Effectiveness of Tepid Sponge Compresses and Plaster Compresses On Children'S Fever Temperature Typhoid
Effectiveness of Tepid Sponge Compresses and Plaster Compresses On Children'S Fever Temperature Typhoid
Effectiveness of Tepid Sponge Compresses and Plaster Compresses On Children'S Fever Temperature Typhoid
Department of Medical Laboratory Technology, School of Health Sciences Jenderal Achmad Yani
Cimahi - Indonesia
(alamat [email protected])
ABSTRACT
Typhoid is infectious disease which is still encountered widely in various developing countries, especially
those located in the tropic and subtropics. Fever is a clinincal manifestation that is often the main complaint
of the sufferer. Action can be done to lower body temperature that is tepid sponge compress and plaster
compress. The purpose of this study is to determine the comparison of the effectiviness of tepid sponge
compress and plaster compress of changes body temperature in school age children with typhoid fever in
cibabat hospital in year 2017.
The method used is quasy experiment research method with the approach of pre test and post test two
design group. As many as 24 samples were taken at the patient ward of hospital Cibabat. Respondents divided
into two groups namely tepid sponge compress and plaster compress by way concecutive sampling. This study
was conducted for 20 minutes at each intervenstion. Data analysis used Wilcoxon test, dependen t test, and
Mann-Withney. Average body temperature before and after given tepid sponge compress are 38,75oC and
38,08oC with temperature different is 0,67oC. While average body temperature before and after given palster
compress are 38,80oC and 38,57oC with temperature different is 0,23oC.
Mann-Withney test result show that the p value = 0,000 < α = 0,05 which means bottom tepid sponge
compress is more effective in lowering body temperature in scholl age children compared with plaster
compress. Based on the result of the study, it can recommend tepid sponge compress in the implementation of
nursing care to lower body temperature in typhoid fever patients.
2012; Darwis, 2010 in Syltami, 2014). Cold sponge therapy was 0.97 ºC in 60 minutes. In the
compresses according to IDAI (2014) are not implementation tepid sponge must prepare water
recommend because it can increase the center of the warm when the child has a fever and water that
temperature setting (set point) in the hypothalamus, widens various parts of the body of the child can
causing the body to shiver and the blood vessels to cause discomfort. Giving this action looks less
shrink (vasoconstriction) resulting in increased practical for mothers but is very economical.
body temperature. However, there are still many parents who have not
According to Alves and Almeida (2008, in done this tepid sponge technique.
Hamid 2011) of several compress actions In this modern era, a new innovation is
performed, tepid sponge is a warm compress emerging to reduce heat when a child has a fever.
technique alternative that is widely researched in The innovation is a compress plaster that is ready to
developed countries and in other developing use, considered practical, and is sold freely at the
countries. The main objective of this compress pharmacy. Likewise with a warm compress, this
technique is to reduce fever body temperature. compress plaster is effective in lowering body
Developed and researched in developed countries temperature. when experiencing a fever. Just put a
like America and England. Until recently this compress plaster that is ready to get into the child's
technique continued to be researched and expanded body, and periodically monitor the child's body
in other countries such as Brazil, Singapore, and (Darwis and Hardiningsih, 2010). Making plaster
India. In the results of the study showed there was a compresses using hydrogel on polyacrylate-base.
decrease in temperature of fever clients who This Hydrogel has become the basic ingredient in
received antipyretic therapy and tepid sponge making compress plaster that is widely used in
compared to clients who only received antipyretic Indonesia. Research by Syltami (2014) says that the
therapy. average temperature change of children who have a
Tepid sponge technique is a combination of fever before and after being given compress plaster
block techniques with wiping. This technique uses is 0.6 ºC within 20 minute. This study was supported
block compresses not only in one place, but directly by research Fatkularini, Mardi, and Solechan (2014)
in several places that have large blood vessels. In saying that the average decrease in body
addition there is still additional treatment that is by temperature after being given compress plaster was
giving some in some areas of the body so that the 0.4ºC for 30 minutes.
