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[ABSTRAK
Nyeri pada anak kanker berdampak jangka panjang dan jangka pendek. Sebagian besar orang tua tidak mengetahui cara mengkaji nyeri pada anak dan belum menggunakan skala nyeri yang sesuai dengan usia anak untuk mengukur nyeri. Pendidikan kesehatan tentang manajemen nyeri yang diberikan kepada pasien belum terstruktur sehingga informasi yang diberikan tidak optimal. Penelitian ini bertujuan untuk mengidentifikasi dampak intervensi edukasi terhadap pengetahuan, sikap dan keterampilan orang tua dalam mengelola nyeri pada anak dengan kanker. Desain penelitian ini menggunakan kuasi eksperimen dengan one grup pre test post test. Sampel berjumlah 29 orang di RSAB Harapan kita dan RSPAD Gatot Soebroto yang diambil secara consecutive sampling. Analisis data menggunakan McNemar dan Uji Chi Square. Hasil penelitian menunjukkan adanya perbedaan yang signifikan dalam aspek pengetahuan, sikap dan keterampilan orang tua dalam mengelola nyeri pada anak sebelum dan sesudah pendidikan kesehatan (pengetahuan, p=0,001; Sikap, p=0,001 dan keterampilan, p<0,001). Karakteristik orang tua yang berhubungan dengan pengetahuan dan sikap adalah pengalaman manajemen nyeri. Rekomendasi dari penelitian ini adalah pendidikan kesehatan tentang mengelola nyeri pada anak sebaiknya dilakukan secara intensif. hr> ABSTRACT
Pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. This study aims to identify the impact of education intervention to the parent?s knowledge, attitudes, and skills in managing pain of children suffers from cancer.This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). Characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Recommendation for this study is the health education about pain management should be carried out intensively.;Pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. This study aims to identify the impact of education intervention to the parent?s knowledge, attitudes, and skills in managing pain of children suffers from cancer.This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). Characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Recommendation for this study is the health education about pain management should be carried out intensively.;Pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. This study aims to identify the impact of education intervention to the parent?s knowledge, attitudes, and skills in managing pain of children suffers from cancer.This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). Characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Recommendation for this study is the health education about pain management should be carried out intensively.;Pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. This study aims to identify the impact of education intervention to the parent?s knowledge, attitudes, and skills in managing pain of children suffers from cancer.This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). Characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Recommendation for this study is the health education about pain management should be carried out intensively., Pain in children suffers from cancer gives effect in short term and long term. Most parents do not know how to assess pain in children. They have not used a pain scale based on children age to measure pain. Health education pain management has not been structured for patients so the given information is not optimal. This study aims to identify the impact of education intervention to the parent’s knowledge, attitudes, and skills in managing pain of children suffers from cancer.This study used a quasi-experimental with one group pretest-posttest. The sample was 29 people in RSAB Harapan Kita and Gatot Subroto Army Hospital, taken by consecutive sampling. The data was analyzed by McNemar and Chi Square. The results showed a significant difference in the aspect of knowledge, attitudes and skills of parent in the pain management of children before and after health education (knowledge, p = 0.001; Attitudes, p = 0.001 and skill, p < 0.001). Characteristics of parents associated with the knowledge and attitudes who have children suffers from cancer is pain management experience. Recommendation for this study is the health education about pain management should be carried out intensively.]

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ABSTRAK
Angka kesembuhan kanker pada anak di dunia, termasuk di Indonesia semakin meningkat seiring dengan kemajuan pengobatan dan perawatan pada anak kanker. Akan tetapi, penyintas kanker belum dapat lepas dari berbagai masalah baik fisik maupun psikososial, sehingga pelayanan kesehatan dan psikososial yang sesuai dengan kebutuhan mereka sangat penting. Tujuan penelitian ini adalah untuk mengetahui gambaran kebutuhan pelayanan kesehatan dan psikososial yang tepat. Penelitian ini menggunakan studi kualitatif fenomenologi, dilakukan wawancara semi terstruktur terhadap delapan orang remaja penyintas kanker anak yang hasilnya kemudian dianalisis menggunakan analisis tematik. Ada tujuh tema yang muncul dari hasil penelitian, yaitu: 1) kebutuhan pemeriksaan fisik secara kontinu, 2) kebutuhan edukasi pasien dan keluarga, 3) kebutuhan pelayanan kesehatan yang menyenangkan, 4) kebutuhan konseling psikologis, 5) kebutuhan dukungan dari teman dan keluarga, 6) kebutuhan dukungan dari sekolah, dan 7) kebutuhan pelayanan sosial. Hasil penelitian menunjukkan bahwa remaja penyintas kanker di Indonesia memiliki kebutuhan pelayanan yang hampir sama dengan penyintas kanker anak secara global. Tema-tema tersebut dapat dijadikan acuan dalam melakukan asuhan keperawatan yang optimal dan sesuai kebutuhan remaja penyintas kanker.

