scholarly journals Literature Review : Penerapan Senam Hamil Terhadap Penurunan Nyeri Punggung Pada Ibu Hamil Trimester III

2021 ◽  
Vol 1 ◽  
pp. 791-798
Author(s):  
Much Ilham Bintara Indah ◽  
Windha Widyastuti
Keyword(s):  
Back Pain ◽  
Literature Review ◽  
Pregnant Women ◽  
Rating Scale ◽  
Health Workers ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Average Value ◽  
The Third ◽  
Numeric Rating

AbstractBack pain is a problem commonly experienced by pregnant women in the third trimester. One of the effective ways to reduce that pain is pregnancy exercise. This scientific writing aims to describe the implementation of pregnancy exercise to pregnant women who experience back pain based on a literature review. The review was done to three articles from similar journal, which were published during 2018 – 2020. The Numeric Rating Scale (NRS) was used as the instrument. From 39 pregnant women who participated, 97.4% of them were 20-35 years old and 69.2% were fulltime housewives. The result showed that average value of the pain scale before the intervention was 5.42, and after the intervention was 2.70. The conclution of this literature review was that the implementation of pregnancy exercise was effective in reducing the intensity of back pain in pregnancy. Hence, health workers are supposed to encourage pregnant women to do pregnancy exercise, especially in the third trimester.Keywords: Keywords: Pregnancy; Back Pain, Pregnancy Exercise AbstrakKetidaknyamanan nyeri punggung umum dialami oleh ibu hamil Trimester III. Salah satu tindakan untuk menurunkan nyeri punggung yang efektif adalah senam hamil. Karya Tulis Ilmiah ini bertujuan untuk menggambarkan penerapan senam hamil pada ibu hamil yang mengalami nyeri punggung berdasarkan literature review. Subyek literature review yang digunakan yaitu 3 jurnal dengan laman jurnal yang yang sama, terbit tahun (2018-2020). Instrumen pada ketiga artikel ini menggunakan NRS (Numeric Rating Scale). Hasil analisa karakteristik responden dari 3 jurnal menunjukkan dari jumlah responden 39 ibu hamil. Sebagian umur responden adalah 20-35 tahun (97,4%), mayoritas status pekerjaan adalah IRT (69,2%). Nilai rata-rata skala nyeri sebelum intervensi 5,42, setelah intervensi 2,70. Kesimpulkan dari literature review adalah senam hamil efektif dalam menurunkan intensitas nyeri punggung pada kehamilan. Saran bagi pelayan kesehatan hendaknya menigkatkan penerapan senam hamil kepada seluruh ibu hamil terutama trimester III.Kata kunci: Kehamilan, Nyeri Punggung, Senam Hamil

scholarly journals Utilization of Back Movement Technique to Intensity of Low Back Pain in Third Trimester Pregnant Women

2020 ◽  
Vol 9 (2) ◽  
pp. 535-542
Author(s):  
Putri Maretyara Saptyani ◽  
Ari Suwondo ◽  
Runjati Runjati
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Low Back ◽  
Third Trimester ◽  
Control Group Design ◽  
Numeric Rating

One of the discomforts in third-trimester pregnancy is lower back pain.The prevalence of back pain during pregnancy can reach 80%. The study aims to prove the use of back movement technique to decrease the intensity of low back pain in third trimester pregnant women. The study used quasy-experimental, pretest-posttest with control group design. The sample of the study was third-trimester pregnant women with low back pain totaling 40 respondents. The instrument used to measure back pain in pregnancy is the Numeric Rating Scale (NRS). Data analysis used wilcoxon and man-whitney. There was a decrease in intensity of low back pain before treatment by 4.75 cm and after being given a back movement technique of 1.55 cm (p = 0.001). Back movement technique is proven to be more effective in reducing the intensity of low back pain in third-trimester pregnant women.

scholarly journals Analisa Determinan Perilaku Seks Bebas di SMA Negeri 1 Kota Fajar di Kabupaten Aceh Selatan

