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Abstrak :
Salah satu gejala paling umum dan menyedihkan yang dilaporkan pasien kanker selama kemoterapi adalah fatigue. Fatigue yang dialami pasien berdampak besar terhadap aktifitas sehari-hari. Taichi merupakan salah satu intervensi mind-body yang terbukti meningkatkan kesehatan mental dan kondisi psikologis. Penelitian ini bertujuan untuk menilai efektifitas latihan tai-chi dalam menurunkan fatigue pada pasien kanker payudara yang sedang menjalankan kemoterapi. Desain penelitian Randomized Clinical Trial (RCT) dengan 50 sampel secara consecutive sampling, 25 kelompok intervensi dan 25 kelompok kontrol. Hasil penelitian latihan taichi efektif menurunkan skor fatigue pada pasien kanker payudara yang menjalankan kemoterapi dibandingkan kelompok kontrol yang mendapatkan standard care di rumah sakit (p= 0,01). Rekomendasi penelitian latihan taichi diberikan pada pasien kanker payudara untuk mengatasi fatigue dalam menjalankan kemotarapi. ......Fatigue is one of the most common and distressing symptoms reported by cancer patients during chemotherapy. Patient fatigue has a significant impact on daily activities. Tai-chi is a mind-body intervention that improves mental health and psychological state. This research aims to evaluate the effectiveness of Tai-chi exercise in reducing fatigue in breast cancer patients undergoing chemotherapy. Research design Randomized Clinical Trial (RCT) with 50 samples by consecutive sampling, 25 intervention groups, and 25 control groups. The results of the Tai-chi exercise effectively reduced fatigue scores in breast cancer patients undergoing chemotherapy compared to the control group who received standard care at the hospital (p = 0.01). Research recommendations Tai-chi exercise is given to breast cancer patients to overcome fatigue in running chemotherapy.

Abstrak :
Penelitian ini diadakan untuk mengetahui peran persepsi dukungan sosial dalam memprediksi posttraumatic growthpada pasien kanker payudara. Pengalaman menderita kanker payudara dapat menjadi pengalaman traumatis, sehingga pasien membutuhkan persepsi dukungan sosial dari orang di sekitarnya. Responden dalam penelitian ini adalah perempuan dengan kanker payudara, minimal berusia 18 tahun, menjalani operasi paling cepat dua bulan lalu, serta berobat di Jabodetabek. Alat ukur yang digunakan adalah Multidimensional Scale of Perceived Social Support (MSPSS) dan Posttraumatic Growth Inventory (PTGI). Data dari 53 responden diolah dengan analisis simple linear regression. Ditemukan bahwa persepsi dukungan sosial berkontribusi sebesar 10,2% terhadap posttraumatic growthF(1,51) = 5,761, p<0,05. Disimpulkan bahwa persepsi dukungan sosial memprediksi posttraumatic growth di mana semakin tinggi persepsi dukungan sosial, semakin tinggi posttraumatic growth. Persepsi dukungan sosial membuat pasien memaknai pengalaman traumatisnya lebih positif, sehingga memunculkan posttraumatic growth. Hasil penelitian ini mendorong tenaga profesional untuk mengadakan intervensi kepada pasien kanker payudara dan orang-orang di sekitarnya, sehingga pasien mampu mempersepsikan dukungan sosial yang ada serta mengalami perubahan positif.

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This study was conducted to examine the role of perceived social support in predicting posttraumatic growth among breast cancer patients. The experience of suffering from breast cancer can be a traumatic experience, so patients need perceived social social support from people around them. Respondents in this study were women who had breast cancer, at least 18 years of age, had surgery at least two months ago, and had treatment in Jabodetabek. The Multidimensional Scale of Perceived Social Support (MSPSS) scale and Posttraumatic Growth Inventory (PTGI) scale were used. Data from 53 respondents were analyzed using simple linear regression analysis. The result showed that perceived social support was contributed 10.2% to posttraumatic growth, F (1,51) = 5.761, p <0.05. It was concluded that the perceived social support predicts posttraumatic growth which the higher perceived social support, the higher posttraumatic growth. Perceived social support can encourage patients to interpret their traumatic experience positively, thus improve their posttraumatic growth. The result of this study encourages professional staff to deliver intervention to breast cancer patients and people around them, so they can perceive the support then experience the positive changes.

