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Hayatun Na Imah
"ABSTRAK
Pendahuluan: Infeksi paru merupakan penyebab morbiditas dan mortalitas terbesar di Intensive Care Unit ICU. Pasien ICU umumnya dalam kondisi critically ill dan riwayat penggunaan antibiotic sebelumnya sehingga memiliki risiko resistensi terhadap antibiotik yang berpengaruh terhadap luaran pasien.Sistem skoring digunakan di ICU untuk menilai derajat keparahan penyakit dan luaran pasien. Penelitian ini menilai eta kuman pasien infeksi paru dan hubungannya dengan derajat keparahan penyakit yang dinilai dengan skor APACHE II. Metode: Penelitian ini menggunakan metode potong lintang yang dilaksanakan pada bulan Agustus-September 2017 di ICU RSUP Persahabatan. Total subjek terdiri atas 59 subjek dengan cara pengambilan sampel consecutive sampling. Semua pasien didiagnosis infeksi paru oleh dokter spesialis dan dikonfirmasi melalui foto toraks kemudian dinilai derajat keparahan penyakit dengan skor APACHE II dan dilakukan biakan dan resistensi mikroorganisme. Hasil: Kuman yang banyak ditemukan merupakan gram negative (37,2%) dengan risiko mortalitas tertinggi 75% jenis Acinetobacter pada skor (APACHE II 30-34). Rerata skor APACHE II 15,78+ 6,04 dengancut off point skor APACHE II 16,5 dan skor APACHE II >16 memiliki mortalitas terbesar (64%) (p=0,032). Diagnosis infeksi paru dengan mortalitas terbesar didapatkan pada CAP (56%). Kesimpulan: Acinetobacter baumanii merupakan kuman terbanyak yang menyebabkan kematian pada pasien infeksi paru dan skor APACHE II merupakan prediktor yang baik dalam menilai derajat keparahan penyakit dan luaran pasien.

ABSTRACT<>br>
Introduction: Lung infection are the most common cause of high mortality and morbidity in Intensive Care Unit (ICU). Patients in ICU mostly critically ill with history of antibiotic use and risk of drug resistant that will influence the outcome of the patients. Scoring system used in ICU to measure severity of the disease and the outcome of the patients. This study asseses the microbiological pattern of patients with lung infection and severity of the disease using APACHE II Score. Methods: This study used cross sectional methods that heldbetween August 2017-September 2017in Persahabatan Hospital Intensive Care Unit. Total subjects consisted of 59 patients with lung infection base on consecutive sampling. All of the patients diagnosed with lung infection from specialist and confirmed with radiological findings, measured the APACHE II Score and performed sputum culture and resistance. Results: The most common isolation found in lung infection patients was gram negative (37,2%) with mortality risk of Acinetobacter baumanii75% (APACHE II Score 30-34). Mean APACHE II Score was 15,78+ 6,04 with cut off point APACHE II Score 16,5 and APACHE II Score > 16 has the highest mortality (64%) (p=0,032). Diagnose of lung infection with the highest mortality found in patients with CAP (56%). Conclusions: Acinetobacter baumanii are the most common cause of mortality in lung infection patients. The APACHE II Score has good predictor in measure severity of the diseases and the outcome of the patients."
Depok: Fakultas Kedokteran Universitas Indonesia, 2017
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Puji Raharja Santosa
"[ABSTRAK
Praktik Spesialis Keperawatan Medikal Bedah Kekhususan Respirasi di RSUP Persahabatan Jakarta bertujuan untuk mengaplikasikan peranners spesialis da1am mengelola pasien dengan gangguan sistem respirasi melalui pendekatan Model Adaptasi Roy (MAR). Seorang ners spesialis memiliki target memberikan asuhan keperawatan sebanyak 30 pasien sebagai resume dan 1 pasien sebagai laporan kelolaan utama pada pasien kanker paro. Peran ners spesialis juga menerapkan tindakan keperawatan berbasis bukti ilmiah (evidence based musing practice) dengan memberikan latihan progressive muscle relaclation (PMR) dalam mengontrol breathlessness pada pasien kanker peru, Selain itu ners spesialis sebagai pembaharu melakukan inovasi Water Seal Drainoge (WSD) Pionir 1 botol, etas dasar aspek estetika, quality and safety guna meningkatkan kualitas pelayanan keperawatan dan rumah sakit. Hasil praktik menunjukkan bahwa MAR. Efektif digunakan pada pasien dengan gangguan sistem respirasi dan PMR memiliki kecenderungan mengon1ro1 breathlessness pada pasien kanker pam dan kegiatan inovasi mendapat respon positif dari pibak rumah sakit untuk menjadi agenda penelitian bersama.

