Tesis

Prevalens Insomnia dan Faktor yang Berhubungan dengan Insomnia pada Pasien Kanker Paru di Rumah Sakit Persahabatan = Prevalence of Insomnia and Factors Associated with Insomnia in Lung Cancer Patients at Persahabatan Hospital.

Latar belakang: Insomnia merupakan gangguan tidur yang sering dialami pasien kanker, termasuk kanker paru dan dapat menurunkan kualitas hidup serta memperburuk kondisi klinis. Faktor-faktor, seperti nyeri, efek terapi, status fungsional dan gangguan psikologis diduga berperan dalam timbulnya insomnia. Namun, data mengenai prevalens dan faktor yang berhubungan dengan insomnia pada pasien kanker paru di Indonesia masih terbatas. Metode: Penelitian ini merupakan studi potong lintang yang melibatkan 60 pasien kanker paru di RS Persahabatan, Jakarta. Data demografi subjek yang meliputi usia, jenis kelamin, indeks massa tubuh (IMT), komorbid, performance status, saturasi oksigen, nyeri, diagnosis kanker paru, stage kanker, pengobatan kanker, penggunaan obat opioid serta efek samping terapi dikumpulkan melalui wawancara dan telaah rekam medis. Kemungkinan terdapatnya gangguan jiwa pada pasien disingkirkan menggunakan instrumen MINI ICD-10. Selanjutnya, dilakukan penilaian insomnia menggunakan kuesioner insomnia severity index (ISI) dan penilaian kualitas tidur dengan kuesioner pittsburgh sleep quality index (PSQI). Analisis bivariat dilakukan menggunakan uji Chi-Square dan KruskalWallis, sedangkan analisis multivariat menggunakan regresi logistik ordinal. Hasil: Sebanyak 60 pasien diikutsertakan dengan prevalens insomnia sebesar 58,3%. Performance status menunjukkan hubungan bermakna dengan insomnia (p = 0,007; OR = 4,46; 95% CI = 1,50–13,30), sedangkan nyeri kanker dan penggunaan opioid tidak berhubungan bermakna (p > 0,05). Analisis kualitas tidur menggunakan PSQI tidak menemukan faktor independen yang berhubungan dengan kualitas tidur buruk. Kesimpulan: Insomnia sering terjadi pada pasien kanker paru dan berhubungan erat dengan penurunan status fungsional. Evaluasi dan penanganan insomnia perlu menjadi bagian integral dari perawatan suportif pasien kanker paru untuk meningkatkan kualitas hidup pasien.
Kata Kunci: insomnia, kanker paru, kualitas tidur, status performa


Background: Insomnia is a common problem among cancer patients, including those with lung cancer and may decrease quality of life and worsen clinical outcomes. Factors such as pain, treatment effects, functional status and psychological disturbances are suspected to contribute to the development of insomnia. However, data on the prevalence and factors associated with insomnia among lung cancer patients in Indonesia remain limited. Methods: This was a cross-sectional study involving 60 lung cancer patients at Persahabatan Hospital, Jakarta. Demographic data including age, sex, body mass index (BMI), comorbidities, performance status, oxygen saturation, pain, lung cancer diagnosis, cancer stage, cancer treatment, opioid use and treatment side effects were collected through interviews and medical record review. The possibility of psychiatric disorders was excluded using the MINI ICD-10 instrument. Insomnia was assessed using the insomnia severity index (ISI) questionnaire and sleep quality was evaluated with the pittsburgh sleep quality index (PSQI). Bivariate analysis was performed using the Chi-Square and Kruskal-Wallis tests, while multivariate analysis used ordinal logistic regression. Results: A total of 60 patients were included with an insomnia prevalence of 58.3%. Performance status showed a significant association with insomnia (p = 0.007; OR = 4.46; 95% CI = 1.50–13.30), whereas cancer-related pain and opioid use were not significantly associated (p > 0.05). Analysis of sleep quality using the PSQI revealed no independent factors associated with poor sleep quality. Conclusion: Insomnia is common among lung cancer patients and is closely associated with decreased functional status. Evaluation and management of insomnia should be an integral part of supportive care for lung cancer patients to improve their quality of life.
Keywords: insomnia, lung cancer, performance status, sleep quality