COVID-19 pandemic raises various challenges faced by health workers in hospitals. This study explored strategies for overcoming challenges in caring for COVID-19 patients at hospitals in Indonesia based on healthcare workers’ experience. In-depth interviews were employed with 28 healthcare workers (physicians and nurses) who were purposively sampled. Data were collected via phone and analysed using the Colaizzi method. Five following challenges were found: difficulties in working with personal protective equipment (PPE), offline training for handling Covid and using PPE not being implemented evenly for all health workers, physical and psychological fatigue, difficulties in carrying out health education and assessment towards patients and families, and limited resources to cope with the COVID-19 pandemic. Meanwhile, some barriers require support from the government, public and hospital managers. The information gained from research on the strategies for caring for COVID-19 patients can contribute to better preparedness for hospitals and health workers facing the COVID-19 pandemic.

Caring was the behavior provide assistance holistically to individuals. In fact, nurses Caring behaviors made only modest, yet an art in nursing care which should always be a nurse. The good personality and spiritual be one of the factors that affect the formation of nurses Caring behaviors. Spiritual was the passion or impulse that comes out from within themselves to do the noble. The research objective was explained a spiritual relationship nurses with nurses caring behaviors. The research design was used cross sectional. The population in this researchs were associate nurses in the ward. A sample were taken of 88 nurses with consecutive sampling technique. Data collection was done at the General Hospital of Haji Surabaya, Al Irsyad General Hospital Surabaya and Muhammadiyah Gresik Hospital. Data collection was used questionnaire, with multivariate data analysis Structural Equation Modeling- Partial Least Square (PLS-SEM). The results showed no significant relationship between demographic with spiritual nurses. Demographic indicators for the hypothesis test was psychological, length of work, education, and wards. Demographics nurses with nurse caring no significant relationship. Spiritual nurses significant relationship with the caring nurses at 7.061. These results indicated that modeling should be done was draw line from the spiritual to the caring nurses and the others deleted. The conclusion of the research was the spiritual nurses significant relationship with the nurses caring behaviors. Suggestions have to do is always give spiritual training to nurses as one of supporting the implementation of nursing care.

[Bahasa]: Hipertensi dan diabetes melitus (DM) yaitu penyakit kronis yang membutuhkan perawatan berkelanjutan sebagai upaya untuk mengendalikan tekanan darah dan kadar gula darah. Keduanya memiliki kerentanan mengalami gangguan vaskular sehingga aliran sirkulasi darah tidak lancar, rentan mengalami gangguan ekstremitas kaki yang bermanifestasi menjadi sumbatan pada pembuluh darah, ulkus bahkan amputasi. Situasi pandemi akibat COVID-19, mengharuskan penderita tetap berada dirumah saja terutama pada individu dengan komorbid seperti hipertensi dan DM yang beresiko lebih tinggi tertular Covid-19, jika tidak ada situasi darurat. Tujuan pengabdian kepada masyarakat (PKM) ini adalah untuk memberikan pendidikan dan pelatihan buerger exercise dan perawatan kaki dalam upaya menurunkan resiko gangguan vaskular penderita DM dan hipertensi. Lokasi Kegiatan PKM di Lembaga Kesejahteraan Sosial Hargo Dedali, Surabaya dengan memperhatikan protokol kesehatan yang keta dengan melibatkan 21 peserta dengan rerata usia 59 tahun, 6 peserta (28,6%) mengalami hipertensi, 7 peserta (33,3%) mengalami DM dan 8 orang (38,1%) mengalami keduanya. Metode yang digunakan dalam PKM ini adalah pendekatan Community Based Research (CBR). Evaluasi akhir program PKM dengan membandingkan nilai pre test dan post test terhadap pengetahuan dan kondisi vaskular kaki serta pemeriksaan Ankle Brachial Index (ABI). Hasil pengukuran terhadap tingkat pengetahuan p = 0,000 (p < 0,05), kuesioner Vascular Quality of Life dengan p = 0,001 (p < 0,05) dan ABI dengan p = 0,002 (p < 0,05) sehingga terdapat perbedaan yang bermakna antara sebelum dan sesudah diberikan pendidikan dan pelatihan dalam hal peningkatan pengetahuan dan perbaikan fisik kondisi vaskular. Pemberdayaan penderita DM dan hipertensi melalui pendidikan dan praktik buerger exercise serta edukasi perawatan kaki dapat dijadikan upaya menurunkan resiko gangguan vaskular dan menguragi resiko komplikasi kaki. Kata Kunci: buerger exercise, perawatan kaki, diabetes, hipertensi Abstract: Hypertension and Diabetes Mellitus (DM) are chronic diseases that need continuous treatment to control blood pressure and blood sugar levels. The diseases are susceptible to vascular problems, so that blood circulation is not smooth and made prone to leg disorders that manifest as blockages in blood vessels, ulcers, and even amputations. Covid 19 pandemic requires people with the diseases stay at home if there is no emergency since they are at high risk of being infected. This community service (PKM) aims to provide education and training about Buerger exercises and foot care to reduce the risk of vascular disorders for people with DM and hypertension. The PKM, which took place at the Lembaga Kesejahteraan Sosial Hargo Dedali, Surabaya, with strict health protocols, included 21 participants (around 59 years old); 6 participants have hypertension, 7 participants have DM, and the remaining 8 participants have both diseases. It applied the Community Based Research (CBR) approach. The program's evaluation compared the scores of pre-test and post-test, which assess the participants’ knowledge and the examination of foot vascular condition. The results of evaluation are p = 0.000 (p <0.05) on the knowledge level, p = 0.001 (p <0.05) on the Vascular Quality of Life, and ABI with p = 0.002 (p <0.05). The numbers show a significant difference between before and after the program on the level of knowledge and the physical recovery of the vascular. The empowerment of people with DM and hypertension through the education and practice of Buerger exercises and foot care can be used to reduce the risk of vascular disorders and foot complications. Keywords: buerger exercise, foot care, diabetes, hypertension

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Introduction: Patients with diabetic ulcers tend to experience problems in implementing spirituality practices. Patients with diabetic ulcers also experience weaknesses and impaired mobilization that have an impact on family dependence and decreased self-efficacy. The purpose of this study was to determine the relationship between spirituality level and family support with spiritual self-care behavior in diabetic ulcer patients. Methods: A descriptive correlation design with a cross-sectional approach. In a total of 92 patients with diabetic ulcers in Sidoarjo General District Hospital in June-July 2019 recruited. Independent variables were the level of spirituality and family support. The dependent variable was spiritual self-care behavior. Data obtained through the Daily Spiritual Experience Scale (DSES) questionnaire, family support questionnaire, and Spiritual Self Care Practice (SSCPS) questionnaire. Data were analyzed using the Chi-square test of categorical variables with a p-value ≤ 0.05 and logistic regression for multivariate analysis. Results: The study showed there was a significant relationship between spirituality level (p = 0,000) and family support (p = 0,001) with spiritual self-care behavior in diabetic ulcer patients. The result of regression analysis showed the respondents with a high level of spirituality would increase 0.138 times of the spiritual self-care behavior probability. Conclusion: The level of spirituality and family support can promote individual coping to be more positive which may accelerate the process of receiving and healing wounds.