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"Di Indonesia umumnya pasien kanker serviks datang berobat pada stadium lanjut (62 %) sehingga kanker serviks merupakan 66 % dari penyebab kematian ginekologik.1 Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan keterlambatan pasien kanker serviks memeriksakan diri. Penelitian menggunakan metode kuantitatif dan kualitatif dengan sampel yang diambil dari seluruh pasien baru kanker serviks tahun 2000 dan 2001 yang datang berkunjung kembali ke RSUPN Dr. Cipto Mangunkusumo Jakarta pada bulan Agustus sampai dengan Oktober 2001. Kesimpulan : Variabel yang berhubungan secara signifikan dengan waktu memeriksakan diri ialah pengetahuan, sikap, ketersediaan pelayanan Pap smear dan dukungan suami. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan. (Med J Indones 2003; 12: 162-5)

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In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %). This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel. (Med J Indones 2003; 12: 162-5)"

"Background: Community acquired pneumonia (CAP) in the elderly is still a major problem due to its high morbidity and mortality. There is considerable variability in ?the result of various studies on prognostic factors. The prognostic factors in Indonesia have not been identified.Methods: We performed a prospective cohort study on 147 elderly patients hospitalized with CAP in the internal medicine ward of Cipto Mangunkusumo National Central General Hospital, Jakarta from September 2002 to March 2003. We calculated the survival rate during hospitalize-tion. We used Cox proportional-hazard regression analysis to examine factors associated with mortality in the first 48 hours of hospitalization. .Results: There were 34 deaths (23.1) associated with CAP in 1471 person-days. The survival rate at day 5, 10 and 15 were 88.9%, 77.2 and 67.2% respectively. Severe. pneumonia, an serum albumin of d"3.5 g/dL, reducedconsciousness, temperature > 37.0"C, and a hemoglobin level of d" 9.0 g/dL demonstrated a tendency towards increased mortality rate. Other factors such as age, sex, immobilization, swollen disorders, co-morbidities, leukocyte count, and serum creatinine level demonstrated no significant relationship with mortality.Conclusion: Severe pneumonia, low serum albumin, decreased consciousness, high temperature and low hemoglobin level in the first 48 hours hospitalization were found to be worse prognostic factors. Early identification and modification of these factors are recommended."

"Diabetics occasionally need enteral nutrition-either as supplement or in situations necessitating total dependency on enteral nutrition to fulfill their energy requirements. Enteral nutrition specifically designed fordiabet-ics is not yet available in our hospital, as sugar is often added to enteral nutrition preparations, subsequently affecting the blood glucose profiles of the patients.

This study was done to determine the glycemic index of 4 kinds of enteraf feeding formulas, conducted among ambulatory diabetics attending the Diabetic Clinic of the Dr Cipto Mangunkusumo General Central National Hospital.

Twenty samples were purposively chosen among the Diabetic Clinic attendees. They were well-controlled non-pregnant diabetics; none of them were having either kidney or liver problems, and were otherwise healthy. Each of the diabetic studied was given 50-g glucose syrup (200 Kcal) as a standard load. With a 3 to 4 days interval, the patients were consecutively given several enteral feeding formulas, i.e., the standard hospital enteral feeding formula (MC-FRS I), a newly developed diabetic formula (MC-FRS II), a frequently-used commercially avai 1-ablepredigested/elemental enteral feeding formula {MC-FK I = Isocal), and a new predigested/elemental enteral feeding formula specifically designed for diabetics (MC-FK II=Diabetasol). All of the formulas tested contained energy equal to 50-g glucose (200 Kcal). Blood glucose was measured with an Accutrend-Ames® glucometer in fasting condition and subsequently 30,60,90 and 120 minutes after the load. Any glucose/enteral feeding loading was given 30 minutes after. Data were presented as a blood glucose curve and glycemic index were calculated as area under the blood glucose curve of each food load compared to the standard glucose load, presented as percentage.

In all the enteral feedings studied, the blood glucose response curves went up and the peaks achieved in 60 minutes, thereafter declined to points above the initial fasting blood glucose values. The glycemic index of the MC-FRS I, MC-FRS II, MC-FK I and MC-FK II were 39.6%, 25%, 45% and 52.1% respectively.

