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"Pendahuluan Fatigue dan gangguan tidur masalah yang sering terjadi pada anak dengan kanker selama menjalani pengobatan. Salah satu intervensi non farmakologis yang dapat menurunkan fatigue dan gangguan tidur adalah slow deep breathing dan sleep hygiene education. Tujuan penelitian untuk mengidentifikasi efektivitas slow deep breathing dan sleep hygiene education terhadap fatigue dan gangguan tidur pada anak usia sekolah dengan kanker. Metode Penelitian eksperimental desain quasi experiment pendekatan nonrandomized pretest and posttest control group. Responden anak usia sekolah dengan kanker berjumlah 36 anak, terdiri dari kelompok kontrol (n=18) dan kelompok intervensi (n=18). Kelompok intervensi diberikan slow deep breathing dan sleep hygiene education sedangkan kelompok kontrol dengan perawatan rutin. Penilaian skala fatigue menggunakan instrumen skala FOA-A dan gangguan tidur dengan skala GATIA. Hasil penelitian menunjukkan adanya perbedaan skor fatigue antara kelompok intervensi dan kontrol (p value=0,001); adanya hubungan karakteristik dengan skor fatigue, yaitu jenis kanker (p value=0,024), stadium kanker (p value=0,001), jenis pengobatan (p value=0,001), dan gangguan tidur (p value=0,002); sedangkan tidak ada hubungan usia, jenis kelamin, dan lama pengobatan dengan skor fatigue. Rekomendasi penelitian yaitu penerapan slow deep breathing dan sleep hygiene education karena mudah dilakukan, nyaman, murah dan tidak berisiko membahayakan dalam menurunkan fatigue dan gangguan tidur pada anak.

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Introduction Fatigue and sleep disorders often occurs in children with cancer. One of the non-pharmacological interventions that can reduce fatigue and sleep disorders is slow deep breathing and sleep hygiene education. The purpose of the study was to identify the effectiveness of slow deep breathing and sleep hygiene education. Purpose of the study was identify effectiveness of slow deep breathing and sleep hygiene education to fatigue and sleep disorders in school age children with cancer. Methods Experimental research design quasi experiment approach nonrandomized pre-post test control group. School age children respondents with cancer totaled 36 children consisting of control groups (n=18) and intervention groups (n=18). Intervention group was given slow deep breathing and sleep hygiene education while control groups with routine care. Fatigue scale assessment using FOA-A scale instruments and sleep disorders with GATIA scale. Results research shows that there is differences in fatigue scores between intervention and control groups (p value=0.001); there is a characteristic relationship with fatigue score cancer type (p value=0.024), stage of cancer (p value=0.001), type of treatment (p value=0.001) and sleep disorders (p value=0.002); whereas there is no relationship age, sex, and long treatment with fatigue score. Recommendations research application of slow deep breathing and sleep hygiene education are easy to do, convenient, cheap and not risk harmful in reducing fatigue and sleep disorders in children."

"Kanker pada anak merupakan masalah kesehatan utama dengan angka kesakitan dan kematian yang tinggi. Masalah yang ditimbulkan oleh kanker diantaranya masalah tidur dan kelelahan. Karya Ilmiah Akhir Spesialistik ini bertujuan untuk menganalisis gambaran aplikasi teori comfort Kolcaba pada anak kanker dengan gangguan tidur dan kelelahan dan penerapan edukasi tidur sehat serta terapi musik untuk mengatasi masalah tersebut. Penerapan asuhan keperawatan diterapkan dengan metode studi kasus yang didapatkan dari lima kasus terpilih. Lima kasus tersebut, semua mengalami gangguan tidur dan kelelahan. Teori comfort mampu memfasilitasi perawat untuk menggali masalah dan kebutuhan anak kanker secara sistematis. Penerapan edukasi tidur sehat dan terapi musik sebagai salah satu intervensi keperawatan juga terbukti dapat mengatasi gangguan tidur dan kelelahan. Penerapan teori kenyamanan dan pemberian edukasi tidur sehat serta terapi musik diharapkan dapat menjadi komponen pemberian asuhan keperawatan anak kanker dengan gangguan tidur dan kelelahan.