treatment applied to the client in this technique will In addition to the advantages it has, the use of
be more complex and complicated compared to plaster compressors also has several disadvantages,
other techniques. Providing block compresses including the plaster compresses can not be attached
directly in various places will facilitate the delivery to the skin properly, so that the process of
of signals to the hypothalamus more intensively. absorption of body heat is not optimal. Therefore, it
Wounding will also accelerate the widening of must be corrected in terms of stickiness. Plaster of
peripheral blood vessels that facilitate heat transfer this compress are white not transparent (Darwis and
from the surrounding body's environment so that it Hardiningsih, 2010). Basically, the action of
accelerates the decrease in body temperature (Alves compressing has been done by nurses in the
and Almeida, 2008 in Hamid, 2011). management of fever patients. However, warm
The research by Hamid (2011) used a compresses are usually done by nurses in the room
Randomized Control Trial approach with the aim to that is only compresses on the forehead and
determine the effectiveness of compressed sponges underarm areas. In addition to providing warm
carried out by the mother in reducing fever in compresses, there are parents of patients who use
children. The design of this study used 30 random compress plaster to reduce fever with the reason that
simple sampling techniques. Decreased body it is easier to do than compressing using warm
temperature in the tepid sponge group began to water. Never research has been conducted regarding
occur at 6 minutes and continued to decrease the effectiveness of these two actions. The purpose
sharply until at minute 90 reached 1 ºC. The of this study was to determine the effectiveness of
decrease in body temperature in each group tepid sponge compresses and compress plaster on
occurred after the treatment arrived at minute 90. changes in body temperature in school-age children
Research by Setiawati (2008, in Bartolomeus, with typhoid fever in Cibabat Hospital in 2017.
Haryani and Arif, 2012) stated that the average
decrease in body temperature when receiving tepid
cause heat dissipation through increased skin are difficult to dissolve in water. The presence of a
(sweating), it is expected that there will be a large water content in the hydrogel structure can be
decrease in body temperature so that it reaches a used to reduce fever through absorption of heat
normal state again. If body temperature rises, the (energy) from parts of the body that fever and
center of temperature regulation tries to reduce it, evaporate it (Darwis et al, 2010 in Mardiyah,
and vice versa (Nurwahyuni 2009, in Mohammad, Rahman, and Lestari, 2015).
2011 in Mahdiyah, Rahman, and Lestari, 2015). The results of the analysis of the average
The results of the study on 12 children who decrease in body temperature after the tepid sponge
experienced typhoid fever obtained an average body compress was 38.08ºC while the average decrease
temperature before being given compress plaster in body temperature after the application of
was 38.80ºC after being given a compress plaster compress plaster was 38.57ºC obtained p value =
was 38.57ºC. All respondents given the intervention 0.001 <α = 0.05, there was a difference in the
of compress plaster experience a decrease in effectiveness of temperature reduction body on
temperature with an average value of 0.23ºC. This tepid sponge compresses and compress plaster.
is in accordance with Potter and Perry's theory Effectiveness between tepid sponge compresses and
(2010, in Syltami 2014) saying that fever occurs due compress plaster can be seen in the difference in the
to changes in setting points in the hypothalamus. or average decrease in body temperature, in groups
viruses that increase body temperature one of which using compressed sponges, the average temperature
is the bacterium Salmonella typhi. Nitrogen acts as decreased by 0.67ºC, whereas in the plaster group
an antigen that triggers the immune system compress is 0.23ºC. This proves that tepid sponge
response. The hypothalamus will increase the compresses are more effective in lowering body
setting point and the body will produce heat. To temperature in febrile patients diagnosed with
reach the new setting point, it takes several hours. typhoid fever. This difference is also caused by
The results of the t-test depend on the results, p other factors, one of which is room temperature,
value = 0.004 <α = 0.05, there is a difference in where body temperature can experience exchange
body temperature in children who have fever in with the room or environment, meaning that body
typhoid fever patients after applying compress heat can be lost or reduced due to room temperature
plaster with a flat difference the decrease in body or cooler environment, and vice versa (Tamsuri,
temperature is 0.23ºC. 2012 in Mardiyah, Rahman, and Lestari, 2015).