The sugar that was added to the MC-FRS I and MC-FK I did not give rise to higher blood glucose levels as compared to the other non-glucose-added food. All of the enteral feeding formula tested showed low glycemic index (Miller, less than 55%). The difference glycemic index among the formulas studied might be due to different food composition (predigested/elemental component in the commercial enteral feeding formula; no sugar added and higher fiber in MC-FRS II as compared to MC-FRS I; higher fat content in MC-FK 1 as compared to MC-FK II). Glycemic index of enteral feeding formula was particularly determined by the total carbohydrate, total fat and total protein content of the food, as well as the presence of fiber and antinutrient in the food studied."

"Di Indonesia kebanyakan pasien kanker serviks datang pada stadium lanjut (62%) yang merupakan 66% dari penyebab kematian ginekologik. Pemeriksaan Pap Smear merupakan salah satu cara untuk mendeteksi secara dini kanker serviks sehingga penanganan kanker serviks dapat dilakukan sebelum menyebar ke luar rahim.Tujuan penelitian ini adalah untuk mengetahui peranan faktor-faktor yang menyebabkan mereka terlambat memeriksakan diri di RSUPN Dr. Cipto Mangunkusumo Jakarta. Penelitian ini memadukan metoda kuantitatif dan kualitatif. Data primer diambil dengan menggunakan kuesioner, wawancara mendalam dan membaca catatan dokumen.Hasil penelitian menunjukkan bahwa variabel-variabel yang berhubungan seeara statistik dengan keterlambatan pasien kanker serviks memeriksakan diri adalah pengetahuan, sikap, ketersediaan pelayanan Pap Smear dan dorongan suami. Biaya dan dorongan petugas kesehatan tidak berhubungan secara statistik tetapi penting khususnya penghasilan untuk membayar biaya pemeriksaan. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan mempengaruhi variabel dependen.Berdasarkan wawancara mendalam dapat disimpulkan bahwa memang tidak tersedianya pelayanan Pap Smear disamping kurangnya pengetahuan yang menjadi penyebab informan terlambat memeriksakan diri dengan alasan tidak ada satupun petugas kesehatan atau orang lain yang menyampaikan informasi mengenai Pap Smear dan kanker serviks.Mempertimbangkan hasil penelitian maka disarankan kepada semua pihak yang terkait untuk meningkatkan upaya penanganan kanker serviks melalui KIE secara terkoordinir lintas sektoral kepada masyarakat umumnya, terutama kepada wanita masa reproduksi dan lansia agar memperhatikan pelayanan deteksi dini (Pap Smear).

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An Analysis on the Delay of Cervix Cancer Patient in Examining Their selves in The National Hospital of Dr. Cipto Mangunkusumo, JakartaIn Indonesia most of the cervix cancer patients come to see doctors after advanced stadium (62 %) which 66 % ended with gynecological death. The smear test is a method to detect the cervix cancer earlier before spreading outside the uterus.

The purpose of this research is to identify factors related to the delay of the health examination in The National Hospital of Dr. Cipto Mangunkusumo, Jakarta. This research combines quantitative and qualitative methods by using questionnaire, in-depth interview and examine medical records to supplement the primary data.

The research result indicates variables related statistically with the cancer patient delay are; knowledge, attitudes, the availability of the Pap smears service, and the husband's support. Financial problem and encouragement from the health providers are not related statistically but it is important especially the income. The availability of Pap smear service plays as a dominant variable in affecting the dependent variable.

Based on depth interview it is concluded that the unavailability of Pap smear services despite the lack of knowledge has caused the informant did not use the early detection service (Pap smear) with reason there was no health provider or other people gave information about the Pap smear and cervix cancer.

Considering the research result, it is suggested that all related parties improve the handling of the cervix cancer through Communication, Information and Education (KIE), which is coordinated through cross sector way to the public, especially KIE should be focused on women during their reproductive term and the elder women so that they will pay more attention to early detection service (Pap smear)."