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Cancer in children is a major health problem with high morbidity and mortality. Problems caused by cancer include sleep problems and fatigue. This Specialist Final Scientific work aims to analyze the application of Kolcaba's comfort theory on sleep problems and fatigue in children with cancer by implementing sleep hygiene  and music therapy, which aims to overcome these problems. The application of nursing care was applied with the case study method from five selected cases. With the same symptoms, they were namely sleep problems and fatigue. The theory of comfort could facilitate nurses to find problems and needs of cancer in children systematically. The application of sleep hygiene and music therapy as one of the nursing interventions had proven to be able to overcome sleep problems and fatigue. And this was expected to be a component in providing cancer nursing care to children with sleep problems and fatigue."

"ABSTRAKAngka kejadian kelelahan pada anak kanker di Indonesia adalah 44,2 . Salah satu faktor yang berkontribusi pada kejadian kelelahan adalah gangguan tidur. Kelelahan dan gangguan tidur yang tidak diatasi dapat berdampak pada penurunan kualitas hidup anak. Penelitian ini bertujuan untuk melihat pengaruh latihan AeRop dalam mengatasi kelelahan dan gangguan tidur pada anak kanker. Penelitian ini menggunakan rancangan penelitian quasi experiment dengan pre-post with control group. Latihan AeRop merupakan kombinasi latihan aerobik dan relaksasi otot progresif yang dapat menghindari kekakuan akibat kelelahan pada anak kanker dan memberikan perasaan nyaman. Sampel dalam penelitian ini berjumlah 64 anak kanker yang sedang menjalani kemoterapi, 32 anak mendapat latihan Aerop dan 32 anak tidak mendapatkan latihan AeRop. Analisis data yang digunakan adalah analisis univariat dan bivariat, yaitu uji T berpasangan dan tidak berpasangan. Hasil penelitian ini menunjukkan hampir ada perbedaan yang bermakna pada skor kelelahan setelah diberikan latihan AeRop p=0,05 . Hasil penelitian ini juga menunjukkan adanya perbedaan yang bermakna pada skor gangguan tidur setelah diberikan latihan AeRop. Hal ini dapat disimpulkan bahwa latihan AeRop efektif dalam mengatasi gangguan tidur pada anak kanker. Perbaikan kualitas tidur anak kemungkinan besar berpengaruh dalam mengurangi kelelahan yang berkaitan dengan kanker.

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ABSTRACTPrevalence of fatigue in cancer children in Indonesia is 44.2 . One of the factors that contribute to fatigue is a sleep disorder. Unexplained fatigue and sleep disturbances can have a detrimental effect on the quality of life of the child. This study aimed to see the effect of AeRop exercise in overcoming fatigue and sleep disorders in children with cancer. This research used a quasi experiment research design with pre post with control group. AeRop exercise is a combination of aerobic exercise and progressive muscle relaxation that can avoid stiffness due to fatigue in cancer children and provide comfortness. The sample in this study amounted to 64 cancer children who were undergoing chemotherapy, 32 children received AeRop training and 32 children did not get AeRop exercise. Data analysis used is univariate and bivariate analysis dependent and independent T test. The results of this study showed almost significant difference in fatigue score after AeRop exercise p 0.05 . The results of this study also showed a significant difference in sleep disturbance score after AeRop exercise. This can be conclude that AeRop exercise is effective in overcoming sleep disorders in children with cancer. Improving the quality of child 39 s sleep is likely to have an effect on reducing cancer related fatigue."

