terhadap Peningkatan Saturasi Oksigen Pasien Penyakit Paru
Obstruktif Kronik. Jurnal Kesehatan Al-Irsyad, Vii(1).
Maulana, S., Komariah, M., & Nurjanah, S. (2020). The Effectiveness Of Herbal
Medicine For Sleep Quality In People With Sleep Disorder:An Update Literature
Review With Single Database (Pubmed). Nucleus, 85–94.
Maunaturrohmah, A., & Yuswatiningsih, E. (2018). Terapi Diafragmauntuk Pasienpenyakit
Paru Obstruktif Kronik(Ppok). Penerbit Stikes Majapahit.
Mcconnell, A. (2013). Respiratory Muscle Training 1st Edition. Elsevier Health Sciences
Uk.
Mertha, I. M., Putri, P. J. Y., & Suardana, I. Ketut. (2018). Pengaruh Pemberian Deep
Breathing Exercise Terhadap Saturasi Oksigen Pada Pasien Ppok. Jurnal Gema
Keperawatan, 1, 1–9.
Mohamed, S. A. (2019). The Effects Of Positioning And Pursed-Lip Breathing
Exercise On Dyspnea And Anxiety Status In Patients With Chronic Obstructive
Pulmonary Disease. Journal Of Nursing Education And Practice, 9(6), 41.
55
Https://Doi.Org/10.5430/Jnep.V9n6p41
Nesreen G. Elnahas, S. A. G. A.-E., & Youssef M.A. Soliman, Z. M. H. S. (2020).
Mouth Mask Versus Pursed Lip Breathing On Ventilatory Functions And
Dyspnea Index In Chronic Obstructive Pulmonary Disease. The Medical Journal Of
Cairo University, 88(12), 1461–1468.
Https://Doi.Org/10.21608/Mjcu.2020.115373
Oktaria, D., & Ningrum, M. S. (2017). Pengaruh Merokok Dan Defisiensi Alfa-1
Antitripsin Terhadap Progresivitas Penyakit Paru Obstruktif Kronis ( Ppok ) Dan
Emfisema. Majority, 6(2), 42–47.
Paramasivam, K. (2017). Pengalaman Belajar Lapangan Penyakit Paru Obstruksi Kronis (
Ppok ). 1102005208.
Pdpi. (2011). Ppok. Diagnosis Dan Penatalaksanaan.
Pdpi. (2018). Pers Release Perhimpunan Dokter Paru Indonesia Dalam Rangka World Copd
Day 2018.
Http://Klikpdpi.Com/Index.Php?Mod=Article&Sel=8720#:~:Text=Penyakit
Paru Obstruktif Kronik Merupakan,Sekitar 9%2c2 Juta Penduduk.
Qamila, B., Ulfah Azhar, M., Risnah, R., & Irwan, M. (2019). Efektivitas Teknik Pursed
Lipsbreathing Pada Pasien Penyakit Paru Obstruksi Kronik (Ppok): Study
Systematic Review. Jurnal Kesehatan, 12(2), 137.
Https://Doi.Org/10.24252/Kesehatan.V12i2.10180
Rahmadi. (2015). Nursing Care On Mr.W With Respiratory System Disorders: Chronic
Obstructive Pulmonary Disease (Copd) In Pandan Arang Governement Hospital Of Boyolali.
Rosyadi, I., Djafri, D., & Rahman, D. (2019). Pengaruh Pemberian Pursed Lip-
Breathing, Diaphragmatic Breathing, Dan Upper Limb Stretching Terhadap Skala
Dispnea Pada Pasien Ppok. Ners Jurnal Keperawatan, 15(2), 103.
56
Https://Doi.Org/10.25077/Njk.15.2.103-109.2019
Sakhaei, S., Sadagheyani, H. E., Zinalpoor, S., Markani, A. K., & Motaarefi, H. (2018).
The Impact Of Pursed-Lips Breathing Maneuver On Cardiac, Respiratory, And
Oxygenation Parameters In Copd Patients. Open Access Macedonian Journal Of
Medical Sciences, 6(10), 1851–1856. Https://Doi.Org/10.3889/Oamjms.2018.407
Salle, S. P. La, Rivest, E. A., Boucher, V. G., Lalande-Gauthier, M., Morisset, J.,
Manganas, H., Poirier, C., Comtois, A. S., & Dubé, B. P. (2019). Effects Of
Pursed Lip Breathing On Exercise Capacity And Dyspnea In Patients With
Interstitial Lung Disease: A Randomized, Crossover Study. Journal Of
Cardiopulmonary Rehabilitation And Prevention, 39(2), 112–117.