ABSTRACT
Surgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda., Surgical Nursing Residency Practice in Respiratory Speciality aims to apply of nurse specialist in caring and supervising respiratory disorders patients through Roy Adaptation Model (RAM) approach at Persahabatan Hospital Jakarta. A nurse specialist has a target to give nursing care to thirty patients as resume and one lung cancer case as primary patient. The other role of nurse specialist is implementing evidence based nursing practice by providing Progressive Muscle Relactation (PMR) exercise in terms of controlling breathlessness especially to lung cancer patient. Furthermore, the other role of nurse specialist is to be an innovator and a change agent on Water Seal Drainage (WSD) Pioneer program based on aesthetic, quality, and safety aspect in order to improve nursing and hospital services. The result shows that RAM is effective to respiratory disorders patients and PMR tends to control breathlessness of lung cancerpatients. Conclusion, this innovative activity gels a positive response from the hospital to be a joint researchagenda.]"
Fakultas Ilmu Keperawatan Universitas Indonesia, 2015
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UI - Tugas Akhir  Universitas Indonesia Library
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Kasum Supriadi
"[ABSTRAK
Pendahuluan. Kanker paru jenis karsinoma bukan sel kecil (KPKBSK) terdiri dari nonskuamosa dan skuamosa. Kanker paru jenis karsinoma bukan sel kecil nonskuamosa adalah adenokarsinoma dan karsinoma sel besar. Saat ini terapi kanker paru sangat berkembang dari agen kemoterapi sampai terapi target terutama EGFR-TKI. Penelitian ini bertujuan untuk menilai angka tahan hidup pasien KPKSBK nonskuamosa yang mendapat kemoterapi lini pertama dibandingkan terapi EGFR-TKI di RSUP Persahabatan.
Metode. Penelitian ini adalah penelitian retrospektif antara tahun 2010 sampai 2013 dari rekam medis pasien KPKBSK non skumosa yang mendapatkan kemoterapi lini pertama dan EGFR-TKI. Pasien dikemoterapi dengan platinum baseddan EGFR-TKI diterapi gefitinib 1x250 mg/hari atau erlotinib 1x150 mg/hari. Angka tahan hidup dinilai dari mulai tegak diagnosis sampai pasien meninggal atau saat penelitian dihentikan.
Hasil. Dari 96 sampel KPKBSK non skuamosa terdiri dari 48 pasien yang mendapat kemoterapi lini pertama dan 48 pasien yang diterapi EGFR-TKI. Berdasarkan karakteristik pasien, usia terbanyak adalah 40-60 tahun (kemoterapi 32 (66,7%) dan EGFR-TKI 31 (64,6%) dengan jenis kelamin laki-laki yang mendominasi (kemoterapi 25(52,1%), EGFR-TKI 27 (56,2%). Pasien merokok yang mendapat kemoterapi lini pertama 41,7% dan EGFR-TKI 56,3% dengan IB terbanyak untuk kemoterapi (IB ringan 27,1%) dan untuk EGFR-TKI (IB sedang 22,9%). Jenis histologi adenokarsinoma 95,8% dengan dominasi stage IV 89,6% (kemoterapi 91,7% dan EGFR-TKI 87,5%) disertai tampilan status 2 59,4%. Angka tahan hidup pasien (ATH) 6 bulan 74%, ATH 1 tahun 22,90% dan ATH 2 tahun 6,20%. Masa tengah tahan hidup (MTTH) pasien yang mendapat EGFR-TKI lebih lama sedikit dibandingkan yang mendapat kemoterapi lini pertama (263 hari versus 260 hari.
Kesimpulan. Masa tahan hidup 1 tahun pasien KPKBSK non skuamosa yang diterapi EGFR-TKI sedikit lebih lama dibandingkan kemoterapi lini pertama (263 hari vs 260 hari). Sedangkan ATH 1 tahun pasien kemoterapi lini pertama lebih besar dibandingkan EGFR-TKI (25% vs 20,8%). Faktor yang paling mempengaruhi angka tahan hidup adalah stage dengan nilai p<0,05.