"Kanker payudara merupakan jenis kanker dengan prevalensi tertinggi di Indonesia pada pasien wanita. Penggunaan kontrasepsi oral pada wanita usia reproduktif merupakan salah satu pilihan kontrasepsi yang sering digunakan di Indonesia. Pada tahun 2012, angka kematian akibat kanker payudara meningkat sebesar 20 jika dibandingkan dengan angka kematian pada tahun 2008. Penelitian ini dilakukan untuk mengetahui hubungan pemakaian kontrasepsi oral terhadap kejadian kanker payudara pada pasien wanita di RSUPN Cipto Mangunkusumo pada tahun 2010-2014. Pada penelitian dengan desain studi potong lintang cross sectional ini, data diambil dari unit arsip Departemen Patologi Anatomik FKUI-RSCM sesuai dengan hasil uji histopatologik, kemudian ditelusuri ke Unit Rekam Medik RSCM sebagai data sekunder yang diolah menggunakan uji Fisher menggunakan SPSS versi 21. Hasil penelitian menunjukan nilai p = 0.03 dari 88 data yang terkumpul. Dari penelitian ini, dapat disimpulkan bahwa penggunaan kontrasepsi oral memiliki hubungan yang bermakna dengan kejadian kanker payudara pada pasien wanita di RSUPN Cipto Mangunkusumo pada tahun 2010-2014.

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Breast cancer is one of the most prevalence types of cancers among women in Indonesia. Oral contraceptive consumption in reproductive age is one of the favorable choices for contraception in Indonesia. In 2012, the mortality rate increases to 20 compared with the mortality rate in 2008. The aim of this study is to find the relationship between oral contraceptive consumption and the occurrence of breast cancer among female patients in Cipto Mangunkusumo Hospital in 2010 2014. This cross sectional study is using collected secondary data taken from patients rsquo medical record based on patients rsquo histopathological examination results that can be analyzed using Fisher test with SPSS version 21. The result of this research shows p value that is 0.03 collected from 88 datas. From this research, it can be concluded that oral contraceptive consumption has statistically significant association on the occurence of breast cancer among female patients in Dr. Cipto Mangunkusumo National General Hospital in 2010 2014."

"Kanker merupakan pertumbuhan selyang abnormal, mampu melakukan metabolisme sel sendiri sehingga dapat dengan mudah bermetastase ke organ lain dan menimbulkan kematian. Insiden kanker dengan bertambahnya tahun bertambah pula angka mortalitas kanker. Dengan kemajuan tehnologi berbagai cara dilakukan untuk menurunkan angka insiden kanker dan morbiditas kanker. Karya Ilmiah Akhir KIA ini adalah sebagai laporan praktek residensi keperawatan medikal peminatan onkologi di RS Cpto Mangunkusumo Jakarta. Karya Ilmiah ini berisi tentang penerapan teori Virginia Henderson pada pasien kanker tiroid yang didalamnya terdapat intervensi penggunaan reflexology foot massage untuk mengurangi kecemasan pada pasien yang menjalani keoterapi dan proyek inovasi Cryoterapyoral pada pasien ca colon yang menjalani kemoterapi untuk mencegah dan mengurangi mukosistis. Kesimpulan : bahwa Teori Virginia Henderson cocok di terapkan pada pasien kanker tiroid. Intervensi penggunaan reflexiology foot massage dapat digunakan sebagai salah satu alternatif pilihan untuk mengurangi kecemasan pasien yang menjalani kemoterapi. Cryoterapi oral diharapkan dapat di terapkan di pelayanan keperawatan untuk mengurangi dan mencegah mukositis.

