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ABSTRAK
Diabetes merupakan penyakit progresif yang tidak hanya membutuhkan perawatan kuratif dan rehabilitatif tetapi juga perawatan paliatif.. Kepuasaan merupakan salah satu indikator penting tercapainya perawatan paliatif yang efektif sehingga pengukuran kepuasan pasien terhadap perawatan menjadi hal yang penting dilakukan. Penelitian ini dilakukan untuk mengetahui gambaran tingkat kepuasan pasien diabetes yang mendapatkan perawatan paliatif. Desain yang digunakan dalam penelitian ini adalah desain penelitian cross sectional menggunakan sampel pasien diabetes di balai asuhan keperawatan Jabodetabek sebanyak 43 responden yang dipilih dengan teknik purposive sampling. Instrumen yang digunakan adalah Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), dan Long-form Patient Satisfaction Questionnaire (PSQ-III). Hasil penelitian ini menunjukkan sebanyak 14% responden merasa cukup puas, 60,5% merasa puas, dan 25,6% merasa sangat puas. Pada penelitian ini juga ditemukan tidak ada perbedaan yang bermakna antara karateristik responden dengan tingkat kepuasan (p>0,05). Penelitian ini merekomendasikan kepada praktisi kesehatan untuk memperdalam pengetahuan mengenai perawatan paliatif dan mengaplikasikannya pada pelayanan kesehatan.

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ABSTRACT
Diabetes is a progressive disease that needs palliative care aside from curative and rehabilitative. Satisfaction play as one of the most important indicator to get effective achievement of palliative care, so the measurement of patient satisfaction with treatment is necessary. This study was conducted to describe the level of satisfaction of diabetes patients who receive palliative care. This study used cross sectional approach with 43 respondents of diabetic patients accommodate under nursing care centers in Jabodetabek selected with purposive sampling technique. This study used Home Care Client Satisfaction Instrument-Revised (HCCSI-R), Clien Satisfaction Inventory (CSI), and the Long-Form Patient Satisfaction Questionnaire (PSQ-III) to measure satisfaction level. The results showed that 14% of respondents felt quite satisfied, 60.5% were satisfied, and 25.6% felt very satisfied. This research also found that there is no significant differences between the characteristics of the respondents with the level of satisfaction (p> 0.05). The study recommend healthcare practitioners to deepen their knowledge about palliative care and apply it to health services.

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ABSTRACT
pain is one of the most often symptoms experienced by patients with advanced or chronic diseases which can cause a decrease in the quality of life of palliative patients. Pain in palliative patients has not yet received enough attention, especially factors associated with pain and its management. This study aimed to determine the factors associated with pain in palliative patients and also assess whether there is a two-way relationship between psychological factors and pain. In addition, we will also see whether spiritual services play a role in relieving pain. Methods: cross-sectional study were used and secondary data were obtained from medical records of 285 palliative patients at Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The data were processed to determine the psycho-socio-demographic characteristics, the reciprocal relationships of psychological and pain aspects, and the relationship of pharmacological therapy (opioids), non-pharmacological therapy (spiritual services), and combination of both therapies in pain management. Results: of the 285 palliative patients, 60.3% had pain, which was found more in cancer patients (74.4% vs 25.6%). Pain was found more in patients aged 41-60 years (51.1%), women (51.2%), and unemployed (30.2%). The severity of the pain was found to be significant in patients with depressive symptoms (p=0.045), while patients with anxiety symptoms (p=0.155) and sleep disorders (p=0.619) had no significant relationship. Pain experienced by palliative patients was not statistically significant in causing depression (p=0.058), anxiety (p=0.107), and sleep disorder (p=0.639). Moreover, pain management with opioids, spiritual services, or combination of them turned out to have significant results (p=0.022). Conclusion: pain in palliative patients is mainly experienced by cancer patients and the elderly. Psychological factors affect the condition of pain, so the management that includes biopsychosocial aspect will be able to reduce pain significantly.

