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"ABSTRAKDiabetes 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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ABSTRACTDiabetes 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."

"ABSTRACTpain 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."

"ABSTRAKTujuan: Mengetahui keluhan-keluhan pasien kanker ginekologi dalam perawatan paliatif dan persentase masing-masing keluhan pasien kanker ginekologi dalam perawatan paliatif.Metode: Penelitian potong lintang dilakukan melalui pembagian kuesioner Edmonton Symptom Assessment System ESAS yang telah dimodifikasi kepada seluruh pasien kanker serviks, kanker ovarium, dan kanker endometrium dalam perawatan paliatif di poli atau ruang perawatan Onkologi dan Ginekologi RSCM dan RSUP Fatmawati selama periode Maret-Juli 2017. Seluruh subjek yang memenuhi kriteria inklusi dan setuju berpartisipasi direkrut dengan metode consecutive sampling. Subjek yang tidak dapat berkomunikasi dengan baik akan dieksklusi. Pengolahan data dilakukan dengan SPSS versi 23.0 untuk Windows..Hasil: Terdapat 103 pasien kanker ginekologi yang termasuk dalam perawatan paliatif terdiri dari 50 pasien dengan kanker serviks, 50 kanker ovarium, dan 3 kanker endometrium. Pada pasien kanker serviks, keluhan paling banyak adalah kelelahan 56 , cemas 54 , kehilangan energi 52 dengan skor ESAS 4-6 sedang . Sementara itu, keluhan dengan skor ESAS 7-10 berat adalah nyeri 48 dan insomnia 46 . Pada pasien kanker ovarium, keluhan paling banyak adalah kelelahan 52 , lemah 48 , kehilangan energi 46 , cemas 44 , insomnia dan penurunan nafsu makan masing-masing 40 , nyeri dan anoreksia masing-masing 32 dengan skor ESAS 4-6 sedang . Sementara itu, keluhan mulut kering didapatkan pada 40 pasien dengan skor ESAS 1-3 ringan . Pada pasien kanker endometrium, keluhan paling banyak adalah kelelahan 66,7 dengan skor ESAS 4-6 sedang .Kesimpulan: Keluhan paling banyak dirasakan pada kanker ginekologi dalam perawatan paliatif adalah kelelahan, cemas, kehilangan energi, lemah, anoreksia, insomnia, dan nyeri.Kata Kunci: keluhan, kanker ginekologi, paliatif

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ABSTRACTAbstractObjective To know the symptoms profile of gynecological cancer patients in palliative care and the percentage of each gynecological cancer patient 39 s symptoms in palliative care.Method The cross sectional study was conducted through distributing questionnaires of the modified Edmonton Symptom Assessment System ESAS to all cervical, ovarian, endometrial cancer patients on palliative care at oncology gynecology outpatient clinic or inpatient in Dr. Cipto Mangunkusumo and Fatmawati hospital from March to July 2017. All subjects participating were recruited by consecutive sampling. Subjects were excluded whether not communicate well. The data were analyzed using SPSS version 23.0 for Windows.Result There were 103 gynecological cancer patients consisting of 50, 50, and 3 patients of cervical, ovarian, and endometrial cancer contributively. In cervical cancer, a lot of patients complained fatigue 56 , anxiety 54 , and lack of energy 52 with ESAS score of 4 to 6 medium . ESAS score of 7 10 severe was shown by pain 48 and insomnia 46 . In ovarian cancer patients, most complaints were fatigue, weakness, lack of energy, anxiety, insomnia and loss of appetite, pain and anorexia as 52 , 48 , 46 , 44 , 40 , 40 , 32 respectively with ESAS score 4 6 medium . While dry mouth was found in 40 patients with ESAS score 1 3 mild . In endometrial cancer, the complaint was about fatigue 66.7 with ESAS score of 4 6 medium .Conclusion A lot of gynecologic cancer patients in palliative care complained fatigue, anxiety, lack of energy, weakness, anorexia, insomnia, and pain.Keywords symptoms, gynecological cancer, palliative care"

