Tesis

Profil Unmet Palliative Needs dan Kualitas Hidup Pasien Keganasan di RSCM = Unmet Palliative Needs Profile and Quality of Life of Cancer Patients in Cipto Mangunkusumo Hospital.

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.
Kata kunci: layanan paliatif, unmet needs, masalah paliatif, kualitas hidup, keganasan



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.
Keyword: palliative care, unmet needs, palliative problems, quality of life, cancer, Indonesia.