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"Penerapan teori Comfort Kolcaba ini dilakukan pada 5 kasus kelolaan yang berbeda untuk memenuhi kebutuhan rasa nyaman nyeri yang berfokus pada faktor fisik, psikospiritual, sosiokultural, dan lingkungan. Asuhan keperawatan untuk memenuhi kebutuhan rasa nyaman nyeri tersebut dilakukan dengan menggunakan intervensi standard comfort, coaching dan comfort food for the soul, yaitu dengan memberikan guided imagery sehingga pasien dapat mencapai tingkat kenyamanan relief, ease, dan transcendence. Evaluasi menggunakan numeric rating scale menunjukkan hasil diakhir perawatan nyeri berkurang, terkontrol dan peningkatan kenyamanan. Residen menyarankan agar meningkatkan peran kemitraan antara perawat, petugas kesehatan lainnya dan keluarga serta melakukan asuhan keperawatan berbasis evidence based practice dalam memberikan asuhan keperawatan pada pasien kanker anak yang mengalami nyeri.

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The application of this theory is done in 5 different managed cases to fulfil the needs of pain-comfort senses which is focused on physical, psychospiritual, sociocultural, and environmental factors. This nursing care uses standard comfort, coaching and comfort food for the soul to fulfil the needs of pain-comfort senses, that the clients can achieve relief, ease, and transcendence comfort. Resident suggests increasing the role of the partnership between nurses, other health workers and family and do nursing care based on evidence based practice."

"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.

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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."

"Kanker merupakan suatu penyakit yang ditandai dengan pertumbuhan sel yang tidak terkendali dan bisa menyebar ke organ lain. Kanker tidak hanya menjadi masalah bagi orang dewasa namun juga menjadi masalah bagi anak-anak. Penanganan kanker pada anak harus mengintegrasikan perawatan paliatif. Orang tua sekaligus caregiver utama mempunyai peranan penting dalam perawatan paliatif. Penelitian ini bertujuan untuk mengetahui kebutuhan dan pengalaman caregiver dalam merawat anak kanker kondisi paliatif. Pendekatan yang digunakan dalam penelitian ini yakni metode fenomenologi dengan melibatkan 9 partisipan Pengumpulan data dilakukan dengan teknik wawancara mendalam (indepth interview). Data penelitian berupa transkrip wawancara dan analisa data menggunakan metode Colaizzi. Hasil penelitian ini didapatkan 5 tema yaitu: orang tua fokus merawat anak, perjalanan menuju resiliensi, kebutuhan support system, gangguan ekonomi dan perubahan peran sosial serta harapan kesejahteraan anak Kesimpulan penelitian ini adalah berdasar 5 tema didapatkan orang tua sebagai care giver mempunyai peranan yang cukup besar dalam merawat anak kanker kondisi paliatif dan menyiapkan akhir yang dignity Perawat berperan dalam memberdayakan fungsi orang tua agar tercapai peningkatan kualitas hidup pada anak kanker serta memberikan asuhan keperawatan yang holistik.

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Cancer is a disease characterized by uncontrolled cell growth and can spread to other organs. Treatment of cancer in children must integrate palliative care. Parents as well as primary caregivers have an important role in palliative care. This study aims to determine the needs and experiences of caregiver in treating children with cancer in palliative conditions. The approach used in this study is phenomenology involving 9 participants. The results of this study 5 themes: parents fokus on caring for children, the journey to resilience, the need for a support system, economic disturbances and changes in social roles and expectations of child welfare. The conclusion of this study is based on 5 The theme is found that parents as care givers have a significant role in caring for children with cancer in palliative conditions and preparing for a dignified ending. Nurses play a role in empowering parents' functions to achieve an increase in the quality of life for children with cancer and provide holistic nursing care."

