Mapping and Visualization of Cancer Research in Indonesia: A Scientometric Analysis

Feasibility, acceptability, and preliminary effectiveness of implementing a 12-week home-based aerobic and resistance exercise program for breast cancer patients receiving endocrine treatment in Indonesia: A mixed methods study

Objectives

To assess the feasibility, acceptability, and preliminary effectiveness of implementing a home-based aerobic and resistance exercise for patients with breast cancer receiving endocrine treatment in Indonesia.

Methods

This is a mixed methods study with concurrent design consisting of quantitative single-arm pre-post intervention and qualitative study. We recruited patients with breast cancer (N = 36) receiving endocrine treatment and assigned 12 weeks of home-based pedometer-driven walking and resistance exercises using therapeutic bands. Descriptive statistics were used to assess the feasibility (recruitment, retention, and adherence) and safety. The modified Bruce treadmill test was used to measure predicted aerobic capacity (V̇O2 peak). Quality of life and fatigue were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire and fatigue severity scale. Measurements were performed at baseline and post-intervention and analyzed with the paired t-test or Wilcoxon test. Semi-structured interviews and thematic analysis were conducted post-intervention to explore patients' acceptability.

Results

The results showed a recruitment rate of 75%, retention rate of 89%, and adherence rates were 53% for aerobic and 78% for resistance exercise. No severe adverse events were reported. Post-intervention interviews identified positive attitudes toward the intervention, with low burden and high perceived benefit. Exercise duration and predicted V̇O2 peak increased significantly (+1.1 min, p = 0.001 and +2.3 ml/kg/min, p = 0.043), but no significant change was detected for Quality of Life (p > 0.050) or fatigue severity (p = 0.299).

Conclusions

A home-based aerobic and resistance exercise was feasible when implemented in the context of routine care in our study population, improving predicted aerobic capacity. Further research is required to understand limited changes to Quality of Life and fatigue and adaptations to support implementation in additional sites in Indonesia.

Ensuring reliability and cultural validity of the Indonesian version of the Quality Of Life Index for patients with cancer

The objective of this study was to translate the Ferrans and Powers Quality of Life Index (QLI) into the Indonesian language, considering its cultural and functional appropriateness, and to evaluate its psychometric properties by testing the reliability and validity. A committee approach was conducted to create the Indonesian version of the QLI (QLI-Id) and cognitive interviewing with 15 patients with cancer was conducted to identify potential problems or errors in answering the QLI-Id. A cross-sectional descriptive study was carried out using 236 responses to the QLI-Id questionnaire from patients with cancer; 62 of whom completed the same questionnaire twice within a 3-week interval to verify stability reliability. Confirmatory factor analysis results supported construct validity with model fit statistics for the original single-factor and four-factor structure of the QLI (corresponding to the QLI's total score and four subscale scores, respectively) with some rearrangement of the items within each subscale. Reliability for the total QLI-Id scale was supported by McDonald's Omega of 0.92 and the intraclass/intrasubject correlation coefficient at two time points of 0.86. The strong correlation between the QLI-Id total and the Satisfaction with Life Scale scores and the overall health/QOL domain of the EORTC QLQ-C30 (both r = 0.73) supported its construct validity. This study provides evidence for the reliability and validity of the QLI-Id as an instrument to measure the impact of cancer on the overall QOL of Indonesian patients.

Planning human resources and facilities to achieve Sustainable Development Goals: a decision-analytical modelling approach to predict cancer control requirements in Indonesia

Objectives

Indonesia aims to achieve universal health coverage (UHC) and Sustainable Development Goals (SDGs), including SDG 3 target 4, which focuses on cancer control, by 2030. This study aimed to forecast the human resources for health (HRH) and facilities required for cancer control in Indonesia over an 11-year period to support these goals.

Design

A two-stage Markov model was developed to forecast the demand side of facilities and HRH requirements for cancer control in Indonesia over an 11-year period.

Setting

Data sources used include the Indonesia Health Profile Report (2019), the Indonesian Radiation Oncology Society Database and National Cancer Control Committee documents (2019).

Methods

The study involved modelling the current availability of HRH and healthcare facilities in Indonesia and predicting future requirements. The gap between the current and the required HRH and facilities related to oncology, and the costs associated with meeting these requirements, were analysed.

Results

Results indicate the need to increase the number of healthcare facilities and HRH to achieve SDG targets. However, UHC for cancer care still may not be achieved, as eastern Indonesia is predicted to have no tertiary hospital until 2030. The forecast shows that Indonesia had a median of only 39% of the HRH requirements in 2019. Closing the HRH gap requires around a 47.6% increase in salary expenditure.

Conclusion

This study demonstrates the application of decision-analytical modelling approach to planning HRH and facilities in the context of a low-to-middle-income country. Scaling up oncology services in Indonesia to attain the SDG targets will require expansion of the number and capability of healthcare facilities and HRH. This work allows an in-depth understanding of the resources needed to achieve UHC and SDGs and could be utilised in other disease areas and contexts.