ABSTRACT
Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.
Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.
Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).
Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.
Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.
Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).
Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.
Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.
Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).
Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.;Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.
Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.
Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).
Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05., Introduction. Lung cancer is the type of non-small cell carcinoma (NSCLC) consists of non-squamous and squamous. Non-small cell lung cancer of non squamous types consist of adenocarcinoma and large cell carcinoma. Currently, lung cancer therapy is highly developed of chemotherapeutic agents to targeted therapy especially EGFR-TKI. This study aims to assess the survival rate of NSCLC patients of non-squamous type who receive first line chemotherapy and those who recieve EGFR-TKI therapy at Persahabatan hospital.
Methods. This study is a retrospective study between 2010 to 2013 from the medical records of NSCLC patients of non-squmous type who receive first-line chemotherapy and thise who recieve EGFR-TKI.Patients with platinum-based chemotherapy and EGFR-TKI with gefitinib therapy 1x250 mg/day or erlotinib 1x150mg/day. Survival rate assessed from start to erect the diagnosis until the patient dies or when the study is discontinued.
Result. From 96 subject of NSCLC patients with non-squamous type consisted of 48 patients who receive first-line chemotherapy, and 48 patients are treate with EGFR-TKI. Based on the characteristics of the patients, most are 40-60 years old (chemotherapy 32 (66.7%) and EGFR-TKI 31 (64.6%) with the male gender that dominates (chemotherapy 25 (52.1%), EGFR-TKI 27 (56.2%). Smoking patients who received first-line chemotherapy are 41.7% and 56.3% of EGFR-TKIs with chemotherapy highest IB (mild IB 27.1%) and for EGFR-TKI (moderate IB are 22.9%). 95.8% of adenocarcinoma histology type with a predominance of stage IV 89.6% (91.7% for chemotherapy and EGFR-TKI 87.5%) with performance status 2 59.4% . Survival rate of patients are 74% for 6 months survival, 1 year survival rate is 22.90% and 2 years survival rate of 6.20%. Median period of survival rate in patients who receiving EGFR-TKI longer than they received first-line chemotherapy (263 days versus 260 days).
Conclusion. Median survival rate of non-squamous NSCLC that treated by EGFR-TKI is longer than first-line chemotherapy (263 days vs 260 days). Although 1 year survival rate first-line chemotherapy in patients is greater than EGFR-TKI (25% vs 20.8%). The factors that most influence the survival rate is stages with p value<0.05.]"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
T58765
UI - Tesis Membership  Universitas Indonesia Library
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Nila Kartika Ratna
"ABSTRAK
Pendahuluan
Penyakit infeksi paru dan kanker paru termasuk 5 penyakit respirasi terbanyak ditemukan di dunia. Infeksi pernapasan akut menyebabkan 4 juta kematian per tahun dan kanker paru sebanyak 1,18 juta kematian secara terpisah. Penyakit infeksi juga merupakan bagian dari perjalanan penyakit kanker paru dan menjadi salah saru penyebab kematian tersering pada kanker paru berkisar 50-70% kasus. Tren munculnya patogen baru dan meningkatnya angka resistensi obat menyebabkan penanganan infeksi ini menjadi lebih sulit.
Metode Studi deskriptif potong lintang pada pasien kanker paru yang dilakukan bilasan bronkus dan diperiksakan biakan mikroorganisme dari bahan bilasan tersebut. Jumlah sampel adalah total sampling dalam kurun waktu 1 tahun. Penelitian dilakukan di SMF Paru RSUP Persahabatan.
Hasil
Bakteri yang banyak ditemukan pada pasien kanker paru merupakan golongan gram negatif dengan species terbanyak adalah K. pneumonia dan B. cephacia. Ditemukan resistensi obat pada hampir semua jenis bakteri dan minimal dari 2 golongan antibiotik. Jenis jamur yang terbanyak dari genus Candida yaitu C. Albicans. Ditemukan resistensi obat anti jamur golongan azol pada species C. tropicalis, C. krusei dan A. Flavus. Hanya ditemukan 2 pasien kanker paru dengan biakan M. tuberculosis positif dari 108 pasien yang diperiksa dan tidak ditemukan resistensi obat anti tuberkulosis (OAT) lini pertama.