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Cancer is an abnormal cell growth, capable of metabolizing the cells themselves so that it can easily metastasize to other organs and cause death. Incidence of cancer with increasing years also the mortality rate kanke. With the advancement of technology various ways are done to reduce the incidence rate of cancer and cancer morbidity. This Final Scientific Work KIA is as a report of medical residency practice of oncology specialization in Cpto Mangunkusumo Hospital Jakarta. This scientific work contains the application of Virginia Henderson 39;s theory to thyroid cancer patients. The intervention of reflexology foot massage is to reduce anxiety in patients undergoing chemotherapy. Oral Cryoterapy innovation project in ca colon patients undergoing chemotherapy to prevent and reduce mucosistis. Conclusions: Virginia Henderson Theory is suitable to apply to patients with thyroid cancer. Intervention of reflexology foot massage may be used as an alternative option to reduce anxiety of patients undergoing chemotherapy. Oral cryotherapy is expected to be applied in nursing services to reduce and prevent mucositis."

"ABSTRAK Nama : Arie Jefry Ka rsquo;arayenoProgram Studi : Ners Spesialis Departemen Medikal Bedah Peminatan OnkologiJudul : Analisis Praktik Residensi Keperawatan Medikal Bedah Pada Pasien Leukimia Limfositik Kronik dengan Pendekatan Teori Adaptasi Roy di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo JakartaPada Karya Ilmiah Akhir KIA ini akan dibahas rangkaian praktek residensi peminatan onkologi. Kegiatan praktek residensi program pendidikan ners spesialis kekhususan onkologi dilaksanakan selama dua 2 semester di Rumah Sakit Kanker Dharmais RSKD dan di Rumah sakit Umum Pusat Nasional DR. Cipto Mangunkusumo RSCM Jakarta. Ruangan yang digunakan praktik disesuaikan dengan kompetensi yang ingin dicapai yaitu diruang rawat inap teratai, rawat inap ruang cempaka, poli radioterapi, poli deteksi dini, poli rawat luka, dan instalasi gawat darurat IGD di RSKD. Sedangkan di Rumah sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo Jakarta ruangan yang digunakan sebagai lahan praktek residensi adalah di Gedung A lantai 8 dan lantai 4 rawat inap unit bedah onkologi, hematologi kemoterapi dan juga di unit poli radioterapi. Kasus terbanyak yang dikelola adalah kanker payudara mengikuti ca sinonasal, adenoma carsinoma, KNF, KSS lidah, leukimia dan kanker rekti. Sebagian besar pasien yang dikelola adalah perempuan sebanyak 17 orang 56,7 sedangkan laki-laki terdapat 13 orang 43,3 dari 30 kasus yang dikelola. Untuk Evidence Based Nursing yaitu pengkajian nyeri khusus kanker menggunakan Brief pain Inventory BPI ditemuikan bahwa BPI merupakan pengkajian yang lebih luas dan dapat menilai nyeri pasien secara lengkap dan lebih dalam. Sedangkan hasil pelaksanaan proyek Inovasi yang dilakukan adalah berupa tindakan keperawatan guided imagery diketahui bahwa dapat menunrunkan skor nyeri pada pasien kanker. Kata kunci: brief pain inventory, guided imagery, karya ilmiah akhir, teori adaptasi Roy ABSTRACT Name Arie Jefry Ka rsquo arayenoStudy program Ners Spesialis Departemen Medikal Bedah Peminatan OnkologiTitle Medical Practice Analysis of Medical Surgical Nursing Surgery In Chronic Lymphocytic Leukemia Patients with Roy Adaptation Theory Approach at National General Hospital Dr. Cipto Mangunkusumo JakartaAsthma as obstructive airway disease with airway narrowing, tends to be followed by an increase in respiratory rate. The basic concept of Buteyko 39 s theory is to teach the correct way of breathing in asthma patients. The purpose of this study is to identify the effect of Buteyko breathing exercises on peripheral oxygen saturation value and expiratory peak currents in asthma patients. The research design used was quasi experiment, pretest and posttest with control group. The study respondents numbered 24 people, consisting of 12 people doing Buteyko breathing exercises in the intervention group and 12 people in the control group. The results showed that there was a significant effect on the peak expiratory currents in the intervention group p value 0.001 . However, there was no significant effect on peripheral oxygen saturation p value 0.082 . The results of this study indicate that Buteyko breathing exercises can be given as complementary therapy, part of the treatment in asthma patients. Kata kunci brief pain inventory, final scientific work, guided imagery, Roy 39 s adaptation theory"