"Kanker payudara merupakan penyakit dengan jumlah terbanyak pada populasi wanita Indonesia dengan prevalensi 42,1 per 100.000 penduduk. Kemoterapi menjadi modalitas pengobatan yang sering digunakan, namun menimbulkan berbagai efek samping. Keluhan fisik sebagai efek samping yang sering diungkapkan yakni gangguan tidur yang berdampak pada perkembangan kanker. Relaksasi pranayama merupakan sebuah intervensi non-farmakologi yang mengadopsi kearifan lokal budaya Bali, dipadukan dengan sleep hygine education, dijadikan sebagai upaya meningkatkan kualitas tidur. Penelitian ini bertujuan mengidentifikasi efektivitas kombinasi relaksasi pranayama dan sleep hygiene education pada pasien kanker payudara yang menjalani kemoterapi. Metode penelitian berupa quasi experimen dengan pendekatan pre-post with control group, sampel sebanyak 49 partisipan, terdiri dari 26 kelompok kontrol dan 23 kelompok intervensi. Penelitian dilaksanakan di RSUP Prof Ngoerah Denpasar, dengan mengajarkan teknik relaksasi pranayama dan sleep hygiene education pada kelompok intervensi serta perawatan biasa dan edukasi standar pada kelompok kontrol. Pengukuran menggunakan kuisioner PSQI dan sleep diary. Hasil penelitian menunjukkan relaksasi pranayama dan sleep hygiene education mampu menurunkan skor kualitas tidur kelompok intervensi dibandingkan kelompok kontrol, dengan nilai P=0,001 (α<0,05). Relaksasi pranayama dapat dijadikan sebagai intervensi mandiri perawat onkologi untuk memperbaiki kualitas tidur, serta menurunkan kelelahan, ansietas, mual muntah dan nyeri khususnya pada pasien kanker payudara yang sedang kemoterapi.

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Breast cancer is the most common disease in the Indonesian female population with a prevalence of 42,1 per 100.000 population. Chemotherapy is a treatment often used, but it causes various side effects. Physical complaints as a side effect that are often expressed are sleep disorders which have an impact on the development of cancer. Pranayama relaxation is a non-pharmacological intervention that adopts local Balinese cultural wisdom, combined with sleep hygiene education, as an effort to improve sleep quality. This study aims to identify the effectiveness combination of pranayama relaxation and sleep hygiene education in breast cancer patients undergoing chemotherapy. The method used quasi-experiment with a pre-post with control group approach, with a sample of 49 participants, consist of 26 control groups and 23 intervention groups. The research was conducted at Prof. Ngoerah General Hospital, by teaching pranayama relaxation techniques and sleep hygiene education to the intervention group as well as usual care and standard education to the control group. Measurements used the PSQI questionnaire and sleep diary. The results showed that pranayama relaxation and sleep hygiene education were able to reduce the sleep quality score of the intervention group compared to the control group, with a value of P=0.001 (α<0.05). Pranayama relaxation can be used as an independent intervention for oncology nurses to improve sleep quality, as well as reduce fatigue, anxiety, nausea, vomiting and pain, especially in breast cancer patients undergoing chemotherapy"

"Latar belakang: Pandemi Covid-19 menyebabkan terbentuknya beberapa kebijakan oleh pemerintah guna mencegah penyebaran penyakit. Kebijakan yang dibuat berupa PSBB (pembatasan sosial berskala besar). PSBB ini menyebabkan semua aktivitas yang tidak mendesak dilakukan dari rumah termasuk sekolah. Hal ini menyebabkan terjadinya perubahan kebiasaan terhadap anak-anak usia sekolah dasar. Perubahan kebiasaan tersebut berupa peningkatan penggunaan internet dan juga perubahan pola tidur. Orang tua yang memiliki anak usia sekolah dasar mengeluhkan bahwa sang anak menngalami penurunan kualitas tidur. Penurunan kualitas tidur dapat menjadi indikasi mengalami gangguan tidur yang kadang tidak disadari oleh sang anak dan orang tuanya. Gangguan tidur dapat berdampak kepada emosi, proses tumbuh kembang dan kognitifnya. Oleh karena itu, perlu diketahuinya hubungan aspek sosiodemografi terhadap gangguan tidur pada anak di sebelum dan selama pandemi Covid-19Metode: Penelitian ini menggunakan data sekunder dari projek SEANUTS II yang diambil dari anak usia 6-12 tahun di 22 Kabupaten/Kota di Indonesia. Jenis studi yang digunakan adalah before and after studies dengan uji yang digunakan adalah uji Chi-square, Uji normalitas, uji Kruskall-Wallis dan uji Mc-Nemar)Hasil: Prevalensi gangguan tidur pada periode sebelum pandemi sebesar 41.82%, sedangkan prevalensi gangguan tidur saat pandemi mengalami penurunan dibanding sebelum pandemi menjadi 40.19%. Akan tetapi, hubungan antara gangguan tidur dengan pandemi Covid-19 tidak memiliki hubungan yang bermakna (p>0.05) Terjadinya peningkatan prevalensi gangguan tidur pada domain sleep-wake transisiton disorders dan diorders of excessive sonolence pada periode saat pandemi dibanding sebelum pandemi. Tidak adanya hubungan yang signifikan antara jenis kelamin dan usia dengan gangguan tidur baik sebelum pandemi dan saat pandemi (p > 0.05). Akan tetapi, pada variabel area tempat tinggal periode sebelum pandemi memiliki hubungan yang signifikan dengan gangguan tidur (p < 0.05), sedangkan area tempat tinggal pada periode pandemi tidak memiliki hubungan yang siginifikan dengan gangguan tidur.Kesimpulan: Terjadinya penurunan prevalensi gangguan tidur pada pandemi dibanding sebelum pandemi. Tidak ditemukannya hubungan yang signifikan antara usia dan jenis kelamin dengan gangguan tidur baik periode sebelum dan selama pandemi, sedangkan aspek area tempat tinggal memiliki hubungan yang signifikan dengan gangguan tidur hanya pada periode sebelum pandemi.