Abstrak :
[ABSTRAK
Kanker merupakan faktor penting dalam beban penyakit global saat ini. Kasus baru setiap tahun terus meningkat. Angka kasus kanker payudara di Rumah Sakit Kanker Dharmais masih menempati urutan pertama dari jenis kanker lain. Informasi mengenai kualitas hidup perempuan dengan kanker payudara menjadi sangat penting mengingat masih tingginya angka kasus kanker payudara serta untuk memberikan dukungan kepada pasien kanker payudara dalam keberlangsungan hidup jangka panjang. Kualitas hidup pasien kanker payudara tak luput dari faktor karakteristik individu, faktor karakteristik klinis dan faktor lingkungan sosial. Penelitian ini menggunakan desain case series dengan 90 sampel diambil secara consecutive sampling. Hasil penelitian menunjukkan bahwa usia, terapi yang sedang dijalani, paparan informasi serta dukungan keluarga berhubungan dengan kualitas hidup pasien kanker payudara. Saran untuk Rumah Sakit Kanker Dharmais agar lebih meningkatkan penyebaran informasi tentang kanker payudara, bagi masyarakat meningkatkan dukungan keluarga terhadap pasien kanker payudara.

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ABSTRACT
Cancer is an important factor in the current global disease burden. New cases each year continues to increase. The numbers of breast cancer cases in the Dharmais Hospital Cancer still ranks first than other types of cancer. Information on the quality of life of women with breast cancer becomes very important considering the high number of cases of breast cancer and to provide support to breast cancer patients in the long-term survival. The quality of life of breast cancer patients litely dependent the individual characteristic, clinical characteristics and social environmental factors. This study used a case series design with 90 samples employed consecutive sampling. The results showed that age, the therapy being undertaken, breast cancer exposure information as well as family support related to the quality of life of the breast cancer patients. Suggestions one made to the Dharmais Cancer Hospital to further improve the dissemination of information about breast cancer, in the family to increase family support for breast cancer patients.;Cancer is an important factor in the current global disease burden. New cases each year continues to increase. The numbers of breast cancer cases in the Dharmais Hospital Cancer still ranks first than other types of cancer. Information on the quality of life of women with breast cancer becomes very important considering the high number of cases of breast cancer and to provide support to breast cancer patients in the long-term survival. The quality of life of breast cancer patients litely dependent the individual characteristic, clinical characteristics and social environmental factors. This study used a case series design with 90 samples employed consecutive sampling. The results showed that age, the therapy being undertaken, breast cancer exposure information as well as family support related to the quality of life of the breast cancer patients. Suggestions one made to the Dharmais Cancer Hospital to further improve the dissemination of information about breast cancer, in the family to increase family support for breast cancer patients.;Cancer is an important factor in the current global disease burden. New cases each year continues to increase. The numbers of breast cancer cases in the Dharmais Hospital Cancer still ranks first than other types of cancer. Information on the quality of life of women with breast cancer becomes very important considering the high number of cases of breast cancer and to provide support to breast cancer patients in the long-term survival. The quality of life of breast cancer patients litely dependent the individual characteristic, clinical characteristics and social environmental factors. This study used a case series design with 90 samples employed consecutive sampling. The results showed that age, the therapy being undertaken, breast cancer exposure information as well as family support related to the quality of life of the breast cancer patients. Suggestions one made to the Dharmais Cancer Hospital to further improve the dissemination of information about breast cancer, in the family to increase family support for breast cancer patients.;Cancer is an important factor in the current global disease burden. New cases each year continues to increase. The numbers of breast cancer cases in the Dharmais Hospital Cancer still ranks first than other types of cancer. Information