2020 ◽  
Vol 7 (1) ◽  
pp. 14
Author(s):  
Mayang Wulan
Keyword(s):  
Back Pain ◽  
Weight Gain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
P Value ◽  
Third Trimester ◽  
Purposive Sampling ◽  
Weight Gain During Pregnancy ◽  
Numeric Rating

ABSTRAKNyeri punggung merupakan kejadian yang sering terjadi pada ibu hamil dan akan meningkat keluhannya saat ibu memasuki Trimester III. Penyebab nyeri punggung antara lain peningkatan berat badan selama hamil. Salah satu upaya untuk mengurangi nyeri punggung pada ibu hamil dengan prenatal yoga. Prenatal yoga dapat membantu ibu hamil dalam melenturkan persendian karena bertambahnya berat badan selama kehamilan dan dapat digunakan untuk relaksasi pikiran ibu selama kehamilan. Penelitian ini bertujuan untuk megetahui efektivitas prenatal yoga untuk mengurangi nyeri punggung pada ibu hamil Trimester III. Jenis penelitian kuantitatif dengan menggunakan satu kelompok intervensi dengan sampel ibu hamil trimester III sebanyak 18 responden yang diambil secara purposive sampling. Instrument yang digunakan untuk mengukur nyeri punggung adalah Numeric Rating Scale (NRS) dengan analisis bivariat dengan uji Wilcoxon. Hasil penelitian menunjukkan p value 0,000 yang artinya ada pengaruh prenatal yoga terhadap nyeri punggung pada ibu hamil trimester III.  Kesimpulan dalam penelitian ini prenatal yoga dapat mengurangi nyeri punggung  ibu hamil trimester III.Kata kunci : prenatal yoga; nyeri punggung; ibu hamil trimester III  PRENATAL YOGA TO REDUCE BACK PAIN IN TRIMESTER III PREGNANT MOTHER ABSTRACTBack pain is a common occurrence in pregnant women and will increase when mothers in third trimester. The causes of back pain include weight gain during pregnancy. One of the efforts to reduce back pain in pregnant women is prenatal yoga. Prenatal yoga can help pregnant women in flexing the joints due to weight gain during pregnancy and can be used to relax the mind of the mother during pregnancy. This study was aimed to determine the effectiveness of prenatal yoga to reduce back pain in third trimester pregnant women. The research quantitative method used one intervention group with a sample of 18 third trimester pregnant women who will be taken by purposive sampling. The instrument used to measure back pain was the Numeric Rating Scale (NRS). Data analysis used Wicoxon test obtained p value 0,000 which means prenatal yoga can reduce back pain in third trimester pregnant women. The conclusion in this study prenatal yoga can be used as an alternative treatment for third trimester pregnant women who experience back pain. Keywords: prenatal yoga; back pain; third trimester pregnant women 

scholarly journals The Effect of William Flexion Exercise on Low Back Pain in Traditional Weaving Workers in The Village of Sidemen Karangasem

2021 ◽  
Vol 5 (2) ◽  
pp. 21
Author(s):  
A A Gede Saska A ◽  
Made Rini Damayanti S ◽  
Komang Menik Sri Krisnawati
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Rating Scale ◽  
Health Workers ◽  
Sampling Technique ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Wilcoxon Test ◽  
Abdominal Muscles ◽  
Low Back

Low back pain (LBP) is a subjective sensation characterized by a major symptom of pain in the lower spine region. One of the basic causes is the stress inflicted on the inter-vertebral disk due to poor posture, so that the lumbar spine of the lumbar lordosis has too much strain on the posterior element. These complaints usually occur in workers due to incorrect posture or work position that does not meet the ergonomic principles of one of the traditional weavingworker. Exercise has been widely developed to cope with LBP such as stretching and muscle strengthening. William's flexion exercise (WFE) is an exercise aimed at stretching the posterior muscles and strengthening the abdominal muscles so that the tendon and spongy muscles are expected to relax. The purpose of this study is to determine the effect of WFE on LBP on traditional weaving workers. This study is a pre-experimental study (One-Group Pretest-Posttest Design). The sample consists of 28 respondents selected by using Purposive Sampling technique. Data collected by using questionnaires for respondent characteristics and Numeric Rating Scale for measuring pain scale before and after intervention. The result of the research before intervention was 75% of respondents had moderate pain, while after intervention 85.7% of respondents had mild pain. Based on the Wilcoxon test results obtained p = 0.000 which means there is the influence of WFE on LBP on traditional weavingworker. Based on the above research, it is suggested to health workers teach WFE in order to reduce LBP on traditional weavingworkers. Index Terms— Low back pain,Traditional weaving worker, William’s flexion exercise

scholarly journals Prenatal Yoga untuk Mengurangi Nyeri Punggung pada Ibu Hamil Trimester III