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Abstrak Berbahasa Inggris:

Introduction: The Covid-19 pandemic has led to the formation of several policies by the government to prevent the spread of the disease. The policy made is in the form of PSBB (large-scale social restrictions). This PSBB causes all non-urgent activities to be carried out from home, including school. This causes a change in the habits of elementary school-age children. Changes in these habits are in the form of increased use of the internet and also changes in sleep patterns. Parents who have elementary school-aged children complain that their children experience a decrease in sleep quality. Decreased sleep quality can be an indication of having a sleep disorder that is sometimes not realized by the child and his parents. Sleep disturbances can have an impact on emotions, growth, and cognitive processes. Therefore, it is necessary to know the relationship between sociodemographic aspects to sleep disorders in children before and during the Covid-19 pandemic.

Method: This study used secondary data from the SEANUTS II project taken from children aged 6-12 years in 22 districts/cities in Indonesia. The type of study used is before and after studies with the tests used are the Chi-square test, normality test, Kruskal-Wallis test, and Mc-Nemar test)

Result: The prevalence of sleep disorders before the pandemic period was 41.82%, while the prevalence of sleep disorders during the pandemic was 41.82%. the pandemic has decreased compared to before the pandemic to 40.19%. However, the relationship between sleep disturbances and the Covid-19 pandemic was not significant (p>0.05). There was an increase in the prevalence of sleep disorders in the domain of sleep-wake transition disorders and orders of excessive somnolence during the pandemic period compared to before the pandemic. There was no significant relationship between sex and age with sleep disturbances before and during the pandemic (p > 0.05). However, the area of ​​residence in the pre-pandemic period had a significant relationship with sleep disturbances (p < 0.05), while the area of ​​residence during the pandemic period did not have a significant relationship with sleep disturbances.

Conclusion: There was a decrease in the prevalence of sleep disorders during the pandemic compared to before the pandemic. No significant relationship was found between age and sex with sleep disturbances both before and during the pandemic, while the area of ​​residence had a significant relationship with sleep disturbances only in the pre-pandemic period"

