PENGEMBANGAN MANAJEMEN PELAYANAN PALIATIF

Editoria

Causal Relationships of Sexual Dysfunction Factors in Women Using S3C-Latent

Women with cancer are at risk for sexual dysfunction characterized by problems with sexual desire, sexual arousal, lubrication, orgasm, sexual satisfaction, and pain during sexual intercourse. The literature review shows that most studies have focused on correlation analysis between factors, and no studies have attempted to identify a causal relationship between factors of sexual dysfunction. This study aims to determine the causal mechanism between factors of sexual dysfunction in cancer patients using a causal algorithm called the Stablespec Specification Search for Cross-Sectional Data With Latent Variables (S3C-Latent). The causal algorithm has been implemented into the R software package called Stablespec. The computation of the model is done in parallel using the CPU server. The result of this study is that there are a causal relationship and association with a high-reliability score of sexual dysfunction factors. We hope that the causal model obtained can be a scientific reference for doctors and health workers in making decisions so that the quality of life of female cancer patients who experience sexual dysfunction can be improved

Causal Relations of Factors Representing the Elderly Independence in Doing Activities of Daily Livings Using S3C-Latent Algorithm

The growth of the elderly population in Indonesia from year to year has always increased, followed by the problem of decreasing physical strength and psychological health of the elderly. These problems can affect the increase in dependence and decrease the independence of the elderly in ADL. In previous studies, various factors affect independence in ADLs such as cognitive, psychological, economic, nutrition, and health. However, In general, these studies only focus on predictive analysis or correlation of variables, and no research has attempted to identify the casual relationship of the elderly independence factors. Therefore, this study aimed to determine the mechanism of the causal relationship of the factors that influence the independence of the elderly in ADLs using a casual method called the Stable Specification Search for Cross-Sectional Data With Latent Variables (S3C-Latent). In this research we found strong causal and associative relationships between factors.The causal relationship of elderly independence in ADLs was influenced by cognitive, psychological, nutritional and health factors and gender with α values respectively (0.61; 0.61;1.00, 0.65;0.70). Cognitive factors associated with psychological, economic, nutrition, and health with a value of α (0.77; 1.00; 1.00; 0.64). Furthermore, psychological factors associated with economy, nutrition, and health with a value of α (0.77; 0.95; 0.63). Bisides, economic factors are associated with nutrition and health with α values of ( 0.86; 0.75) and nutrition with health with α values of 0.64. The last association was found between nutritional factors and gender with a value of α 0.76. This research is expected to increase the independence of the elderly in carrying out daily activities

Validity and reliability testing of home care stroke quality indicators

It is disconcerting that until today there are no agencies or research to recommend the appropriate indicators of home nursing care of stroke patients according to Indonesian conditions. Hence, this research aimed to verify the validity and reliability of quality indicators of home nursing care for stroke patient that resulted from Delphy process. Confirmatory factor analysis was carried out for validity and reliability testing with data collected from 350 respondents. Based on the value of loading factors, 62 indicators were declared valid and five indicators were invalid. This study successfully proved the validity of 62 indicators of quality home care for stroke patients. Further research is needed to pilot project this indicator in a larger area

Modified Delphi Consensus on Developing Home Care Service Quality Indicator for Stroke Survivor in Yogyakarta, Indonesia

BACKGROUND: Assessing the quality of health services provided at home (home care) is a challenge. The formulation of indicators requires open-minded people, who able to formulate several purposes objectively, and play an active role in decision making. PURPOSE: To test the face validity of the home care quality indicator in stroke patients with the modified Delphi method. METHOD: Eighty-one indicators generated from previous studies were assessed using 3 processes to get the final results: 1) conducted modified Delphi in two rounds, namely rating or scoring by experts (using median scores); 2) reviewing qualitative suggestions from experts during the Delphi process (using comments from both Delphi rounds); 3) sorting out and correcting the grammar of the appropriate indicator (based on the median score > 7, and no disagreement). RESULT: Eighty-seven experts were involved in the first round Delphi and 34 experts in the second round. The experts were home care team selected from health care institutions in Yogyakarta with various professional backgrounds. Delphi process resulted in 67 indicators from 81 indicators which were divided into 10 domains: 1) Personal (2 indicators), 2) Documents (13 indicators), 3) Professionalism development (3 indicators), 4) Supporting facilities (8 indicators), 5) Administrative activities (4 indicators), 6) Health workers interaction with patients and families (15 indicators), 7) Physical conditions (2 indicators), 8) Self-actualization (1 indicator), 9) Psychological condition (5 indicators), 10) Family independent and coping (14 indicators). Selected indicators got to score more than 7 and no disagreement at all. CONCLUSION: Sixty-seven indicators of the quality of home care, which were generated from modified Delphi consensus, were face validated. Further research could be conducted particularly on the trial process of these indicators at the actual home dwelling service setting