"Kanker ginjal merupakan penyakit keganasan yang mulai meningkat angka kejadiannya di daerah perkotaan. Akibat invasi dan pertumbuhan sel kanker yang semakin membesar dapat menekan jaringan atau organ sekitar ginjal. Hal ini sering mengakibatkan keluhan nyeri pada pasien dengan kanker ginjal. Sebagai penyakit dengan progresivitas lambat, kanker menyebabkan nyeri yang bersifat kronis, sehingga pengunaan obat analgesik dalam jangka waktu perlu dipertimbangkan karena akan meningkatkan efek toksisitas terhadap organ. Maka dari itu diperlukan manajemen nyeri non farmakologik. Tujuan penulisan ini adalah untuk melakukan analisis evidence based mengenai teknik manajemen nyeri non farmakologik khususnya teknik relaksasi dan teknik distraksi. Hasil dari latihan teknik relaksasi dan distraksi yang dilakukan secara terus-menerus dapat mengatasi rasa nyeri klien dengan kanker ginjal baik pra bedah maupun paska bedah.

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Kidney cancer is a malignant disease which the incidence began to increase in urban areas. The growth and invasion of cancer cells can suppress the tissues or organs around the kidney. This often results in complaints of pain in patients with kidney cancer. As a disease with a slow progression, cancer causes chronic pain, so the use of analgesic drugs in the long period needs to be considered because it will increase the effect of toxicity to organs. Because of that, it is required nonpharmacologic pain management.

The purpose of this paper is to analyze evidence based of non-pharmacologic pain management techniques, especially relaxation techniques and distraction techniques. Results of relaxation and distraction exercises are performed regularly can overcome the pain of kidney cancer both pre and post surgical clients."

"Praktik klinik lanjut di ruang neurologi untuk memberikan asuhan keperawatan pada pasien gangguan neurologi menggunakan teori keperawatan Model Adaptasi Roy, menerapkan praktik keperawatan berdasarkan pembuktian dan melakukan inovasi keperawatan. Masalah keperawatan terbanyak akibat respon perilaku inefektif pada mode adaptasi fisiologis yaitu perfusi jaringan serebral tidak efektif, dan mode fungsi peran yaitu manajemen kesehatan diri tidak efektif. Intervensi keperawatan berdasarkan pembuktian yang telah diterapkan yaitu Skrining Malnutrisi menggunakan Mini Nutrional Assesment (MNA) dan Barthel Index (BI) yang dapat mendeteksi risiko kejadian malnutrisi pada pasien gangguan neurologi yang di rawat inap, sehingga dapat mencegah malnutrisi dengan kolaborasi dengan tim gizi. Inovasi keperawatan yaitu Bladder Training dengan menggunakan chart Bladder diary untuk mencegah kejadian infeksi nosokomial dan melatih pasien gangguan neurologi agar dapat berkemih mandiri tanpa bantuan alat. Perawat dapat menerapkan Model Adaptasi Roy, menerapkan skrining malnutrisi untuk mendeteksi awal risiko kejadian malnutrisi serta melakukan kegiatan inovatif dalam memberikan asuhan keperawatan pada gangguan neurologi.

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Advanced clinical practice in neurology ward is conducted to give nursing implementation on patients with neurological system disorder by using Roy’s Adaptation theory, implementing nursing practice based on evidence and implementation of nursing innovation. The most frequent nursing problems that occurred resulted from ineffective behavior response on physical adaptation mode were ineffective cerebral tissue perfusion and role function mode, ineffective self-care management. Nursing intervention based on evidence-based practice on Malnutrition Screening by using Mini Nutritional Assesment (MNA) and Barthel Index (BI) is used to know the risk of malnutrition on patients with neurological in the ward, so we can prevent malnutrition by collaborating with the nutrition team. Nursing innovation with Bladder Training by using Bladder diary is used to prevent infection in hospital and to train patients with neurological system disorder, so that the patients can be autonomous without using any equipment. Nurses can implement Roy’s Adaptation Theory with Malnutrition Screening application to prevent malnutrition, and at the same time it can execute innovation in nursing implementation on patients with neurological system."