2020 ◽  
Vol 7 (1) ◽  
pp. 9
Author(s):  
Dyah Ayu Wulandari ◽  
Euis Ahadiyah ◽  
Fitria Hikmatul Ulya
Keyword(s):  
Back Pain ◽  
Weight Gain ◽  
Pregnant Women ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
P Value ◽  
Third Trimester ◽  
Purposive Sampling ◽  
Weight Gain During Pregnancy ◽  
Numeric Rating

ABSTRAKNyeri punggung merupakan kejadian yang sering terjadi pada ibu hamil dan akan meningkat keluhannya saat ibu memasuki Trimester III. Penyebab nyeri punggung antara lain peningkatan berat badan selama hamil. Salah satu upaya untuk mengurangi nyeri punggung pada ibu hamil dengan prenatal yoga. Prenatal yoga dapat membantu ibu hamil dalam melenturkan persendian karena bertambahnya berat badan selama kehamilan dan dapat digunakan untuk relaksasi pikiran ibu selama kehamilan. Penelitian ini bertujuan untuk megetahui efektivitas prenatal yoga untuk mengurangi nyeri punggung pada ibu hamil Trimester III. Jenis penelitian kuantitatif dengan menggunakan satu kelompok intervensi dengan sampel ibu hamil trimester III sebanyak 18 responden yang diambil secara purposive sampling. Instrument yang digunakan untuk mengukur nyeri punggung adalah Numeric Rating Scale (NRS) dengan analisis bivariat dengan uji Wilcoxon. Hasil penelitian menunjukkan p value 0,000 yang artinya ada pengaruh prenatal yoga terhadap nyeri punggung pada ibu hamil trimester III.  Kesimpulan dalam penelitian ini prenatal yoga dapat mengurangi nyeri punggung  ibu hamil trimester III.Kata kunci : prenatal yoga; nyeri punggung; ibu hamil trimester III PRENATAL YOGA TO REDUCE BACK PAIN IN TRIMESTER III PREGNANT MOTHER ABSTRACTBack pain is a common occurrence in pregnant women and will increase when mothers in third trimester. The causes of back pain include weight gain during pregnancy. One of the efforts to reduce back pain in pregnant women is prenatal yoga. Prenatal yoga can help pregnant women in flexing the joints due to weight gain during pregnancy and can be used to relax the mind of the mother during pregnancy. This study was aimed to determine the effectiveness of prenatal yoga to reduce back pain in third trimester pregnant women. The research quantitative method used one intervention group with a sample of 18 third trimester pregnant women who will be taken by purposive sampling. The instrument used to measure back pain was the Numeric Rating Scale (NRS). Data analysis used Wicoxon test obtained p value 0,000 which means prenatal yoga can reduce back pain in third trimester pregnant women. The conclusion in this study prenatal yoga can be used as an alternative treatment for third trimester pregnant women who experience back pain.Keywords: prenatal yoga; back pain; third trimester pregnant women 

Differences in calculated percentage improvement versus patient-reported percentage improvement in pain scores: a review of spinal cord stimulation trials

2021 ◽  
pp. rapm-2020-102238
Author(s):  
Jonathan M Hagedorn ◽  
Timothy R Deer ◽  
Nicholas C Canzanello ◽  
Stephen M Covington ◽  
Darrell R Schroeder ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Concordance Correlation ◽  
Percentage Improvement ◽  
Patient Reported ◽  
The Mean ◽  
Numeric Rating