Kesimpulan
Pemeriksaan jenis mikroorganisme pada saluran napas bawah pasien kanker paru perlu dilakukan sebagai dasar pemberian terapi empiris bila terjadi infeksi
Introduction: Lung infections and lung cancer include in 5 most common respiratory diseases in the world. Acute respiratory infection and lung cancer caused 4 million deaths per year and 1.18 million deaths respectively. Infectious diseases are part natural course of lung cancers and become one of the most common causes of death in lung cancer patients ranging from 50-70%. The emergence of new pathogens and the increasing numbers of drug resistance causing infections treatment become more difficult.
Method: A cross-sectional descriptive study obtaining cultured microorganisms results in lung cancer patients who have been performed bronchial washings. These have been a total sampling within a period of 1 year. Research has been conducted in the Department of Pulmonology Persahabatan Hospital.
Result: Most common bacteria type found in lung cancer patients belong to gram-negative group with K. pneumoniae and B. cepacia as the most common species. Drug resistance found in most of bacteria from at least two classes of antibiotics. Most common types of fungi come from Candida genus, namely C. albicans. Drugs resistance in antifungal drug, azole, was found in C. tropicalis, and C. krusei. Only 2 lung cancer patients had M. tuberculosis positif culture from 108 patients were examined and first line anti-tuberculosis drugs resistance was not found.
Conclusion: Microorganism culture obtained from lower respiratory tract in lung cancer patient is neccesary as basis of empiric therapy when infection occurs"
2016
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Amira Anwar
"ABSTRAK
Latar belakang: Penyebab kematian pada kanker paru seringkali tidak tergambarkan dengan jelas. Penelitian ini untuk mengetahui gambaran penyebab kematian pada kanker paru dan faktor-faktor yang mempengaruhinya di RS Persahabatan dan untuk mengetahui kesesuaian antara penyebab kematian yang terdapat dalam lembar kematian dengan penyebab kematian sesuai dengan audit kematian. Metode: Penelitian potong lintang ini dilakukan di RS Persahabatan dengan subjek penelitian adalah semua pasien kanker paru yang mengalami kematian pada Januari 2010 – Desember 2011. Penyebab kematian langsung dan tidak langsung pada pasien kanker paru dicatat dari rekam medis kemudian dilakukan audit kematian dan dinilai kesesuaian dengan penyebab kematian langsung dan tidak langsung yang tertulis di rekam medis dengan audit kematian. Hasil: Total data kematian dari 96 rekam medis. Penyebab kematian langsung berdasarkan rekam medis adalah efusi pleura masif 19 kematian (19,8%) sedangkan penyebab kematian tidak langsung menurut rekam medis adalah sepsis s 44 kematian (45,8%) Sementara itu, penyebab kematian langsung berdasarkan audit kematian terbanyak adalah efusi pleura masif 48 kematian (50%), penyebab kematian tidak langsung menurut audit kematian adalah sepsis 16 kematian (16,7%). Lembar kematian yang sesuai dengan rekam medis adalah 43 kasus (44,8%) dan yang tidak sesuai 53 kasus (55,2%) sedangkan SOP yang dijalankan adalah 37 kasus (38,5%) dan SOP yang tidak dijalankan 59 kasus (61,5%). Alasan mengapa SOP tidak dijalankan adalah karena keadaan umum pasien yaitu 12 kasus (20,3%) sedangkan karena biaya dan administrasi 47 kasus (79,6%). Dari hasil uji statistik yang menilai hubungan antara SOP yang dijalankan dengan faktor pembiayaan ternyata tidak didapatkan hubungan yang bermakna (p=0,48). Diskusi : Audit kematian memang bukan standar baku emas penentuan penyebab kematian melainkan dengan autopsi klinis. Dalam konteks sosial dan budaya di Indonesia, autopsi klinis tidak mudah dilakukan sebagai penentu penyebab kematian. Dalam penelitian ini audit kematian mempunyai peran jaminan dan kendali mutu layanan kesehatan. Ketidaksesuaian penyebab kematian antara rekam medis dan kematian, serta seberapa banyak SOP yang dijalankan dan mengapa SOP tidak dijalankan dapat diungkapkan. Walaupun dari penelitian ini menunjukkan tidak terdapat hubungan bermakna antara faktor pembiayaan dengan SOP yang dijalankan atau tidak..