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Advances in childhood cancer treatment and therapy have improved the survival rates of childhood cancer survivors in the world as well as in Indonesia. However, as cancer survivors, they encounter physical and psychosocial problems and hence proper health facility and psychosocial support services are important. The aim of the research is to identify health facility & psychosocial services needed among adolescent childhood cancer survivors. The research used a phenomenological approach through semi-structured interview with eight adolescent childhood cancer survivors, the data was analyzed using thematic analysis. Seven themes of health facility and psychosocial services needs emerged from the analysis: follow-up care; education for patients and their families, comfort care from the clinical services, psychological counseling, support from family and friends, support from school and social services. The results show that adolescent childhood cancer survivors in Indonesia have similar services needs to ones in developed countries.The themes can be references for nurse to do optimal nursing care based on adolescent childhood cancer survivors needs.

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Nama : Noor Siti Noviani Indah SariProgram Studi : Magister Keperawatan Fakultas Ilmu KeperawatanJudul : Determinan Kejadian Fisura Ani Berat pada Anak dengan Kanker yang Mendapat Kemoterapi Fisura ani merupakan suatu kondisi yang dapat dialami oleh anak penderita kanker dan berdampak pada adanya ketidaknyamanan, gangguan pada proses pengobatan kanker, meningkatnya lama dan biaya perawatan. Penelitian ini bertujuan untuk mengidentifikasi faktor yang berhubungan dengan kejadian fisura ani berat pada anak dengan kanker yang mendapat kemoterapi. Penelitian ini menggunakan desain cross sectional, melalui teknik non probability sampling dengan jumlah responden 70 orang. Analisis data menggunakan Spearman, Chi square dan Regresi logistik ganda. Hasil penelitian menunjukkan kecenderungan kejadian fisura ani adalah fisura ani derajat ringan 61, 4 dan derajat berat 38,6 . Hasil analisis bivariat menunjukkan terdapat hubungan yang signifikan antara jenis kelamin, riwayat fisura ani dan kebiasaan perineal hygiene terhadap kejadian fisura ani berat p value , 0,05 . Kesimpulan penelitian ini jenis kelamin merupakan faktor utama yang berhubungan dengan kejadian fisura ani berat OR=26, p= 0,001 . Perawat diharapkan dapat meningkatkan kemampuan pengkajian, pengenalan faktor risiko, tanda dan gejala serta perawatan fisura ani pada anak dengan kanker yang berisiko mengalami fisura ani berat terutama pada anak laki-laki. Kata kunci:Anak, kanker, kemoterapi, fisura ani

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ABSTRACT Name Noor Siti Noviani Indah SariStudy Program Graduate Program Nursing FacultyTitle Determinant of Severe Anal Fissure Incident Among Children with Cancer Who Receiving Chemotherapy Anal fissure among children with cancer is a condition that affect child rsquo s comfort, treatment process, increased cost and lenght of stay. The aim of this study was to identify factors associated with the incidence of severe anal fissure among children with cancer receiving chemotherapy. This study used cross sectional where 70 respondents were choosen with non probability sampling technique. Analysis of data used Spearman, Chi square and Multiple logistic regression. The results of study showed a tendency fissure occurrence of anal fissure was mild degree 61,4 and severe degree 38,6 , and there was significant relationship between gender, history of anal fissure, and perineal hygiene habits to the incidence of severe anal fissure. The study concluded that gender was the determinant occurrence of severe anal fissure OR 26 p 0,001 . The nurses were expected to improve the assessment, recognition of risk factors, signs and symptoms as well as treatment of anal fissures especially among boys. Key words Children, cancer, chemotherapy, anal fissure