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ABSTRAK
LatarBelakang: Di Indonesia insidens keganasan meningkat dan mayoritas datang pada stadium lanjut sehingga peran layanan paliatif sangat penting. Profil unmet needs pada pasien keganasan meliputi seluruh stadium belum tersedia di Indonesia dan di RSCM.Unmet needs diduga berperan pada kualitas hidup pasien keganasan. Tujuan: Mengetahui profil unmet palliative needs dan kualitas hidup pasien keganasan di RSCM. Metode: Studi ini merupakan studi potong lintang dengan metode pengambilan sampel secara konsekutif di poliklinik dan gedung rawat inap RSCM sejak bulan September hingga Desember 2015. Profil unmet needs diperoleh menggunakan kuesioner PNPC-sv sedangkan kualitas hidup dinilai dengan kuesioner EORTC QLQ-C30. Kriteria inklusi adalah pasien keganasan berusia 18 tahun atau lebih yang bersedia mengikuti studi. Kriteria eksklusi adalah pasien dengan gangguan kognitif, afektif, atau kondisi umum lemah sehingga tidak memungkinkan pengisian kuesioner. Hasil: Sejumlah 329 pasien didapatkan melalui consecutive sampling di poliklinik dan gedung A RSCM.Unmet needssecara umum masih tinggi dengan dominasi pada ranah fisik pada kisaran 59,5-73,2%; spiritual 58,1-78,1%; sosial (masalah dengan pasangan 58,8%; kesulitan menemukan orang untuk diajak bicara 66,1%), psikologis (takut dengan penderitaan akibat penyakitnya 56,7%; tidak siap dengan kondisi masa depan 62,9%) dan finansial (kehilangan penghasilan, 51,3%). Kualitas hidup global 66,7 dengan kecenderungan skor yang lebih baik pada item unmet needs yang lebih sedikit. Kesimpulan: Unmet palliative needs ranah spiritual, fisik, psikologis, sosial, dan finansial masih tinggi, dengan dominasi aspek spiritual dan fisik. Skor kualitas hidup global pasien keganasan di RSCM adalah 66,7, dengan skala fungsional terendah pada fungsi peran dan skala simtomatik tertinggi pada nyeri, fatik, dan masalah finansial

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ABSTRACT
Background: The incidence of cancer is increasing globally. In Indonesia the majority of them admitted at advanced stage where the target of treatment is to support the best possible quality of life.Unmet palliative needs are thought to be associated with quality of life and influenced by cultural background.The data regarding unmet palliative needs among all stages of cancer patients in Indonesia is limited. Objectives: To know unmet palliative needs profile and quality of life of cancer patients in RSCM. Method: This is a cross sectional study using consecutive sampling method in outpatient and inpatient clinic of Cipto Mangunkusumo Hospital since September to December 2015. Unmet palliative needs was evaluated using PNPC-sv while quality of life was evaluated with EORTC QLQ-C30. Inclusion criterias werecancer patients aged 18 years or more and approved to join the study. Exclusion criterias were cognitive or affective disorders, and medically unstable patient. Result: Three hundred twenty nine cancer patients joined the study. In general, unmet needs prevalence were high, with predominance of physical(59.5-73.2%); spiritual (58.1-78.1%); social (problems in the relationship with life companion 58.8%; difficulties in finding someone to talk to 66.1%), psychological (fear of physical suffering 56,7%; difficulty coping with the unpredictability of the future 62.9%) and financial (loss of income because of the disease, 51.3%). Global quality of life was 66.7 with a trend of better score in less items of unmet needs. Conclusion: The proportion of unmetspiritual, physical, phsycological, social, and financial needs are still high, with predominance of spiritual and physical domain. Global quality of life score of cancer patients in RSCM is 66.7, the lowest functional scale was role and highest symptomatic scale were pain, fatigue, and financial problems