"Masalah tidur pada anak di rumah singgah yang sedang menjalani kemoterapi dapat meningkat bila tidak ditangani dengan tepat. Rumah singgah merupakan rumah kedua bagi anak dan orang tua/pendamping untuk tinggal bersama saat menjalani pengobatan. Jumlah anak dengan kanker yang tinggal di rumah singgah Jakarta dan Pekanbaru ada 104 anak. Penelitian ini bertujuan untuk menganalisis faktor yang dapat memengaruhi masalah tidur pada anak dengan kanker di rumah singgah. Jenis penelitian ini studi kuantitatif, dengan desain penelitian cross sectional, menggunakan tekhnik consecutive sampling. Penelitian dilakukan di rumah singgah Yayasan Kasih Anak Kanker Indonesia (YKAKI) Jakarta dan Pekanbaru dengan melibatkan 62 anak yang memenuhi kriteria inklusi (42 anak di Jakarta dan 20 anak di Pekanbaru). Pengambilan data menggunakan instrumen data demografi, Skala Fatigue Onkologi Anak_Allen (Skala FOA_A), Skala Depresi CES-DC, Skala Nyeri (Face), dan Skala Gangguan Tidur pada Anak (Skala GATIA). Hasil penelitian menunjukkan bahwa faktor yang berpengaruh terhadap masalah tidur di rumah singgah yaitu depresi (p=0,002, B=-9,907) dan jenis kanker (p=0,003, B=-4,480). Kedua faktor ini dapat dijadikan pertimbangan bagi perwat anak dalam memberikan intervensi yang tepat dan berkualitas dalam mengatasi masalah tidur di rumah singgah.

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Sleep problems which happened in children at halfway house are undergoing to the chemotherapy that can increase if it is not treated properly. A halfway house is a second home for children and their parents/guardians to live together while undergoing treatment. The number of children with cancer living in shelter homes that located in Jakarta and Pekanbaru are 104 children. The aims of this study is to analyze the factors that can affect sleep problems in children with cancer in shelter homes. This type of research is a quantitative study, with a cross-sectional research design, using a consecutive sampling technique. The study was conducted at the Indonesian Cancer Child Care Foundation (YKAKI) shelter in Jakarta and Pekanbaru, involving 62 children who met the inclusion criteria (42 children in Jakarta and 20 children in Pekanbaru). Data retrieval using demographic data instruments, Pediatric Oncology Fatigue Scale_Allen (FOA_A Scale), CES-DC Depression Scale, Pain Scale (Face), and Sleep Disorders Scale in Children (GATIA Scale). The results showed that the factors that influenced sleep problems in the halfway house were depression (p=0.002, B=-9.907) and the type of cancer (p=0.003, B=- 4.480). These two factors can be taken into consideration for pediatric nurses in providing appropriate and quality interventions in overcoming sleep problems in shelter homes."

"[ABSTRAK Latar belakang: Gangguan tidur adalah kumpulan kondisi yang ditandai dengan gangguan jumlah, kualitas, atau waktu tidur. Dampaknya adalah gangguan belajar, memori, perubahan mood, perilaku, dan kesulitan mempertahankan perhatian. Data intervensi Sleep Hygiene di Indonesia belum tersedia.Tujuan: Untuk mengetahui: (1) prevalens dan gambaran gangguan tidur, (2) pengaruh intervensi Sleep Hygiene pada keluhan mengantuk, mood, kesulitan bangun, dan durasi tidur, (3) pengaruh intervensi terhadap nilai SDSC dan PDSS.Metode: Penelitian quasi eksperimental di 3 SDN di Jakarta Pusat pada bulan Mei-Juni 2015. Skrining gangguan tidur menggunakan Sleep Disturbance Scale for Children (SDSC) dan Pediatric Daytime Sleepiness Scale (PDSS). Murid dengan gangguan tidur dimintakan persetujuan intervensi selama 8 minggu. Evaluasi dengan kuesioner SDSC dan PDSS.Hasil: Prevalens gangguan tidur 25,1%. Gambaran gangguan tidur yaitu Disorder of initiating and maintaining sleep (DIMS) 61,5%, Sleep wake transition disorder (SWTD) 61,5%, Disorder of excessive somnolence (DOES) 55,4%, dan Disorder of arousal (DA) 51,5%. Terdapat perbaikan keluhan mengantuk, perubahan mood, dan kesulitan bangun pagi. Terdapat penurunan nilai SDSC pre dan post intervensi (p < 0,001).Kesimpulan: Prevalens gangguan tidur anak usia sekolah 25,1%. Dampak intervensi sleep hygiene yaitu perbaikan keluhan mengantuk, perubahan mood, dan kesulitan bangun pagi. Terdapat perbedaan bermakan nilai SDSC pre dan post intervensi.ABSTRACT

Background: Sleep disorder is a condition characterized by disorder of amount, quality, or duration of sleep. Its impacts are difficulties in learning, memory, mood, behavior, and attention. No data of sleep hygiene intervention in Indonesia.