ABSTRACT
Introduction: The causes of death for patients with lung cancer were inadequately described. This study objectives were to describe the causes of death in lung cancer and contributing factors in Persahabatan Hospital and to describe discrepancies between the causes of death from medical records and death audit. Method: A cross sectional study was held in PersahabatanHospital involving lung cancer patients who were died between January 2010 to December 2011. The immediate and indirect causes of death from medical records were assessed and compared with death audit. The discrepancies between were analysed. Result: A total of 96 cases were found from medical record, massive pleural effusion was found as the immediate causes in 19 cases (19.8%), while sepsis was found as the indirect causes 44 cases (45.8%). From the death audit, massive pleural effusion was found as immediate causes in 48 cases (50%), while sepsis was found asthe indirect causes 16 cases (16.7%). The discrepancies between both were found in 53 cases (55.2%). SOP was executed in 37 cases (38.5%) and unexecuted in 59 cases (61.5%). The reason of unexecuted SOP due to cost was found in 47 cases (79.6%). There is no significant correlation between the executed SOP with cost was found in factors (p=0.48). Discussion : The death audit is not the gold standard method in determining the causes of death but the clinical autopsy. This study reveals that death audit have roles inhealth care quality control and assurance. The causes of death discrepancies, the unexecueted SOP, and why SOP could not be executed could be revealed from this study."
2013
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UI - Tesis Membership  Universitas Indonesia Library
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Amanda Cherkayani Sejati
"Efusi pleura ganas (EPG) sebagai bentuk perluasan dari keganasan sering muncul pada penderita kanker paru, mempersulit penatalaksanaan kanker paru, dan membuat prognosis pasien memburuk dengan rerata angka ketahanan hidup 6 bulan. Penelitian ini bertujuan untuk melihat karakteristik dan ketahanan hidup pasien kanker paru dengan EPG di RS Kanker Dharmais Jakarta tahun 2009-2013. Desain penelitian ini adalah kohort longitudinal dengan analisis univariat dan ketahanan hidup. Sampel penelitian ini adalah pasien kanker paru dengan EPG (stadium IIIB atau IV) dari metastasis kanker paru berdasarkan pemeriksaan sitologi atau biopsi dan memiliki rekam medik lengkap.
Hasil penelitian menunjukkan bahwa rata-rata umur pasien adalah 58,73 tahun, berjenis kelamin laki-laki, tidak merokok, dan status pekerjaan terbanyak adalah pensiunan. Mayoritas pasien mengeluhkan gangguan respirasi saat pertama berobat, memiliki jenis sel kanker adenokarsinoma, sudah mencapai stadium IV, dan lokasi efusi berada di paru-paru kanan. Sekitar 68.5% pasien bertahan hidup 6 bulan setelah diagnosis dan median survival adalah 12,5 bulan. Diharapkan ada KIE bagi masyarakat, terutama terkait kebiasaan merokok dan ditujukan untuk populasi berisiko, mengenai kanker paru untuk mengurangi jumlah pasien yang baru berobat setelah kanker mencapai stadium lanjut.

Malignant pleural effusion (MPE) often appears in patients with lung cancer and deteroriates prognosis of patients with mean survival rate of 6 months. This study aims to look at the characteristics and survival of lung cancer patients with MPE (stage IIIB or IV) at Dharmais Cancer Hospital Jakarta in 2009-2013. Study design was longitudinal cohort with univariate and survival analysis. Sample was lung cancer patients with metastatic MPE based on cytology test or biopsy with complete medical record.
Results showed average age of patients was 58.73; most were male, nonsmoker, and pensioner. Majority of patients had respiratory disorder, adenocarcinoma cancer type, reached stage IV, and effusion in the right lung. Approximately 68.5% of patients surviving 6 months after diagnosis and median survival were 12.5 months. IEC is needed for community; especially population with lung cancer risk, to help reducing number of new patients seeking treatment after cancer reaches advanced stage.
"
Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2014
S56600
UI - Skripsi Membership  Universitas Indonesia Library
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Yulia S.