The results of this study are in line with Providing complete compresses according to
research by Fatkularini, Mardi, and Solechan (2014) Kozier in Suprapti, 2008 in Syltami 2014, heat has
which states that there are differences in a different effect on the body, the effect also
temperature before and after the intervention of depends on the duration of heat. Heat administration
giving compress plaster with p value = 0,000 <α = of 15-30 minutes has a vasodilating effect on blood
0.05. The implementation of fever using compress vessels resulting in an increase in blood flow.
plaster is by how to attach plaster on the forehead, Increased blood flow will reduce blood viscosity
armpits and groin (Mardiyah, Rahman, and Lestari, and local metabolism because blood flow carries
2015). In this study, compress plaster was applied oxygen to the tissues. Compress with temperature
to the forehead, armpit, and thigh folds with a maintenance methods using liquids or tools that
frequency of 1 time for 20 minutes. Plaster cause warm temperatures aims to facilitate blood
compresses help the blood vessels in the skin to circulation and provide a sense of comfort (Asmadi,
widen so that the pores become open which further 2008 in Fatkularini, Mardi, and Solechan, 2014).
facilitates the removal of heat from the body, so the The effectiveness of tepid sponge compresses
body can experience a large drop in temperature in this study was supported by a previous study by
(Djuwariyah, 2011 in Mardiyah, Rahman, and Syltami (2014) on "Comparison of the effectiveness
Lestari, 2015). The ready-made compress plaster is of tepid sponging and compress plaster in reducing
now widely circulated in the community with body temperature in children under five who
disposable packaging. This compress plaster is experienced a fever in Puskesmas Salaman 1" with
made from hydrogel on polyacrylate-base with the p value = 0,002 <α = 0,05, which means there is a
content of parabens and menthol formulated so as to difference in the decrease in body temperature in
accelerate the process of transferring heat from the toddlers after doing tepid sponging and compress
body to compress plaster. Parabens are white plaster. This is in line with the research that was also
crystals that dissolve easily in methanol, ethanol and by Ernawati about "Comparison of plaster
compresses with warm tepid sponge compresses to edition Series Evidence Based Medicine 2.
decrease in body temperature in Toddler children Jakarta: Salmeba Medika.
(1-3 years) who have a fever in Flamboyan C RSUD Darwis, D and Hardiningsih, L. (2010). Scientific
Kanudjoso Djatiwibowo Balikpapan "with p value Journal of Isotope and Radiation Applications.
= 0,000 <α = 0,05, so it can be concluded that there The potential of polyvinyl pyrrolidone (PVP)
are differences between the two groups after being hydrogel as a result of gamma irradiation as a
given intervention compress plaster and compress fever-lowering plaster 6 (1), 46.
warm tepid sponge. Darwis, dkk.(2010). The development of polyvinyl-
based hydrogel (PVP) results from electron
CONCLUSION beam irradiation as a fever-lowering plaster, 11
The results of the study on the differences in (2), 62-64.
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compress plaster on changes in body temperature in Effectiveness of Decreasing Body Temperature
school-aged children with typhoid fever in Cibabat Using Warm Water Compress and Compressing
Hospital showed that there were differences in body Plaster in Children with Fever in the Kanthil
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05) and the difference in temperature decrease is Compress Plaster with Warm Tepid Sponge
0.67ºC. There was a difference in body temperature Compress to Tethering Body Temperature in
before and after the application of compress plaster Toodler Children (1-3 Years) Experiencing
(dependent t test p value = 0.004 <α = 0.05) and a Fever in Space Flamboyan C RSUD
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effective in lowering body temperature compared to Effectiveness of ordinary temperature water
compressed plaster (Mann-withney test with p value compresses and compress tape to decrease body
= 0.001 <α = 0.05). temperature in children with fever preschool age
at RSUD Ungaran Semarang.
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