IntroductionSpinal cord stimulation is frequently used for the treatment of intractable chronic pain conditions. Trialing of the spinal cord stimulator device is recommended to assess the patient’s response to neurostimulation before permanent implantation. The trial response is often assessed by Numeric Rating Scale changes and patient-reported percentage pain improvement. Using number rating scale changes between prespinal and postspinal cord stimulation trial, a calculated percentage pain improvement can be obtained. The aim of this study was to assess the difference between calculated and patient-reported percentage improvement in pain scale during spinal cord stimulation trials.MethodsThis study was a retrospective single center review of all spinal cord stimulation trials from January 1 2017 to July 1 2019. A total of 174 patients were included. The paired t-test was used to compare numeric pain scores obtained prestimulation versus poststimulation. The mean difference between methods (patient-reported minus calculated) was compared with zero using the 1-sample t-test. Lin’s concordance correlation coefficient was computed with a 95% CI, calculated using Fisher z-transformation; and a bootstrapping approach was used to compare the concordance correlation coefficient between groups. In all cases, two-tailed tests were used with p<0.05 considered statistically significant.ResultsBased on prestimulation and poststimulation numeric rating scale scores, the mean±SD calculated percentage improvement in pain scale was 54±28. The mean±SD patient-reported percentage improvement in pain scale was 59±25. The overall 95% limits of agreement for the two methods are −30% to +41%. The overall concordance correlation coefficient was 0.76 (95% CI 0.69 to 0.81).ConclusionAlthough the two methods are highly correlated, there is substantial lack of agreement between patient-reported and calculated percentage improvement in pain scale, suggesting that these measures should not be used interchangeably for spinal cord stimulator trial outcome assessment. This emphasizes the need for improved metrics to better measure patient response to neuromodulation therapies. Additionally, patient-reported percentage improvement in pain was found to be higher than calculated percentage improvement in pain, potentially highlighting the multidimensional experience of pain and the unpredictability of solely using Numeric Rating Scale scores to assess patient outcomes.

Do Illness Perceptions and Coping Strategies Change Over Time in Patients Recently Diagnosed With Axial Spondyloarthritis?

2020 ◽  
Vol 47 (12) ◽  
pp. 1752-1759
Author(s):  
Miranda van Lunteren ◽  
Robert Landewé ◽  
Camilla Fongen ◽  
Roberta Ramonda ◽  
Désirée van der Heijde ◽  
...  
Keyword(s):  
Back Pain ◽  
Disease Activity ◽  
Coping Strategies ◽  
Illness Perceptions ◽  
Rating Scale ◽  
Axial Spondyloarthritis ◽  
Numeric Rating Scale ◽  
And Coping ◽  
Numeric Rating ◽  
Over Time

ObjectiveIt is unknown if in axial spondyloarthritis (axSpA) patients’ illness perceptions and coping strategies change when disease activity changes.MethodsPatients diagnosed with axSpA and with 1 or more follow-up visits (1 and/or 2 yrs in the SPACE cohort) were included. Mixed linear models were used for illness perceptions (range 1–5), coping (range 1–4), back pain (numeric rating scale range 0–10), health-related quality of life (range 0–100), physical and mental component summary (PCS and MCS; range 0–100), work productivity loss (WPL; range 0–100), and activity impairment (AI; range 0–100%), separately, to test if they changed over time.ResultsAt baseline, 150 axSpA patients (mean age 30.4 yrs, 51% female, 65% HLA-B27+) had a mean (SD) numeric rating scale back pain of 4.0 (2.5), PCS of 28.8 (14.0), MCS of 47.8 (12.4), WPL of 34.1% (29.8), and AI of 38.7% (27.9). Over 2 years, clinically and statistically significant improvements were seen in the proportion of patients with an Ankylosing Spondylitis Disease Activity Score (ASDAS) of low disease activity (from 39% at baseline to 68% at 2 years), back pain (−1.5, SD 2.2), AI (−14.4%, SD 27.2), PCS (11.1, SD 13.3), and WPL (−15.3%, SD 28.7), but MCS did not change (0.7, SD 13.9; P = 0.201). In contrast, illness perceptions and coping strategies did not change over a period of 2 years. For example, at 2 years patients believed that their illness had severe “consequences” (2.8, SD 0.9) and they had negative emotions (e.g., feeling upset or fear) towards their illness [“emotional representation”, 2.5 (0.8)]. Patients most often coped with their pain by putting pain into perspective [“comforting cognitions”, 2.8 (0.6)] and tended to cope with limitations by being optimistic [“optimism”, 2.9 (0.7)].ConclusionWhile back pain, disease activity, and health outcomes clearly improved over 2 years, illness perceptions and coping strategies remained remarkably stable.