on the quality of life of women with breast cancer becomes very important considering the high number of cases of breast cancer and to provide support to breast cancer patients in the long-term survival. The quality of life of breast cancer patients litely dependent the individual characteristic, clinical characteristics and social environmental factors. This study used a case series design with 90 samples employed consecutive sampling. The results showed that age, the therapy being undertaken, breast cancer exposure information as well as family support related to the quality of life of the breast cancer patients. Suggestions one made to the Dharmais Cancer Hospital to further improve the dissemination of information about breast cancer, in the family to increase family support for breast cancer patients., Cancer is an important factor in the current global disease burden. New cases each year continues to increase. The numbers of breast cancer cases in the Dharmais Hospital Cancer still ranks first than other types of cancer. Information on the quality of life of women with breast cancer becomes very important considering the high number of cases of breast cancer and to provide support to breast cancer patients in the long-term survival. The quality of life of breast cancer patients litely dependent the individual characteristic, clinical characteristics and social environmental factors. This study used a case series design with 90 samples employed consecutive sampling. The results showed that age, the therapy being undertaken, breast cancer exposure information as well as family support related to the quality of life of the breast cancer patients. Suggestions one made to the Dharmais Cancer Hospital to further improve the dissemination of information about breast cancer, in the family to increase family support for breast cancer patients.]

Abstrak :
Kejadian berulang atau kekambuhan kanker payudara bukan hanya menyerang kembali fisik, namun juga kondisi psikis pasien kanker payudara. Serangkaian pemeriksaan untuk memprediksi kemungkinan kambuh kanker payudara sangat dibutuhkan untuk mencegah terjadinya kekambuhan kanker payudara. Pemeriksaan darah lengkap merupakan salah satu rangkaian peme iksaan awal pasien kanker payudara yang relatif murah dan mudah. Belum ada penelitian sebelumnya mengenai perhitungan inter rasio pada pemeriksaan darah lengkap untuk mendiagnosis penyakit kanker, khususnya kemungkinan kambuh kanker payudara. Hasil penelitian ini diharapkan dapat membantu tenaga medis dalam memprediksi kemungkinan pasien kambuh berdasarkan klasifikasi dari hasil perhitungan inter rasio pemeriksaan darah lengkap. Data dalam penelitian ini diambil dari rumah sakit XYZ di Jakarta dengan 47 pasien. Algoritma klasifikasi yang digunakan dalam penelitian ini yaitu Classification and Regression Tree (CART) untuk mengetahui variabel yang berpengaruh dalam klasifikasi pasien kambuh dan tidak kambuh. Pada penelitian ini digunakan teknik SMOTE untuk mengatasi permasalahan data tidak seimbang. Variabel inter rasio pemeriksaan darah lengkap antara rasio dari neutrofil terhadap limfosit dan rasio dari platelet terhadap sel darah putih, inter rasio pemeriksaan darah lengkap antara rasio dari limfosit terhadap monosit dan rasio dari limfosit terhadap sel darah putih, inter rasio pemeriksaan darah lengkap antara rasio dari hemoglobin terhadap platelet dan rasio dari platelet terhadap sel darah putih, inter rasio pemeriksaan darah lengkap antara rasio dari platelet terhadap limfosit dan rasio dari hemoglobin terhadap platelet merupakan variabel yang berpengaruh dalam mendiagnosis kekambuhan dengan tingkat akurasi 93.7%, sensitivity 100%, specificity 87.5% pada training data yang sudah seimbang dengan teknik SMOTE. Selanjutnya hasil klasifikasi tersebut dikuantifikasi menggunakan metode regresi logistik untuk mengetahui seberapa besar peran masingmasing variabel dalam memprediksi kekambuhan pasien. ......Repeated events or recurrences of breast cancer not only re-attack the condition of breast cancer patients physically, but also psychologically. Diagnostics checking to predict the relapse possibility of breast cancer patients is needed to prevent the recurrence of breast cancer. Complete blood count are one of the diagnostic checking of early breast cancer patients that relatively cheap and easy. There has been no previous research on the calculation of inter-ratios for complete blood count to diagnose cancer, especially possibility relapse of breast cancer. The results of this study