LITERATURE REVIEW: PENERAPAN TEORI ELLA JOY LEHRMAN-MORTHEN DAN REVA RUBIN PADA PELAYANAN PALIATIF IBU DENGAN KONDISI TERMINAL

Ibu dengan kondisi terminal memiliki kebutuhan akan pelayanan paliatif dengan melihat keadaan BIOPSIKOSOSIAL SPIRITUALNYA. Keadaan ini memungkinkan ibu mengalami penurunan keadaan psikologis yang dapat berdampak pada kesehatan ibu dan anak. Perawatan paliatif ini merupakan perawatan yang sangat komprehensif sehingga pelayanan yang diberikan dapat dipadukan dengan pendekatan teori Ella Joy Lehrman-Morthen dan Reva Rubin sehingga tujuan awal untuk mengetahui tidak hanya keadaan psikologis ibu akan tetapi keadaan janin juga dapat terpantau dengan baik.  Metode yang digunakan adalah analisa kualitatif dengan pendekatan literature review. Tujuan akhir dari pendekatan teori Ella Joy Lehrman-Morthen dan Reva Rubin dalam implikasi pelayanan paliatif secara berkesinambungan pada ibu dengan kondisi terminal yaitu ibu akan  dapat terus menjalankan peranannya tanpa ada keterbatasan dalam aktivitasnya. Tujuan dalam pelayanan ini dapat dicapai dengan pemberian komunikasi efektif pada pasien dan keluarga. Komunikasi efektif merupakan dasar dalam pengkajian sehingga kebutuhan dan permasalan juga penyelesaian dapat diberikan dengan maksimal. Pelayanan paliatif merupakan pelayanan komprehensif yang dapat menjadi wadah dalam implikasi pelayanan maternitas dengan menggunakan pendekatan teori Ella Joy-Lehrman dan Reva Rubin. Teori ini dapat meningkatkan kualitas hidup pasien dengan kondisi terminal sehingga secara BIOPSIKOSOSIAL SPIRITUAL pasien dapat memperoleh pelayanan baik maternitas maupun paliatif dengan maksimal. Kata kunci: pelayanan paliatif, teori Ella Joy-Lehrman dan Reva Rubin, ibu kondisi termina

Implementation of self-care symptom management program to enhance the quality of life of cancer patients undergoing chemotherapy and their family caregivers

Background: Chemotherapy affects the condition of cancer patients, physically, psychologically, socially and spiritually. The Self-care Symptom Management (SSM) program is a psychoeducation program with the goal of enhancing patients' self-care abilities to manage the side effects of chemotherapy, and thus improve the Quality of Life (QOL) of adult cancer patients and their family caregivers. The objective of the study is to determine the effects of the SSM program on the QOL of cancer patients undergoing chemotherapy and their family caregivers.Methods: The study adopts a quasi-experimental design, with one group and pre- and post-intervention tests. The study was conducted in a public hospital in Yogyakarta, Indonesia, with 40 cancer patients and 30 of their family caregivers. The QOL of patients is measured using the EORTC QLQ-C30, and for their family caregivers the CQOLC is used. Data analysis are carried out using a paired t-test and Wilcoxon test, with a 95% level of significance.Results: The data show significant differences between the mean scores on a single item of sleep disturbance (15.84 points) and a single item of financial difficulties (8.34 points) before and after the implementation of the SSM program. Clinical relevance is shown on a single item of sleep disturbance (≥10 points).Conclusions:The Self-care Symptom Management program represents a promising intervention to promote self-care management for cancer care in Indonesia.