Objectives: To evaluate: (1) prevalence and description of sleep disorder in school age children, (2) impact of intervention on daytime sleepiness, mood, difficulty waking up, and duration of sleep, (3) impact of intervention on SDSC and PDSS score.

Methods: A quasi experiment study in 3 elementary school in Central Jakarta on Mei-June 2015. Screening of sleep disorder used the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Daytime Sleepiness Scale (PDSS). Students with sleep disorder followed intervention for 8 weeks. Evaluation used SDSC and PDSS.

Results: There were 25.1% subjects with sleep disorders, consisting of Disorder of initiating and maintaining sleep (DIMS) 61.5%, Sleep wake transition disorder (SWTD) 61.5%, Disorder of excessive somnolence (DOES) 55.4%, and Disorder of arousal (DA) 51.5%. There were improvements in daytime sleepiness, mood, difficulty waking up, and the SDSC score.

Conclusions: Sleep disorder prevalence in school age children is 25.1%. Sleep hygiene intervention shows improvement in daytime sleepiness, mood, difficulty waking up, and significant improvement of the SDSC score.;Background: Sleep disorder is a condition characterized by disorder of amount, quality, or duration of sleep. Its impacts are difficulties in learning, memory, mood, behavior, and attention. No data of sleep hygiene intervention in Indonesia.

Objectives: To evaluate: (1) prevalence and description of sleep disorder in school age children, (2) impact of intervention on daytime sleepiness, mood, difficulty waking up, and duration of sleep, (3) impact of intervention on SDSC and PDSS score.

Methods: A quasi experiment study in 3 elementary school in Central Jakarta on Mei-June 2015. Screening of sleep disorder used the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Daytime Sleepiness Scale (PDSS). Students with sleep disorder followed intervention for 8 weeks. Evaluation used SDSC and PDSS.

Results: There were 25.1% subjects with sleep disorders, consisting of Disorder of initiating and maintaining sleep (DIMS) 61.5%, Sleep wake transition disorder (SWTD) 61.5%, Disorder of excessive somnolence (DOES) 55.4%, and Disorder of arousal (DA) 51.5%. There were improvements in daytime sleepiness, mood, difficulty waking up, and the SDSC score.

Conclusions: Sleep disorder prevalence in school age children is 25.1%. Sleep hygiene intervention shows improvement in daytime sleepiness, mood, difficulty waking up, and significant improvement of the SDSC score., Background: Sleep disorder is a condition characterized by disorder of amount, quality, or duration of sleep. Its impacts are difficulties in learning, memory, mood, behavior, and attention. No data of sleep hygiene intervention in Indonesia.

Objectives: To evaluate: (1) prevalence and description of sleep disorder in school age children, (2) impact of intervention on daytime sleepiness, mood, difficulty waking up, and duration of sleep, (3) impact of intervention on SDSC and PDSS score.

Methods: A quasi experiment study in 3 elementary school in Central Jakarta on Mei-June 2015. Screening of sleep disorder used the Sleep Disturbance Scale for Children (SDSC) and the Pediatric Daytime Sleepiness Scale (PDSS). Students with sleep disorder followed intervention for 8 weeks. Evaluation used SDSC and PDSS.

Results: There were 25.1% subjects with sleep disorders, consisting of Disorder of initiating and maintaining sleep (DIMS) 61.5%, Sleep wake transition disorder (SWTD) 61.5%, Disorder of excessive somnolence (DOES) 55.4%, and Disorder of arousal (DA) 51.5%. There were improvements in daytime sleepiness, mood, difficulty waking up, and the SDSC score.

Conclusions: Sleep disorder prevalence in school age children is 25.1%. Sleep hygiene intervention shows improvement in daytime sleepiness, mood, difficulty waking up, and significant improvement of the SDSC score.]"