"Latar belakang: Penyakit kanker pada anak masih memiliki angka kematian yang tinggi. Pandemi Coronavirus disease 2019 (COVID-19) dapat memperlebar kesenjangan luaran pasien kanker anak di negara berkembang dengan negara maju. Data mengenai pasien kanker anak dengan COVID-19 terkonfirmasi di negara berkembang masih terbatas.Tujuan: Mengetahui prevalens dan luaran pasien kanker anak dengan COVID-19 terkonfirmasi serta faktor yang memengaruhinya agar luaran kanker dapat optimal.Metode: Penelitian ini merupakan studi prognostik dengan desain penelitian kohort retrospektif di rumah sakit rujukan nasional menggunakan data rekam medis. Subyek penelitian adalah pasien kanker anak usia 0-18 tahun dengan COVID-19 terkonfirmasi yang dirawat di pusat COVID-19 - RSCM pada Maret 2020 – Juni 2023. Data deskriptif mengenai prevalens, karakteristik, dan luaran dikumpulkan, dilakukan juga analisis untuk mengetahui pengaruh antara jenis kanker, fase pengobatan, penundaan pengobatan, dan derajat keparahan COVID-19 terhadap luaran.Hasil: Dari 585 pasien kanker anak yang dirawat, 110 (18,8%) di antaranya terkonfirmasi COVID-19 berdasarkan swab PCR SARS-COV-2. Pasien mayoritas berusia 0-5 tahun (39,1%), menderita kanker darah (50,9%), dalam fase pengobatan (88,1%), dan pengobatan tersebut tertunda sebanyak 56,4%. Gejala tersering adalah demam (78,2%), nilai CT PCR terbanyak terdeteksi di bawah 30 (54,6%), dan mayoritas mengalami COVID-19 derajat ringan (55,5%). Tata laksana yang diberikan adalah terapi oksigen (29,1%) dengan penggunaan ventilator sebanyak 8,2% dan dirawat di PICU sebanyak 12,7%, pemberian antivirus (69,1%), antibiotik (80,9%), antiinflamasi (14,5%), dan antikoagulan (22,7%). Sebanyak 19,1% kasus meninggal dan mayoritas terjadi pada 14 hari pertama perawatan. Kesintasan kumulatif adalah 66,1% dan rerata kesintasan selama 40 hari (IK 95% 33,743-46,064). Jenis kanker, fase pengobatan, dan penundaan pengobatan tidak berpengaruh bermakna terhadap luaran kematian. Sementara, derajat keparahan COVID-19 berpengaruh bermakna terhadap luaran kematian dengan HR 4,38 (IK 95% 1,34-14,26; p=0,000) pada derajat sedang/berat dan HR 16,29 (IK 95% 4,83-54,8; p=0,014) pada derajat kritis.Simpulan: Prevalens dan angka kematian pasien kanker anak dengan COVID-19 terkonfirmasi lebih tinggi dibanding COVID-19 pada anak secara keseluruhan, terutama di negara berkembang. Penundaan kemoterapi dapat dipertimbangkan, terutama dalam 14 hari pertama perawatan di rumah sakit.

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Background: Pediatric cancer still has a high mortality rate. The Coronavirus disease 2019 (COVID-19) pandemic has further widened the disparity in pediatric cancer outcomes between developing and developed countries. Limited data exist on the prevalence and consequences of pediatric cancer with confirmed COVID-19 in developing countries.

Objectives: To determine the prevalence and outcomes of these patients and identify influencing factors to optimize cancer outcomes.

Method: This prognostic study employed a retrospective cohort design at a tertiary referral hospital in Indonesia using medical record data. Subjects included pediatric cancer patients aged 0-18 years with confirmed COVID-19 treated at the Kiara COVID-19 Center – dr. Cipto Mangunkusumo Hospital from March 2020 to June 2023. Descriptive data on prevalence, characteristics, and outcomes were collected, along with analysis of the relationship between cancer type, treatment phase, delayed treatment, and COVID-19 severity.

Result: Among 585 pediatric cancer patients treated, 110 (18.8%) were confirmed COVID-19 based on SARS-COV-2 PCR. The majority were aged 0-5 years (39,1%), diagnosed with blood cancer (50,9%), undergoing radio-chemotherapy (88,1%), and delayed treatment 56,4%. Fever was the most prevalent symptom (78.2%), the most CT PCR values were below 30 (54,6%), with 55,5% experiencing mild COVID-19. Management included oxygen therapy (29,1%) with ventilator use (8.2%) and intensive care (12.7%), antiviral (69.1%), antibiotic (80.9%), anti-inflammatory (14.5%), and anticoagulant (22.7%). The mortality rate was 19,1% and the highest number of deaths occurred within 14 days of hospitalization. Cumulative survival was 66.1% and a mean survival was 40 days (95% CI 33.743-46.064). Cancer type, treatment phase, and delayed treatment were not association with mortality outcomes. Meanwhile, COVID-19 severity was associated with mortality outcomes with HR 4.38 (95% CI 1.34-14.26; p=0.000) in moderate/severe COVID-19 and 16.29 (95% CI 4.83-54.8; p=0.014) in critical case.

Conclusion: The prevalence and mortality rates of pediatric cancer with confirmed COVID-19 are notably higher than the general pediatric COVID-19, especially in developing countries. Chemotherapy may be considered postponed, particularly within the first 14 days of hospitalization."

"ABSTRAKDiagnosis dan pengobatan kanker anak dapat menimbulkan stres pada anak kanker dan orang tua. Tujuan penelitian untuk mengidentifikasi faktor-faktor yang mempengaruhi stres anak kanker dan ibunya. Penelitian ini menggunakan rancangan cross sectional dengan jumlah sampel sebanyak 99 responden anak kanker dan ibunya melalui teknik consecutive sampling. Hasil penelitian menunjukkan bahwa faktor yang berpengaruh terhadap stres anak yaitu usia anak, frekuensi dukungan sosial anak, dan frekuensi stres ibu. Hasil analisis berikutnya didapatkan bahwa usia anak sebagai faktor yang paling berpengaruh terhadap stres anak (p=0,003). Variabel yang berpengaruh terhadap stres ibu adalah usia ibu, tingkat pendidikan, status pernikahan, jumlah anak, dukungan sosial ibu, kepentingan dukungan anak, jenis terapi anak dan stres anak. Hasil analisis berikutnya didapatkan bahwa status pernikahan sebagai faktor yang paling berpengaruh terhadap stres ibu (PIP-F, p=0,013; PIP-D, p=0,010). Perlu dioptimalkan dukungan sosial dan manajemen stres untuk dapat meningkatkan koping anak dan ibu sehingga tercapai kualitas hidup yang lebih baik