are expected to help medical personnel in predicting the relapse possibility of breast cancer patients based on the classification of the results of the inter ratio calculation of complete blood count. The data in this study were taken from XYZ hospital in Jakarta with 47 patients. The classification algorithm used in this study is Classification and Regression Tree (CART) to determine the effect of the variables in the classification of relapse and non-relapse patients. In this study, the SMOTE technique was used in handling imbalanced data problems. Inter ratio of complete blood tests between the ratio of neutrophils to lymphocytes and the ratio of platelets to white blood cells, inter ratio of complete blood tests between the ratio of lymphocytes to monocyte and the ratio of lymphocytes to white blood cells, inter ratio of complete blood tests between the ratio of hemoglobin to platelet and the ratio of platelet to white blood cells, and inter ratio of complete blood tests between the ratio of platelet to lymphocytes and the ratio of hemoglobin to platelet are the variables that influence in diagnosing recurrence with 93.7% accuracy rate, 100% sensitivity, and 87.5% specificity on training data that balanced using SMOTE technique. Furthermore, the results of the classification are quantified using the logistic regression method to determine how substantial the role of each variable in predicting patients relapse.

Abstrak :
ABSTRAK
Kanker adalah penyebab kematian nomor dua di dunia dan diperkirakan mencapai 9,6 juta kematian pada tahun 2018, dengan kanker payudara menjadi kanker kedua yang sering terjadi setelahnya kanker paru-paru. Kanker payudara terjadi karena pertumbuhan sel abnormal yang tidak terkendali, yang dimulai di saluran yang membawa susu ke puting susu atau kelenjar pembuat susu. Pengobatan kanker payudara tergantung pada subtipe tumor, stadium, penanda genetik, usia pasien, kesehatan pasien umum, status menopause, dan mutasi pada gen kanker payudara yang diwariskan. Di akhir pengobatan pasien diberikan terapi tambahan yang bertujuan meminimalkan risiko kekambuhan. Meskipun terapi ini telah dilakukan, risiko kekambuhan tetap ada. Penanda pengganti adalah penanda yang digunakan untuk menggantikan titik akhir dari uji klinis yang biasanya digunakan mempercepat penanganan pasien. Tujuan dari penelitian ini adalah untuk mengetahui rasio hematologi pengukuran yang dapat digunakan sebagai penanda pengganti dalam kekambuhan kanker payudara sepanjang dengan titik cut-off. Pohon keputusan digunakan untuk menemukan titik batas rasio hematologi pengukuran yang mempengaruhi kekambuhan kanker payudara, dan kemudian hutan acak itu digunakan untuk mengetahui urutan variabel penting dalam klasifikasi. Hasil keduanya metode dikuantifikasi menggunakan regresi logistik. Berdasarkan analisis, ditemukan bahwa rasio jumlah trombosit ke darah putih (titik potong 47.560) dan neutrofil terhadap rasio limfosit (titik potong 1,953) mempengaruhi kekambuhan kanker payudara.

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ABSTRACT
Cancer is the number two cause of death in the world and is estimated to reach 9.6 million deaths in 2018, with breast cancer becoming the second most common cancer that follows lung cancer. Breast cancer occurs because of uncontrolled abnormal cell growth, which starts in the ducts that carry milk to the nipples or milk glands. Treatment of breast cancer depends on the tumor subtype, stage, genetic markers, patient age, general patient health, menopausal status, and mutations in inherited breast cancer genes. At the end of treatment the patient is given additional therapy aimed at minimizing the risk of recurrence. Despite this therapy, the risk of recurrence remains. A surrogate marker is a marker used to replace the endpoints of clinical trials that are usually used to speed up patient management. The aim of this study is to determine the hematological ratio measurements that can be used as surrogate markers in breast cancer recurrence along with the cut-off point. The decision tree is used to find the hematological ratio boundary point measurements that affect breast cancer recurrence, and then the random forest is used to determine the order of important variables in the classification. Both results the method is quantified using logistic regression. Based on the analysis, it was found that the ratio of platelet count to white blood (cut point 47,560) and neutrophils against lymphocyte ratio (cut point 1.953) influences breast cancer recurrence.