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Kanker pada anak memengaruhi kualitas hidup anak, dan keluarganya. Orang tua anak dengan kanker harus mampu beradaptasi dengan kondisi penyakit dan efek samping pengobatan. Penelitian ini bertujuan untuk mengetahui hubungan efikasi diri orang tua dengan kualitas hidup anak kanker usia 8-12 tahun. Penelitian kuantitatif menggunakan desain cross sectional dilakukan pada 39 orang tua dan 39 anak kanker yang dipilih dengan metode consequtive sampling. Alat ukur yang digunakan adalah Self-Efficacy Parenting Task Index (SEPTI) diisi oleh orang tua, dan The Pediatric Quality of Life Inventory (PedsQLTM). Alat ukur PedsQLTM yang digunakan terdiri dari dua, yaitu: PedsQLTM 4.0 Generic Core Scale dan secara khusus dengan menggunakan PedsQLTM 3.0 Cancer Module versi Indonesia diisi oleh anak kanker. Analisis data menggunakan uji korelasi Pearson. Hasil menunjukkan efikasi diri orang tua dengan kualitas hidup anak generik berkorelasi kuat dan arah korelasi positif (r=0,680), selanjutnya efikasi diri orang tua dengan kualitas hidup anak modul kanker juga berkorelasi kuat dan arah korelasi positif (r=0,715). Hasil penelitian ini merekomendasikan supaya orang tua dan anak kanker mendapat intervensi manajemen efek samping pengobatan kanker yang adekuat untuk meningkatkan efikasi diri dan kualitas hidup anak dengan kanker.

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Cancer in children affects the children quality of life, and their families. Parents of children with cancer must be able to adapt the disease conditions and treatment side effects. This study aims to determine the relationship between parental self-efficacy and the quality of life children with cancer aged 8-12 years. The quantitative study using a cross sectional design was carried out on 39 parents and 39 cancer children who were selected by consequtive sampling method. The measuring instrument used are the Self-Efficacy Parenting Task Index (SEPTI) filled by parents, and The Pediatric Quality of Life Inventory (PedsQLTM). The PedsQLTM measuring instrument used consists of two, namely: PedsQLTM 4.0 Generic Core Scale and specifically using PedsQLTM 3.0 Cancer Module Indonesian version, filled by children with cancer. Data analysis using Pearson correlation test. The results showed that parents self-efficacy with the children quality of life generic core scale correlated strongly and have positive correlation (r=0.680), then the parents self-efficacy with the children quality of life cancer module also correlated strongly and have positive correlation (r=0.715). The results of this study recommends that parents and children with cancer have adequate management of cancer treatment and side effects to improve self-efficacy and quality of life for children with cancer.

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Peran orang tua sangat penting dalam merawat anak kanker. Kepercayaan diri dan kemampuan orang tua dalam merawat anak kanker dilihat dari efikasi diri. Penelitian ini dilakukan untuk mengetahui faktor-faktor yang berhubungan dengan efikasi diri pada orang tua dengan anak kanker. Desain penelitian menggunakan cross sectional dengan sampel 66 orang tua dari anak kanker usia 0-14 tahun. Hasil penelitian menunjukkan bahwa 47 (71%) orang tua memiliki tingkat efikasi diri yang sedang. Terdapat hubungan yang bermakna antara tingkat pendidikan (p=0,003), status ekonomi (p=0,003), pengalaman diri (p=0,002), pengamatan model (p=0,002), persuasi verbal (p=0,008), dan dukungan keluarga (p=0,003) dengan efikasi diri orang tua. Perawat disarankan dapat memahami efikasi diri pada orang tua dan hubungannya dengan pengobatan dan perawatan anak dengan kanker. ......The role of parents is very important in treating children with cancer. Confidence and ability of parents in caring for children is seen from self-efficacy. This study was conducted to determine the factors associated with self-efficacy in parents with children with cancer. The design of this study was cross sectional with a sample size of 66 parents of cancer children aged 0-14 years. The results showed that 47 (71%) parents had a moderate level of self-efficacy. There was a significant relationship between education level (p=0.003), economic status (p=0.003), self-experience (p=0.002), model observation (p=0.002), verbal persuasion (p=0.008), and family support (p=0.008). =0.003) with parental self-efficacy. Nurses can understand self-efficacy in parents and their relationship with treatment and child care.