Https://Doi.Org/10.1097/Hcr.0000000000000387
Sandu Siyoto, M. A. S. (2015). Dasar Metodologi Penelitian. Literasi Media Publishing.
Sari, N. K., & Suhartono. (2016). Effect Of Self Efficacy Pursed Lip Breathing To
Decrease Tightness And Improved Oxygen Saturation In Patients With Chronic
Obstructive Pulmonary Disease. Journal Of Medical Research & Health Sciences, 17–
21.
Septia, N., Wungouw, H., & Doda, V. (2016). Hubungan Merokok Dengan Saturasi
Oksigen Pada Pegawai Di Fakultas Kedokteran Universitas Sam Ratulangi
Manado. Jurnal E-Biomedik, 4(2), 2–7.
Https://Doi.Org/10.35790/Ebm.4.2.2016.14611
Setyopranoto, I. (2019). Pemeriksaan Analisis Gas Darah Arteri Pada Pasien Stroke. Gajah
Mada University Press.
Shivangi S, Sonia P, S. K. (2018). Effect Of Pursed Lip Breathing And Mouth Mask
On Dyspnea In Healthy Individuals- A Pilot Study. International Journal Of Health
Sciences And Research, 8(7).
57
Siregar, K. L. S. T. H. (2019). Pengaruh Pulsed Lip Breathing Exercise Terhadap
Penurunan Sesak Napas Pada Pasien Penyakit Paru Obstruktif Kronik (Ppok) Di
Rsu Royal Prima Medan 2018. Jurnal Keperawatan Priority, 2(1), 93–103.
Smeltzer, S. C., & Bare, B. G. (2013). Buku Ajar Keperawatan Medikal - Bedah, Vol. 3.
Egc.
Somantri, I. (2012). Asuhan Keperawatan Pada Klien Dengan Gangguan Sistem Pernapasan.
2nd Ed. Salemba Medika.
Stockley, J. A., & Stockley, R. A. (2016). Pulmonary Physiology Of Chronic
Obstructive Pulmonary Disease, Cystic Fibrosis, And Alpha-1 Antitrypsin
Deficiency. Annals Of The American Thoracic Society, 13(April), S118–S122.
Https://Doi.Org/10.1513/Annalsats.201504-224kv
Sudarsa, I. W. (2020). Perawatan Komprehensif Paliatif. Airlangga University Press (Aup).
Sumedi, ., Philip, K., & Hafizurrachman, M. (2021). The Effect Of Pursed Lips
Breathing Exercises On The Oxygen Saturation Levels Of Patients With Chronic
Obstructive Pulmonary Disease In Persahabatan Hospital, Jakarta. Kne Life
Sciences, 2021, 35–64. Https://Doi.Org/10.18502/Kls.V6i1.8589
Suyanto, S., & Al Islami, V. E. (2020). The Difference In Oxygen Saturation Values
Of Copd Patients Using Pursed Lip Breathing And 6 Minutes Walk Exercise.
Jurnal Bahana Kesehatan Masyarakat (Bahana Of Journal Public Health), 4(1), 17–22.
Https://Doi.Org/10.35910/Jbkm.V4i1.250
Syarifah, S., & Amin, M. (2020). Penggunaan Extrafine Beclometason
Diproprionat/Formoterol Fumarat Pada Ppok. Jurnal Respirasi, 5(2), 47.
Https://Doi.Org/10.20473/Jr.V5-I.2.2019.47-56
Takatelide, F., Kumaat, L., & Malara, R. (2017). Pengaruh Terapi Oksigenasi Nasal
Prong Terhadap Perubahan Saturasi Oksigen Pasien Cedera Kepala Di Instalasi
58
Gawat Darurat Rsup Prof. Dr. R. D. Kandou Manado. Jurnal Keperawatan Unsrat,
5(1), 111716.
Utama, S. Y. A. (2018). Buku Ajar Keperawatan Medikal Bedah Sistem Respirasi. Deepublish
Publisher.
Wahidati, H. W., Dwiningsih, S. U., & Putrono, P. (2019). The Effectiveness Of
Tripod Position And Pursed Lips Breathing To Enhance Oxygen Saturation In
Patients With Copd. Jendela Nursing Journal, 3(2), 68–76.
Https://Doi.Org/10.31983/Jnj.V3i2.4613
Wahyudin Rajab, M.Epid, Yudhia Fratidhina, F. (2018). Konsep Dasar Keterampilan
Kebidanan. Wineka Media.