Abstrak :
Demam neutropenia merupakan efek samping yang sering terjadi setelah kemoterapi. Demam neutropenia dapat menyebabkan penundaan dosis kemoterapi sehingga dapat mengurangi efektivitas terapi. Kejadian demam neutropenia paskakemoterapi dapat dicegah dengan pemberian Granulocyte-colony Stimulating Factor (G-CSF). Regimen kemoterapi yang digunakan dapat memengaruhi kejadian demam neutropenia. Selain itu, usia, stadium kanker, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi merupakan faktor risiko demam neutropenia paskakemoterapi. Penelitian ini bertujuan untuk mengetahui perbandingan kejadian demam neutropenia regimen TAC (dosetaksel, doksorubisin, siklofosfamid) dengan profilaksis primer G-CSF dan regimen FAC (fluorourasil, doksorubisin, siklofosfamid) pada pasien kanker payudara di RSUP Dr. Hasan Sadikin Bandung periode Januari 2017-Juni 2019. Desain penelitian adalah cross sectional uji dua populasi. Jumlah sampel sebanyak 61 regimen TAC dan 102 regimen FAC. Kejadian demam neutropenia dianalisis menggunakan chi-square. Hasil penelitian menunjukkan kejadian demam neutropenia paskakemoterapi lebih banyak terjadi pada regimen TAC dengan profilaksis primer G-CSF dibandingkan dengan regimen FAC. Kejadian demam neutropenia 12 kali lebih banyak terjadi pada regimen TAC dengan GCSF dibanding regimen FAC. Usia, stadium kemoterapi, riwayat kemoterapi dan kadar hemoglobin sebelum kemoterapi secara statistik tidak signifikan memengaruhi kejadian demam neutropenia paskakemoterapi.

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Febrile Neutropenia is a common side effect of chemotherapy. Febrile neutropenia can cause delayed chemo doses that can reduce the effectiveness of therapy. The incidence of febrile neutropenia can be prevented by administering Granulocyte-colony Stimulating Factor (G-CSF). The chemotherapy regimen can affect the incidence of febrile neutropenia. In addition, age, stage of cancer, history of chemotherapy and prechemotherapy hemoglobin level are risk factors for febrile neutropenia. This study aimed to compare the incidence of febrile neutropenia between TAC (docetaxel, doxorubicin, cyclophosphamide) regimen with G-CSF primary prophylaxis and FAC regimen (fluorouracil, doxorubicin, cyclophosphamide) in breast cancer patients at RSUP Dr. Hasan Sadikin Bandung period January 2017 - June 2019. The study design was cross sectional test of two populations. The sample consisted of 61 TAC regimen and 102 FAC regimen. The incidence of febrile neutropenia were analyzed using chi-square. The results showed that the incidence of post-chemotherapy febrile neutropenia is more common in TAC regimen with G-CSF primary prophylaxis than FAC regimen. The incidence of neutropenia is 12 times more common in TAC regimens with G-CSF than FAC regimen. Age, stage of chemotherapy, history of chemotherapy and pre-chemotherapy hemoglobin levels did not statistically significantly influence the incidence of febrile neutropenia.