"ABSTRAK
Pasien kanker paru stadium lanjut bergantung pada pasangannya terkait cepatnya penurunan fisik, beban gejala yang berat dan depresi yang dialami. Pasangan dari pasien seringkali tidak siap untuk menjalankan peran caregiver yang mempengaruhi kualitas perawatan dan dukungan yang diberikan. Tujuan penelitian ini adalah menggali pengalaman pasangan dari pasien kanker paru stadium lanjut berperan sebagai caregiver pasien yang sedang menjalani perawatan di rumah sakit. Metode penelitian menggunakan pendekatan studi fenomenologi. Pengumpulan data dilakukan dengan wawancara dan analisis data mengggunakan Metode Collaizi. Penelitian melibatkan sembilan partisipan yang termasuk kelompok rentan caregiver yakni wanita, pria dan usia lanjut. Hasil penelitian menemukan tiga tema: 1 perubahan peran dalam rumah tangga, 2 keikhlasan dalam merawat pasangannya yang sakit, dan 3 perubahan kedekatan dengan pasangan yang sakit. Kesimpulan penelitian ini adalah pasangan dari pasien kanker paru stadium lanjut yang berperan sebagai caregiver berperan penting dalam perawatan pasien sehingga perlu diintervensi untuk meningkatkan kesiapan dan proses adaptasi dalam menjalankan peran caregiver.

ABSTRACT
Advanced lung cancer patients experienced rapid physical deteriorations, burdened and depression that contributed to high dependency to caregiver. Caregiver rsquo s role was frequently applied by spouse of patient with lack of experience that influenced quality of care and support given to patient. The aim of this study is to gain deep understanding about the experience of spouse having role as spousal caregiver of advanced lung cancer patients during treatment in hospital. Qualitative descriptive phenomenology approach was applied to nine participants which were chosen based on vulnerable group of caregivers female, male and elderly caregivers. Data collection was done using in depth interview. Collaizi rsquo s method was appllied in data analysis. The findings revealed three themes 1 changing roles in family, 2 acceptance of the roles as caregiver to ill spouse, and 3 changes in spousal closeness. The conclusion of this study is spousal caregivers have important role in treatment and need interventions to enable them performing and adjusting caregiver rsquo s role. "
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2017
T48463
UI - Tesis Membership  Universitas Indonesia Library
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Mirna Nurasri Praptini
"Latar Belakang: Usia lanjut dan hubungannya dengan kesintasan kanker paru karsinoma bukan sel kecil sudah diteliti sebelumnya, namun kesintasannya di rumah sakit di Indonesia belum diteliti. Belum banyak penelitian lain yang memperhitungkan faktor perancu antara lain derajat keparahan penyakit, status fungsional, komorbiditas, dan indeks massa tubuh dalam meneliti pengaruh pertambahan usia dengan kesintasan kanker paru karsinoma bukan sel kecil.
Tujuan: Mengetahui adakah perbedaan kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil usia lanjut dan bukan usia lanjut yang diterapi di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas.
Metode: Kohort retrospektif dengan pendekatan analisis kesintasan terhadap 227 pasien kanker paru karsinoma bukan sel kecil yang berobat jalan maupun rawat inap di RS Cipto Mangunkusumo dan RS Kanker Dharmais tahun 2002-2012, terbagi 2 kelompok berdasarkan usia saat diagnosis (<60 tahun dan >60 tahun). Kurva Kaplan-Meier digunakan untuk mengetahui kesintasan satu tahun masingmasing kelompok. Analisis bivariat menggunakan uji log-rank, analisis multivariat menggunakan cox proportional hazard regression. Besarnya hubungan variabel usia dengan kesintasan dinyatakan dengan crude HR dan IK 95% serta adjusted HR dan IK 95% setelah dimasukkan variabel perancu.
Hasil dan Pembahasan: Terdapat 227 pasien adalah kanker paru karsinoma bukan sel kecil yang diterapi dimana karakteristik kedua kelompok (<60 tahun dan >60 tahun) sebanding kecuali jenis kelamin, merokok, ada tidaknya komorbiditas, dan jumlah komorbiditas. Persentase mortalitas satu tahun adalah 68,0% dan 61,9% untuk kelompok usia <60 dan >60 tahun dengan median kesintasan 8 dan 9 bulan bulan. Analisis bivariat tidak menunjukkan hubungan bermakna antara usia dengan kesintasan satu tahun.
Simpulan: Tidak ada pengaruh usia terhadap kesintasan satu tahun pasien kanker paru karsinoma bukan sel kecil yang diterapi di RS Cipto Mangunkusumo dan RS Kanker Dharmais di semua stadium dengan mempertimbangkan functional status, indeks massa tubuh, dan komorbiditas.