Effectiveness of Simulated Horseback Riding for Patients With Chronic Low Back Pain: A Randomized Controlled Trial

2020 ◽  
Vol 29 (2) ◽  
pp. 179-185 ◽  
Author(s):  
TaeYeong Kim ◽  
JaeHyuk Lee ◽  
SeJun Oh ◽  
Seungmin Kim ◽  
BumChul Yoon
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Oswestry Disability Index ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Low Back ◽  
Baseline Values ◽  
Numeric Rating

Context: A simulated horseback riding (SHR) exercise is effective for improvement of pain and functional disability, but its comparative effectiveness with the other is unknown. Objective: The authors aimed to demonstrate the effect of a SHR exercise in people with chronic low back pain. Design: A randomized controlled trial. Settings: Community and university campus. Participants: A total of 48 participants with chronic low back pain were divided into 2 groups, and SHR exercises (n = 24) or stabilization (STB) exercises (n = 24) were performed. Interventions: The exercises were performed for 30 minutes, 2 days per week for 8 weeks. Main Outcome Measures: Numeric rating scale, functional disabilities (Oswestry disability index and Roland–Morris disability), and fear-avoidance beliefs questionnaire (FABQ) scores were measured at baseline and at 4 weeks, 8 weeks, and 6 months. Results: A 2-way repeated analysis of variance identified that between-group comparisons showed significant differences in the FABQ related to work scale (F = 21.422; P = .01). There were no significant differences in the numeric rating scale (F = 1.696; P = .21), Oswestry disability index (F = 1.848; P = .20), Roland–Morris disability (F = 0.069; P = .80), and FABQ related to physical scale (F = 1.579; P = .24). In within-group comparisons, both groups presented significant differences in numeric rating scale (both SHR and STB after 4 wk), Oswestry disability index (both SHR and STB after 6 mo), and Roland–Morris disability (SHR after 6 mo and STB after 8 wk) compared with baseline values. In FABQ-related physical (SHR after 4 wk) and work scales (SHR after 6 mo), there were only significant differences in the SHR compared with baseline values. Conclusions: SHR exercise for 8 weeks had a greater effect than STB exercise for reducing work-related FABQ. The SHR exercise performed in a seated position could substantially decrease pain-related fear disability in young adults with chronic low back pain.

CAN PATIENTS WITH SAGITTALLY WELL-COMPENSATED LUMBAR DEGENERATIVE KYPHOSIS BENEFIT FROM SURGICAL TREATMENT FOR INTRACTABLE BACK PAIN?

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Jee-Soo Jang ◽  
Sang-Ho Lee ◽  
Jung Mok Kim ◽  
Jun-Hong Min ◽  
Kyung-Mi Han ◽  
...  
Keyword(s):  
Back Pain ◽  
Oswestry Disability Index ◽  
Lumbar Lordosis ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Leg Pain ◽  
Compensatory Mechanisms ◽  
The Mean ◽  
Numeric Rating