Abstrak :
Kanker payudara merupakan penyebab kematian tersering pada wanita. Salah satu faktor risiko kanker payudara adalah obesitas. Obesitas merupakan masalah kesehatan global yang diderita 13% populasi dunia. Sekitar 56 % pasien kanker payudara mengalami obesitas. Sebagian besar pasien kanker payudara dengan obesitas mengalami peningkatan berat badan setelah diagnosis dan semakin memberat saat mejalani terapi anti-kanker. Peningkatan massa lemak berperan dalam progresivitas sel kanker dan resistensi kanker terhadap kemoradiasi. Asam lemak omega-3, yaitu eicosapentaenoic acid (EPA) dan docosahexaenoic acid (DHA) merupakan nutrien spesifik dalam terapi medik gizi pasien kanker. Penelitian menunjukkan EPA dan DHA dapat memiliki efek anti-kanker, antiinflamasi, dan anti-obesitas yang dapat menurunkan massa lemak, berat badan, dan meningkatkan sensitivitas terapi anti-kanker. Terapi medik gizi dilakukan pada empat pasien kanker payudara dengan obesitas dengan rentang usia 44–58 tahun. Satu pasien tidak mencapai target asupan energi dan satu pasien melebihi target asupan energi, dengan rentang rerata asupan 23–31 kkal/kgBB. Satu pasien tidak mencapai target asupan protein dengan rentang rerata asupan 1–1,4 g/kgBB. Asupan nutrien spesifik asam amino rantai cabang keempat pasien belum mencapai 10 g/hari dengan rentang rerata asupan 8,3–9,3 g/hari. Asupan EPA dan DHA keempat pasien memiliki rentang rerata 1,8–1,9 g/hari. Tiga dari empat pasien mengalami penurunan berat badan dan free fat mass index (FFMI), satu pasien mengalami peningkatan BB dan FFMI, dan dua dari empat pasien mengalami peningkatan kekuatan genggam. Satu pasien mengalami peningkatan C-reactive protein (CRP) dan satu pasien mengalami penurunan CRP. Keempat pasien memiliki rasio neutrofil limfosit diatas 3,49 yang mengindikasikan peningkatan risiko rekurensi. Keempat pasien mengalami toksisitas akur ringan selama radioterapi. Kendala utama dalam aplikasi terapi medik gizi pada keempat pasien adalah tingkat kepatuhan terhadap preskripsi yang semakin menurun menjelang minggu akhir pemantauan Dibutuhkan tatalaksana gizi lebih lanjut pasca radiasi untuk mencapai target nutrisi disertai peningkatan aktivitas fisik untuk mempertahankan atau meningkatkan massa otot. ......Breast cancer is a leading cause of death in women. One risk factor for breast cancer is obesity, a global health problem affecting 13% of the world's population. About 56% of breast cancer patients are obese. Most breast cancer patients with obesity gain weight after diagnosis and get worse while undergoing anti-cancer therapy. Increased fat mass plays a role in the progression of cancer cells and cancer resistance to chemoradiation. Omega-3 fatty acids, namely eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are specific nutrients in medical nutrition therapy for cancer patients. Research shows that EPA and DHA have anti-cancer, anti-inflammatory, and anti-obesity effects that can reduce fat mass and body weight and increase the sensitivity of anti-cancer therapy. Medical nutrition therapy was done on four obese breast cancer patients aged 44–58. One patient did not reach the energy intake target, and one exceeded the energy intake target, with a mean intake range of 23–31 kcal/kg BW. One patient did not achieve the target protein intake with an average intake of 1–1.4 g/kg BW. The intake of specific nutrients for branched-chain amino acids in the four patients had not yet reached ten g/day with a mean intake range of 8.3–9.3 g/day. The EPA and DHA intakes of the four patients had a mean range of 1.8–1.9 g/day. Three of four patients experienced weight loss and free fat mass index (FFMI), one patient experienced an increase in weight and FFMI, and two of four patients experienced an increase in grip strength. One patient had an increase in C-reactive protein (CRP), and one had a decrease in CRP. All four patients had a neutrophil-lymphocyte ratio above 3.49, indicating an increased risk of recurrence. All four patients experienced mild acute toxicity during radiotherapy. The main obstacle in applying medical nutrition therapy to the four patients was the level of adherence to prescriptions which decreased towards the end of the monitoring week. Further nutritional management after radiation was needed to achieve nutritional targets with increased physical activity to maintain or increase muscle mass.