"Perawat memiliki peran yang sangat penting dalam perawatan paliatif seperti penapisan. Penapisan perawatan paliatif dilakukan untuk mengetahui pasien kanker yang membutuhkan perawatan paliatif. Penapisan perawatan paliatif di RSUP Fatmawati belum berjalan dengan baik. Pada bulan Juni 2016, terdapat pasien kanker sebanyak 99 orang, tetapi tidak ada satupun pasien kanker yang dilakukan penapisan perawatan paliatif oleh perawat. Penelitian ini merupakan penelitian kualitatif yang bertujuan untuk mengetahui faktor-faktor yang mempengaruhi perilaku perawat terhadap penapisan perawatan paliatif pada pasien kanker RSUP Fatmawati. Hasil dari penelitian ini menunjukkan bahwa faktor individu pengetahuan , faktor organisasi pelatihan, kebijakan rumah sakit, sarana prasarana dan pengawasan dan faktor psikologis persepsi mempengaruhi perawat dalam melakukan penapisan perawatan paliatif. Setiap variabel dalam faktor tersebut memiliki masalah masing-masing terkait dengan penapisan perawatan paliatif. Oleh sebab itu, perlu diadakannya perbaikan pada setiap variabel untuk meningkatkan mutu pelayanan perawatan paliatif di RSUP Fatmawati. Kata Kunci : Penapisan perawatan paliatif, kanker, perilaku.

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Nurses have an important role in palliative care such as screening. Screening is performed to determine the palliative care of cancer patients requiring palliative care. Screening of palliative care in Fatmawati wasn rsquo t run well. In June 2016, there were as many as 99 cancer patients, but none of them who do palliative care screening by nurses. This thesis discusses about factors that affecting nurse rsquo s behavior to Palliative care screening in Cancer Patients at RSUP Fatmawati rsquo s Teratai Inpatient Care in 2016. This study is a qualitative research. The results of this study indicated that individual factors knowledge , organizational factors training, hospital policies, infrastructure and supervision and psychological factors perception affects palliative care screening. Each variable in these factors have their respective problems associated with palliative care screening. Therefore, each variable should be repaired to improve the quality of Palliative care services at Fatmawati Hospital. Keywords Screening of palliative care, cancer, behavior"

"Skripsi ini membahas mengenai peran Pekerja Sosial Medis (PSM) didalam perawatan paliatif yang bertujuan untuk meningkatkan kualitas hidup menggunakan metode pendekatan penelitian kualitatif dan jenis penelitian deskriptif. Informan yang digunakan dalam penelitian ini adalah pekerja sosial medis, pasien kanker stadium lanjut, keluarga pasien dan tim paliatif berdasarkan purposive sampling.Hasil penelitian ialah dari total sepuluh kualitas hidup yang menjadi acuan untuk melayani pasien dan anggota keluarga pasien, PSM memiliki peran yang mencakup 9 kualitas hidup, satu-satunya dimensi yang tidak melibatkan PSM adalah dimensi spiritual yang hanya dilakukan rohaniawan. Peran yang dilaksanakan oleh PSM adalah peran enabler, mediator, edukator dan motivator.

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The focus of the study is about medical social worker?s role in palliative care that have purpose to increasing the quality of life using research metodology of qualitative and description type of research. The informan who had been use for this study is Medical Social Worker, patient of cancer stadium IV, family of patient and team palliatve based on purposive sampling.The result of the research is that MSW has 9 role of 10 that palliative care unit have as it guide, only in spiritual dimention that MSW doesnt have any role. MSW role are enabler, mediator, educator dan motivator. "

"ABSTRAK Kanker serviks yang paling sering menyerang wanita dan menjadi salah satu penyakit serius di dunia yang mengancam jiwa. Insiden kanker serviks dilaporkan meningkat dari tahun ke tahun. Perempuan yang didiagnosa menderita kanker serviks dan menjalani terapi pengobatan sangat berpengaruh terhadap kualitas hidup pasien. Pengelolaan penderita lebih banyak berfokus pada kondisi sakit fisik, dan belum secara holistik integratif. Perawatan palliative belum mendapat perhatian khusus dalam memberikan asuhan keperawatan, masing-masing tenaga kesehatan hanya memberikan pelayanan t e r h a d a p kebutuhan fisik yang dirasakan penderita. Berdasarkan data WHO, terdapat lebih dari 40 juta orang di dunia yang membutuhkan perawatan palliative, namun hanya 14 saja yang baru memperolah perawatan tersebut. Sama halnya di Indonesia, masih banyak masyarakat yang belum mengetahui perawatan palliative itu sangat penting dalam upaya peningkatan kualitas hidup penderita. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis yaitu pengelolaan kasus klien kanker serviks dengan pendekatan studi kasus yang menerapkan teori adaptasi roy dan Konsep Palliative Care, dapat saling melengkapi sehingga asuhan dapat diberikan lebih maksimal.