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ABSTRACTThe diagnosis and treatment of pediatric cancer might be stressful for children and their parents. The Research aims to identify factors that correlate to the child dan their mothers‟stress. This study used cross sectional design, with total sample of 99 cancer children and their mothers. The result shown that some variables affect child‟s stress: child‟s age, frequency of social support and frequency of mother‟s stress. The study further found that child‟s age as the most factor associated with child‟s stress (p=0,003). Variables that affect mother‟ stress: Mother‟s age, education level, marital status, number of children, mother‟s social support, the important of social support, therapy and child‟s stress. The study further found that marital status as the most factor associated with mother‟s stress (PIP-F p=0,013; PIP-D p=0,010). Social support and stress management need to be optimized to improve coping of children and mother to reach a better quality of life."

"pasien yang membutuhkan. Kesimpulan: Pengetahuan mahasiswa tahap klinik lebih tinggi dibandingkan tahap preklinik, dilihat dari hasil jawaban dan nilai rerata kuesioner. Sikap mahasiswa tahap preklinik dan klinik terhadap kanker anak beragam. Hampir 50% subjek tidak tertarik menjadi dokter spesialis anak subspesialis pediatrik onkologi dengan beberapa alasan. Namun, subjek tetap menunjukkan sikap bentuk kepedulian untuk pasien kanker anak.

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Introduction: Cancer cases are a significant cause of global mortality, particularly among children. As medical students, it is important to understand early symptoms of cancer in children. However, there is currently no data regarding the knowledge and awareness of medical students towards pediatric cancer in Indonesia. Therefore, this research aims to determine the level of knowledge and awareness of students at the Faculty of Medicine, University of Indonesia, towards pediatric cancer. Method: The research was conducted out by distributing a questionnaire from the South Asian Journal of Cancer, consisting of 18 presented in English, along with Indonesian translations below each question. Results: A total of 217 subjects from FKUI completed this research questionnaire, with a distribution of 96 males and 121 females. The subjects were from batch 2017 to 2021, with 102 (47%) students in the preclinical phase and 115 (53%) students in the clinical phase. Regarding knowledge about pediatric cancer, 53,9% preclinical students were able to answer more than 50% of the questions correctly, while a larger number of clinical phase students, namely 76,5%, achieved this. The overall mean score for the preclinical phase was 4.56 out of 8, while the clinical phase had a higher mean score of 5.38 out of 8. In terms of attitudes toward pediatric cancer, 40,1% preclinical students and 35,6% clinical students expressed an interest in becoming pediatricians. Among these, 51,2% students did not wish to specialize in pediatric oncology, with the most common reason being a lack of adequate knowledge about pediatric cancer. According to 65,4% subjects, the best way to raise awareness about pediatric cancer is through mass media communication. Most (67,7%) subjects also mentioned that a form of support as medical students for pediatric cancer patients is donating blood to those in need. Conclusion: Clinical phase students have a higher level of knowledge compared to preclinical phase students, as observed from their questionnaire responses and mean scores. The attitudes of preclinical and clinical phase students toward pediatric cancer vary. Nearly 50% of the subjects are not interested in becoming pediatric oncologists for several reasons. However, the subjects still demonstrate a positive attitude toward pediatric cancer patients."

"[ABSTRAKNyeri merupakan salah satu masalah utama pada pasien kanker anak. Karya Ilmiah Akhir ini bertujuan memberikan gambaran penerapan, analisis Comfort Theory Kolcaba pada pasien kanker anak dengan nyeri, dan pencapaian kompetensi ners spesialis keperawatan anak. Penerapan teori dilakukan pada lima pasien, menggunakan pendekatan proses keperawatan. Pengkajian dan penetapan masalah keperawatan menggunakan struktur taksonomi Kolcaba. Intervensi dan implementasi menggunakan intervensi kenyamanan standar, coaching, dan comfort food for the soul. Evaluasi menggunakan comfort behavior scale menunjukkan hasil diakhir perawatan, nyeri berkurang, terkontrol, dan kenyamanan bertambah. Kompetensi tercapai sesuai target. Comfort Theory bisa menjadi pilihan dalam merawat pasien kanker anak dengan nyeri.

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ABSTRACTPain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.;Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer., Pain is one of main problems in children with cancer. This study aimed to describe and to analyze: (1) the application of Kolcaba's Comfort Theory on children with cancer who experience pain, and (2) the competencies achieved by pediatric clinical nurse specialist. The theory was applied to five patients using nursing process approach. The assessment and decision of the nursing problem was conducted using Kolcaba's taxonomic structure. The intervention and implementation using standard comfort intervention, coaching, and comfort food for the soul. Comfort behavior scale was used for the evaluation. The results showed that at the end of the nursing implementation, pain was reduced, controlled, and the comfort was increased. The targeted competencies were achieved. Comfort Theory can be recommended for caring children with cancer.]"

"ABSTRAKAngka 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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ABSTRACTAdvances 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."