Background: Old age and its relations to non-small cell lung carcinoma survival has been studied before but its survival in Indonesia has not been studied before. Not many studies that have considered confounders, such as stage, functional status, comorbidities and body mass index, in the study between advancing age and non-small cell lung cancer carcinoma survival.
Aim: To evaluate differences of treated non-small cell lung carcinoma one year survival between non-elderly and elderly considering stages, functional status, body mass index and comorbidities.
Methods: Retrospective cohort design and survival analysis were used to 227 patients with non-small cell lung cancer that being treated at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital between 2002 and 2012 that divided into 2 groups according to age at diagnosis (<60 years and >60 years). Kaplan-Meier curve was used to evaluate the one year survival of each group. Bivariate analysis was conducted using log-rank test, multivariate analysis was conducted using cox proportional hazard regression. The extend of relation between advancing age and survival was expressed with crude HR with 95% CI and adjusted HR with 95% CI after adjusting for confounders.
Results and Discussion: There were 227 non-small cell lung carcinoma being treated whereas the characteristics between two groups (<60 years and >60 years) were the same except for sex, smoking status, comorbidities and number of comorbidities. One year mortality percentage were 68.0% and 61.9% to <60 years and >60 years groups, respectively, with the survival median of 8 and 9 months. Bivariate analysis didn’t find statistically significant relation between age and one year survival.
Conclusion: Age didn’t influence one year survival of treated non-small cell lung carcinoma at Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital considering stage, functional status, comorbidities and body mass index.
"
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Ana Fawziah
"Latar Belakang : Penelitian perbandingan kesintasan pasien karsinoma paru bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi dan non-kemoterapi sudah pernah diteliti di negara lain sebelumnya, namun penelitian tersebut di Indonesia belum pernah dilakukan. Penelitian-penelitian terdahulu belum banyak yang memperhitungkan faktor perancu seperti komorbiditas, jenis histopatologi, indeks massa tubuh, stadium, usia dan status fungsional dalam meneliti pengaruh kemoterapi terhadap kesintasan karsinoma paru bukan sel kecil usia lanjut.
Tujuan : Mengetahui adakah perbedaan kesintasan satu tahun antara pasien kanker paru karsinoma bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi dan non-kemoterapi.
Metode : Kohort retrospektif dengan analisis kesintasan terhadap 232 pasien kanker paru karsinoma bukan sel kecil stadium IIIB/IV dan status fungsional ECOG 0-2 yang berobat jalan maupun rawat inap di RS Cipto Mangunkusumo dan RS Kanker Dharmais Januari 2007-April 2013, terbagi menjadi dua kelompok yaitu yang menjalani kemoterapi dan non-kemoterapi. Kurva Kaplan-Meier digunakan untuk mengetahui kesintasan satu tahun masing-masing kelompok. Analisis bivariat menggunakan uji log-rank, analisis multivariat menggunakan cox proportional hazard regression. Besarnya hubungan variabel kemoterapi dengan kesintasan dinyatakan dengan crude HR dan IK 95% serta adjusted HR dan IK 95% setelah dimasukkan variabel perancu.
Hasil : Terdapat 232 pasien kanker paru karsinoma bukan sel kecil yang dibagi menjadi dua kelompok yaitu kemoterapi (118 subyek) dan non-kemoterapi (114 subyek). Persentase mortalitas satu tahun adalah 93,9% pada kelompok non-kemoterapi dan 57,6% pada kelompok kemoterapi. Median kesintasan kelompok non-kemoterapi adalah 2 bulan, sedangkan kelompok kemoterapi 9,73 bulan, p<0,001, HR 3,447(IK 95% 2,522-4,711). Analisis bivariat menunjukkan hubungan bermakna antara kemoterapi dengan kesintasan satu tahun. Analisis multivariat menunjukkan stadium adalah perancu kemoterapi terhadap kesintasan.
Simpulan : Kesintasan satu tahun pasien kanker paru bukan sel kecil usia lanjut stadium IIIB/IV yang menjalani kemoterapi lebih baik dibandingkan dengan non-kemoterapi.

Background : The effects of chemotherapy on survival in elderly with advanced non-small cell lung cancer has been studied in other country before, but in Indonesia this topic hasn?t been studied. The influence of confounding factors such as comorbidity, histopathology, body mass index, functional status, age and stage of cancer were seldom considered in the earlier studies.
