LINTANG RIZKI JOHARI, NIM. 202503027 (2026) ASUHAN KEPERAWATAN PENERAPAN KOMBINASI TERAPI BERMAIN PUZZLE DAN PLASTISIN PADA ANAKDEMAMTIFOID DENGAN MASALAH ANSIETAS DI RUANG ANGGREK RSUD PREMBUN. KIA thesis, UNIVERSITAS MUHAMMADIYAH GOMBONG.

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Abstract

Background: Typhoid fever is a systemic infection in children that often triggers a psychological response in the form of hospitalization anxiety due to an unfamiliar environment, medical procedures, and past traumatic memories. Untreated anxiety can hinder the healing process, cause the child to be uncooperative toward medical actions, and prolong the length of hospital stay. Combined play therapy using puzzles and clay serves as an innovative non-pharmacological intervention to reduce anxiety through cognitive distraction and emotional catharsis mechanisms tailored to the developmental stage of preschool-age children. Objective: To describe nursing care through the application of combined play therapy using puzzles and clay to address hospitalization anxiety in children with typhoid fever. Method: This report employs a descriptive case study design focusing on An. A (aged 5 years and 8 months) diagnosed with typhoid fever. The anxiety reduction intervention was conducted for 3 consecutive days (January 7–9, 2026) with a duration of 15–30 minutes per session. Anxiety levels were measured periodically using the standardized Facial Image Scale (FIS) instrument. Nursing Care Results: The initial assessment showed the patient experiencing severe anxiety with a FIS score of 5, characterized by hysterical crying, restlessness, regressive behavior (constantly clinging to parents), and refusal to interact with medical staff. After receiving the combined play therapy for three days, the anxiety score significantly decreased to a FIS score of 2 (mild). The final evaluation indicated the patient was much calmer, cooperative during vital sign examinations, maintained good eye contact, and was able to communicate actively with the nurse. Recommendation: Healthcare institutions are expected to legitimize play therapy within the daily Standard Operating Procedures (SOP) in pediatric wards. Families are advised to provide consistent presence as a primary support system to break the cycle of hospitalization trauma. Future researchers are recommended to conduct comparative studies between different play therapy modalities to enrich evidence-based pediatric nursing literature.

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