Tesis

Hubungan Kesejahteraan Spiritual dan Kualitas Hidup pada Pasien Kanker Stadium Lanjut = The Association ofSpiritual Well-Being with Quality of Life in Advanced Cancer Patients.

Latar Belakang: Gejala dan efek pengobatan kanker dapat berdampak pada aspek fisik, psikologis, sosial, dan spiritual yang pada akhirnya akan memengaruhi kualitas hidup pasien. Spiritualitas sebagai bagian dari perawatan paliatif kurang mendapat perhatian baik dalam aspek pelayanan maupun penelitian. Tujuan: Mengetahui prevalensi kesejahteraan spiritual yang buruk dan kualitas hidup yang buruk pada pasien kanker stadium lanjut, mengetahui hubungan kesejahteraan spiritual dan kualitas hidup pada pasien kanker stadium lanjut dengan memerhatikan faktor demografis, fisik, psikologis, dan sosial-budaya. Metode: Penelitian ini berdesain potong lintang menggunakan data dari survey multisenter berjudul Asian Patient Perspectives Regarding Oncology Awareness, Care, and Health (APPROACH) di Indonesia. Subjek terdiri dari pasien kanker solid stadium IV berusia 21 tahun atau lebih yang mendapat terapi kanker di RSUPN Dr. Cipto Mangunkusumo. Kesejahteraan spiritual dinilai berdasarkan kuesioner FACIT Sp-12 dengan nilai cut off36. Kualitas hidup dinilai berdasarkan kuesioner FACT-G, nilai cut off ditentukan berdasarkan kurva ROC. Variabel perancu terdiri dari usia, jenis kelamin, pendidikan, status pernikahan, pekerjaan, gejala nyeri, distres psikologis, agama, pengetahuan tentang penyakit, preferensi tempat meninggal, dan keterlibatan keluarga dalam pengambilan keputusan. Hasil: Dari 116 subjek penelitian didapatkan sebanyak 27,6% memiliki kesejahteraan spiritual yang buruk. Berdasarkan nilai cut off 67,5 pada skor total kualitas hidup, didapatkan sebanyak 41,4% subjek memiliki kualitas hidup yang buruk. Hubungan kesejahteraan spiritual dan kualitas hidup signifikan secara statistik dengan PR 2,415 (IK95% 1,626 – 3,586, p < 0,0001). Hasil ini tetap signifikan setelah dilakukan adjustment terhadap faktor perancu dengan fully adjusted PR 1,942 (IK 95 % 1,329 – 2,836, p=0,001). Simpulan : Kesejahteraan spiritual berhubungan dengan kualitas hidup pada pasien kanker stadium lanjut.
Kata Kunci: kesejahteraan spiritual, kualitas hidup, kanker stadium lanjut.


Background: Symptoms and effects of cancer treatment can impact physical, psychological, social, and spiritual aspects, which ultimately affect the quality of life of patients. Spirituality as part of palliative care receives less attention in both medical service and research aspects. Objective: To examine the prevalence of poor spiritual well-being and poor quality of life among advanced cancer patients, and the association between spiritual wellbeing and quality of life in advanced cancer patients, considering demographic, physical, psychological, and sociocultural factors. Method: This study was designed as a cross-sectional study using secondary data from a multicenter survey titled Asian Patient Perspectives Regarding Oncology Awareness, Care, and Health (APPROACH) in Indonesia. The subjects are stage IV solid cancer patients aged 21 years or older who were treated at RSUPN Dr. Cipto Mangunkusumo, Jakarta, and received cancer treatment. Spiritual wellbeing was assessed based on the FACIT Sp-12 questionnaire, with a cut-off value of 36. Quality of life was assessed based on the FACT-G questionnaire, the cut-off value was determined using the ROC curve.. The confounding variables consist of age, gender, education, marital status, occupation, pain symptoms, psychological distress, religion, knowledge about the disease, preferred place of death, and family involvement in decision-making. Results: Out of 116 study subjects, 27.6% were found to have poor spiritual wellbeing. Based on the cut-off value of 67.5 for the total quality of life score, it was found that 41.4% of the subjects had poor quality of life. The relationship between spiritual well-being and quality of life is statistically significant with a PR of 2.415 (95% CI 1.626 – 3.586, p < 0.0001). These results remain significant after adjusting for confounding factors with a fully adjusted PR of 1.942 (95% CI 1.329 – 2.836, p=0.001). Conclusion: Spiritual well-being is associated with the quality of life in patients with advanced-stage cancer.
Keywords: spiritual well-being, quality of life, advanced stage cancer