Objective : To determine whether there?s a difference in one year survival between elderly with advanced non-small cell lung cancer who received chemotherapy and those who received non-chemoterapeutic approaches.
Methods : Retrospective cohort design and survival analysis were used to 232 elderly with advanced non-small cell lung cancer (IIIB/IV) and performance status of ECOG 0-2 who visited Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital between January 2007 and April 2013 that divided into 2 groups according to therapy that they received (chemotherapy and non-chemotherapy). Kaplan-Meier curve was used to evaluate the one year survival of each group. Bivariate analysis was conducted using log-rank test, multivariate analysis was conducted using Cox proportional hazard regression. The extend of relation between advancing age and survival was expressed with crude HR with 95% CI and adjusted HR with 95%CI after adjusting for confounders.
Results : There were 232 elderly advanced non-small cell lung cancer that divided into two groups ; chemotherapy (118 subjects) and non-chemotherapy (114 subjects). One year mortality percentage were 93,9% and 57,6% to non-chemotherapy and chemotherapy group. The survival median were 2 months in non-chemotherapy group and 9,73 months in chemotherapy group, with p< 0,001 and HR 3,447 (95% CI : 2,522-4,711). Bivariate analysis showed statistically significant relation between chemotherapy and one year survival. Multivariate analysis showed that stage of cancer was a confounder to chemotherapy relation to survival.
Conclusion : One year survival in elderly with advanced non-small cell lung cancer who received chemotherapy were better compared to those who received non-chemotherapeutic approaches."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
cover
Ratna Sari Dinaryanti
"Gangguan yang paling sering dikeluhkan oleh pasien kanker paru adalah adanya kesulitan bernapas dan kecemasan yang menyebabkan pasien menjadi tidak relaks.
Tujuan dari penelitian ini adalah untuk mengetahui pengaruh program latihan pursed lip breathing (PLB) dan Progressive Muscle Relaxation (PMR) terhadap peningkatan saturasi oksigenasi dan tingkat relaksasi pada pasien kanker paru. Metode penelitian yang digunakan adalah Quasi eksperiment dengan desain pre dan post test without control group. Jumlah sampel yang digunakan sebanyak 19 orang. Alat ukur yang digunakan yaitu oksimetri nadi untuk menilai saturasi oksigen dan lembar monitoring subjektif dan objektif untuk menilai tingkat relaksasi.
Hasil penelitian menunjukkan bahwa ada perbedaan yang signifikan antara nilai saturasi oksigen sebelum dan sesudah latihan PLB dan PMR (p value < 0,05) dan ada perbedaan yang signifikan antara tingkat relaksasi sebelum dan sesudah latihan PLB dan PMR (p value < 0,05). Hasil analisis multivariate didapatkan bahwa usia menjadi prediktor terhadap peningkatan saturasi oksigen.
Penelitian ini menyimpulkan bahwa latihan PLB dan PMR dapat meningkatkan saturasi oksigen dan tingkat relaksasi sebagai terapi komplementer pendamping terapi oksigen standar. Rekomendasi dari penelitian ini adalah perlunya terapi pengaturan napas dan teknik relaksasi untuk meningkatkan saturasi oksigen dan tingkat relaksasi pada pasien kanker paru stadium III dan IV.

The most common symptoms in lung cancer are dyspnea and anxiety that cause patients restlessness.
This study aimed to find out the influence of PLB and PMR training program on the increase oxygen saturation and relaxation level in patients with lung cancer. This study employed a Quasy Experiment with pre test and post test without control group. There were 19 participants in this study. The instruments used were pulse oxymetry to measure oxygen saturation and monitoring form to measure subjective and objective relaxation level.
The results show that there is a significant difference on oxygen saturation before and after PLB and PMR training program (p value < 0,05) and a significant difference on relaxation level before and after PLB and PMR training program (p value < 0,05). A Multivariate analysis shows that age becomes a strong predictor of oxygen saturation.
This study concludes that PLB and PMR training program apllied to patient with lung cancer increases oxygen saturation and relaxation level as a complementary therapyalong with oxygen standart therapy. This study sugests breathing and relaxation training program to increase oxygen saturation and relaxation level for patient with lung cancer at grade III and IV.
"
Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2014
T42666
UI - Tesis Membership  Universitas Indonesia Library
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