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ABSTRACTCervical cancer most often affects women and becomes one of the world 39 s most life threatening illnesses. The incidence of cervical cancer is reported to increase from year to year. The treatment therapy for women diagnosed with cervical cancer greatly affects the quality of life of patients. Patient management focuses more on physical illness, and has not been holistically integrative. Palliative care has not received special attention in providing nursing care, each health worker only provide services to the physical needs of patients. Based on WHO data, there are more than 40 million people in the world who require palliative care, but only 14 are just getting the treatment. Similarly in Indonesia, there are still many people who do not know that palliative care is very important in an effort to improve the quality of life of patients. The purpose of this report is to provide an overview of the implementation of residency practice of ners specialist case management of cervical cancer clients. The application of Roy 39 s Theory of Adaptation and the Concept of Palliative Care can be complementary so that gives more leverage to the care."

"Nyeri pada pasien kanker serviks berupa nyeri kronik. Beberapa dampak dari nyeri kronik seperti kelemahan, depresi, insomnia, hambatan pada kehidupannya sehari-hari seperti mandi, berpakaian dan makan akan mempengaruhi kualitas hidup pasien. Perawatan paliatif merupakan jenis pelayanan kesehatan yang berfokus untuk meringankan gejala seperti nyeri sehingga diharapkan kualitas hidup pasien dapat meningkat. Imajinasi terbimbing adalah terapi komplementer yang digunakan untuk mengurangi nyeri dengan memanfaatkan narasi atau cerita yang tujuannya untuk mempengaruhi pikiran seseorang agar fokus dalam berimajinasi dan berkhayal. Tujuan dari laporan asuhan keperawatan ini adalah untuk menganalisis manfaat penerapan intervensi imajinasi terbimbing pada pasien kanker serviks yang menjalani operasi laparatomi debulking dan sistoscopi. Intervensi keperawatan yang diberikan berupa intervensi relaksasi nafas dalam dan imajinasi terbimbing. Setelah diberikan terapi imajinasi terbimbing dengan durasi 30 menit selama 4 hari berturut-turut, terjadi penurunan skala nyeri dari nyeri sedang (skala 6-4) menjadi ringan (skala 1-3). Selain itu, pasien juga menunjukan ekspresi yang lebih tenang, meningkatnya toleransi dalam beraktivitas, dan tidak tampak meringis kesakitan. Oleh karena itu, intervensi imajinasi terbimbing dapat digunakan sebagai upaya alternatif nonfarmakologis yang melengkapi intervensi farmakologis analgetik untuk mengurangi nyeri pada pasien kanker. Kata kunci: imajinasi terbimbing, kanker serviks, nyeri, perawatan paliatif......Pain in cervical cancer patients in the form of chronic pain. Some of the effects of chronic pain such as weakness, depression, insomnia, obstacles in daily life such as bathing, dressing and eating will affect the patient's quality of life. Palliative care is a type of health service that focuses on alleviating symptoms such as pain so that the patient's quality of life is expected to improve. Guided imagination is a complementary therapy that is used to reduce pain by utilizing narratives or stories whose purpose is to influence one's mind to focus on imagining and imagining. The purpose of this nursing care report is to analyze the benefits of implementing guided imagination interventions in cervical cancer patients undergoing debulking laparotomy and cystoscopy. The nursing interventions provided are deep breathing relaxation interventions and guided imagination. After being given guided imagination therapy with a duration of 30 minutes for 4 consecutive days, the pain scale decreased from moderate pain (scale 6-4) to mild (scale 1-3). In addition, the patient also showed a calmer expression, increased tolerance in activities, and did not seem to wince in pain. Therefore, guided imagination intervention can be used as an alternative non- pharmacological effort that complements analgesic pharmacological interventions to reduce pain in cancer patients"