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Latar Belakang Kanker adalah penyebab kematian secara global dan merupakan penyebab utama kematian pada anak. Dampaknya besar pada anak-anak di negara berpenghasilan rendah dengan tingkat kelangsungan hidup di bawah 30% akibat diagnosis terlambat, pengobatan yang tidak memadai, dan diagnosis tidak tepat. Hingga saat ini, belum ada publikasi terkait epidemiologi kanker anak pada pasien RSCM. Metode Penelitian ini adalah studi deskriptif mengenai epidemiologi kanker pada anak di Rumah Sakit dr. Cipto Mangunkusumo pada tahun 2017 sampai dengan 2022. Penelitian ini menggunakan rekam medis dari Departemen Ilmu Kesehatan Anak RSCM. Hasil Di RSCM, terdapat 1699 kasus kanker anak pada tahun 2017-2022. Sepuluh kasus kanker anak tertinggi adalah leukemia limfositik akut (630 kasus, 39,5%), diikuti oleh leukemia mieloid akut (311 kasus, 19,5%), retinoblastoma (221 kasus, 13,8%), tumor tulang (100 kasus, 6,3%), neuroblastoma (81 kasus, 5,1%), limfoma non-Hodgkin (73 kasus, 4,6%), rhabdomiosarcoma (70 kasus, 4,4%), leukemia mieloid kronik (54 kasus, 3,4%), hepatoblastoma (31 kasus, 2,0%), dan tumor otak (23 kasus, 1,5%). Pasien laki-laki memiliki kemungkinan 1,3 kali lebih tinggi untuk mengalami kanker (971 kasus, 57,1%). Pasien dengan kategori usia 0-5 tahun mempunyai prevelansi kanker paling tinggi (881 kasus, 51,9%), dan kebanyakan berdomisili di DKI Jakarta (552 kasus, 32,5%). Luaran pasien kebanyakan pada tahap loss-to-follow-up (664 kasus, 39,0%), dan 2021 adalah tahun dengan kasus terbanyak (335 kasus, 19,7%). Kesimpulan Dengan mengetahui epidemiologi kanker anak di RSCM, dapat dibuat sebuah strategi untuk prioritas penanganan kasus kanker tertinggi pada anak. Lalu, menjaga database yang terkini dengan melakukan follow-up secara berkala untuk mendapatkan data yang akurat mengenai relaps, kematian, penyembuhan, dan lost-to-follow-up dan dibutuhkan sebuah studi epidemiologi multi-senter yang mencakup prevalensi kanker anak di Indonesia untuk memperbaiki penanganan kanker anak. ......Introduction Cancer is a leading global cause of death, particularly among children. Its impact is substantial in low-income countries, where survival rates are below 30% due to delayed diagnosis, inadequate treatment, and misdiagnosis. To date, there have been no publications regarding the epidemiology of childhood cancer in RSCM patients. Method This research is a descriptive study on the Epidemiology of Childhood Cancer at dr. Cipto Mangunkusumo Hospital from 2017 to 2022. This study utilizes medical records from the Department of Pediatrics at RSCM. Results At RSCM, there were 1699 cases of childhood cancer from 2017 to 2022. The top ten childhood cancer cases were acute lymphoblastic leukemia (630 cases, 39.5%), followed by leukemia mieloid akut(311 cases, 19.5%), retinoblastoma (221 cases, 13.8%), bone tumors (100 cases, 6.3%), neuroblastoma (81 cases, 5.1%), non-Hodgkin lymphoma (73 cases, 4.6%), rhabdomyosarcoma (70 cases, 4.4%), chronic myeloid leukemia (54 cases, 3.4%), hepatoblastoma (31 cases, 2.0%), and brain tumors (23 cases, 1.5%). Male patients have a 1,3 times higher likelihood of experiencing cancer (971 cases, 57.1%). Patients in the 0-5 age group have the highest cancer prevalence (881 cases, 51.9%), and most of them reside in Jakarta (552 cases, 32.5%). The majority of patients had an outcome classified as loss-to-follow-up (664 cases, 39.0%), and 2021 had the highest number of cases (335 cases, 19.7%). Conclusion By understanding the epidemiology of childhood cancer at RSCM, a strategy can be developed to prioritize the management of the highest cases of childhood cancer. Maintaining an up-to-date database by conducting regular follow-ups is essential to obtain accurate data on relapses, deaths, recoveries, and cases lost to follow-up. A multicenter epidemiological study that includes the prevalence of childhood cancer in Indonesia is needed to improve the management of childhood cancer.