Abstract OBJECTIVE To analyze pre- and postoperative x-rays of sagittal spines and to review the surgical results of 21 patients with lumbar degenerative kyphosis whose spines were sagittally well compensated by compensatory mechanisms but who continued to suffer from intractable back pain METHODS We performed a retrospective review of 21 patients treated with combined anterior and posterior spinal arthrodesis. Inclusion criteria were: lumbar degenerative kyphosis patients with intractable back pain and whose spines were sagittally well compensated by a compensatory mechanism, defined as a C7 plumb line to the posterior aspect of the L5–S1 disc of less than 5 cm. Outcome variables included: radiographic measures of preoperative, postoperative, and follow-up films; clinical assessment using the mean Numeric Rating Scale, Oswestry Disability Index, and Patient Satisfaction Index; and a review of postoperative complications. RESULTS All patients were female (mean age, 64.5 years; age range, 50–74 years). The mean preoperative sagittal imbalance was 19.5 (± 17.6) mm, which improved to −15.8 (± 22.2) mm after surgery. Mean lumbar lordosis was 13.2 degrees (± 15.3) before surgery and increased to 38.1 degrees (± 14.4) at follow-up (P &lt; 0.0001). Mean thoracic kyphosis was 5.5 degrees (± 10.2) before surgery and increased to 18.9 degrees (± 12.4) at follow-up (P &lt; 0.0001). Mean sacral slopes were 12.9 degrees (± 11.1) before surgery and increased to 26.3 degrees (± 9.6) at follow-up (P &lt; 0.0001). The mean Numeric Rating Scale score improved from 7.8 (back pain) and 8.1 (leg pain) before surgery to 3.0 (back pain) and 2.6 (leg pain) after surgery (P &lt; 0.0001). The mean Oswestry Disability Index scores improved from 56.2% before surgery to 36.7% after surgery (P &lt; 0.0001). In 18 (85.5%) of 21 patients, satisfactory outcomes were demonstrated by the time of the last follow-up assessment. CONCLUSION This study shows that even lumbar degenerative kyphosis patients with spines that are sagittally well compensated by compensatory mechanisms may suffer from intractable back pain and that these patients can be treated effectively by the restoration of lumbar lordosis.

scholarly journals Pengaruh Teknik Relaksasi Guided Imagery Music terhadap Intensitas Nyeri pada Klien Post Operasi Apendicitis di Ruang Rawat Inap Bedah Rspad Gatot Soebroto Ditkesad Jakarta Tahun 2015

2019 ◽  
Vol 2 (1) ◽  
pp. 1-14
Author(s):  
Astrid Astrid ◽  
Memed Sena Setiawan
Keyword(s):  
Guided Imagery ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
T Test ◽  
Control Group ◽  
Random Assignment ◽  
Purposive Sampling ◽  
Post Test ◽  
Numeric Rating

Apendicitis adalah peradangan dari apendiks vermiformis yang menyebabkan usus berhenti mengeluarkan sisa makanan yang tidak diserap oleh tubuh sehingga dilakukan Apendictomy dimana terjadi nyeri akut pada level severe. Tujuan penelitian ini untuk mengetahui pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri post operasi apendicitis di ruang rawat inap bedah RSPAD Gatot Soebroto Ditkesad Jakarta. Desain penelitian menggunakan purposive sampling dengan rancangan random assignment pre test-post test with control group. Jumlah sampel adalah 36 orang (18 orang kelompok kontrol dan 18 orang kelompok intervensi). Nyeri diukur dengan menggunakan Numeric Rating Scale (NRS) dan Faces Pain Scale Resived (FPSR). Uji statistik menggunakan uji T test independen. Hasil uji menunjukkan ada pengaruh teknik relaksasi Guided Imagery Music terhadap intensitas nyeri pada klien post operasi Apendicitis. Perbedaan rata-rata intensitas nyeri pada kelompok kontrol sebesar 1,55 dan pada kelompok intervensi sebesar 3,17. Variabel confounding telah dilakukan uji normalitas didapatkan hasil tidak ada hubungan usia, jenis kelamin, koping, individu pendukung, lingkungan, pengalaman nyeri sebelumnya terhadap intensitas nyeri, ini dikarenakan klien tidak mampu mengalihkan perhatian dari rasa nyeri yang hebat post operasi apendicitis, sehingga hasil statistik nya tidak perlu dilakukan transformasi. Teknik relaksasi Guided Imagery Music dapat digunakan sebagai intervensi mandiri keperawatan untuk mengurangi intensitas nyeri klien post operasi apendicitis. Kata Kunci: Guided Imagery Music, Klien Post Operasi Apendicitis, Intensitas Nyeri

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