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Pakpahan C, Agustinus A, Sa'adi A, Nguyen TTA, Liamputtong P, Effendy C, Hinting A. Lay understanding and experience of sexual intercourse among couples with infertility undergoing an assisted reproduction technology program: A qualitative study. Heliyon 2024; 10:e26879. [PMID: 38434274 PMCID: PMC10907792 DOI: 10.1016/j.heliyon.2024.e26879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Abstract
Aim To explore the perception and lay understanding of sexual intercourse and sexual life experiences among infertile couples before, during, and after undergoing an assisted reproduction technology (ART) program. Method The participants of this descriptive qualitative study were Indonesian couples with infertility who underwent an ART program. Semi-structured interviews were conducted between September and December 2022, and the participants' responses were recorded. Data were analyzed using a step-by-step analysis based on Braun's qualitative analysis. The study was reported based on the Consolidated Criteria for Reporting a Qualitative Research (COREQ) Checklist. Results Fifty participants were included, and five themes were developed before and two themes during or after the ART program. The couples' knowledge varied as they experienced sexual intercourse at different periods, such as before, during, and after the ART program. Many participants reported that ART affected their emotions and mood, leading to decreased desire to engage in sexual intercourse. However, some used sexual intercourse as a basis for creating optimism and confidence in having offspring. Furthermore, couples perceived that the purpose of sexual intercourse is not only to have offspring but also to improve communication, promote intimacy, and express affection. In contrast, some perceived the ART program as time consuming, preventing them from engaging in sexual activities. However, not all couples considered sexual activity solely as a means of procreation. They concluded that sexual behavior is not only determined by genetics. Conclusion Couples who underwent the ART program regardless of its effectiveness were aware that sexual interaction is not only for having children but also for preserving harmony and familial connection.
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Affiliation(s)
- Cennikon Pakpahan
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Agustinus Agustinus
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
| | - Ashon Sa'adi
- Ferina Mother and Child Hospital, Surabaya, Indonesia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Pranee Liamputtong
- College of Health Sciences, VinUniversity, Gia Lam District, Hanoi, Viet Nam
- Center for Global Health, Perelman School of Medicine, University of Pennsylvania, USA
| | - Christantie Effendy
- Medical Surgical Nursing Department, Faculty of Medicine, Public Health and Nursing. Universitas Gadjah Mada, Indonesia
| | - Aucky Hinting
- Andrology Study Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Ferina Mother and Child Hospital, Surabaya, Indonesia
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Susianti NA, Prodjohardjono A, Vidyanti AN, Setyaningsih I, Gofir A, Setyaningrum CTS, Effendy C, Setyawan NH, Setyopranoto I. The impact of medial temporal and parietal atrophy on cognitive function in dementia. Sci Rep 2024; 14:5281. [PMID: 38438548 PMCID: PMC10912680 DOI: 10.1038/s41598-024-56023-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/29/2024] [Indexed: 03/06/2024] Open
Abstract
Although medial temporal atrophy (MTA) and parietal atrophy (Koedam score) have been used to diagnose Alzheimer's disease (AD), early detection of other dementia types remains elusive. The study aims to investigate the association between these brain imaging markers and cognitive function in dementia. This cross-sectional study collected data from the Memory Clinic of Dr. Sardjito General Hospital Yogyakarta, Indonesia from January 2020 until December 2022. The cut-off value of MTA and Koedam score was set with Receiver Operating Curve. Multivariate analysis was performed to investigate the association between MTA and Koedam score with cognitive function. Of 61 patients, 22.95% had probable AD, 59.01% vascular dementia, and 18.03% mixed dementia. Correlation test showed that MTA and Koedam score were negatively associated with Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) score. MTA score ≥ 3 (AUC 0.69) and Koedam score ≥ 2 (AUC 0.67) were independently associated with higher risk of poor cognitive function (OR 13.54, 95% CI 1.77-103.43, p = 0.01 and OR 5.52, 95% CI 1.08-28.19, p = 0.04). Higher MTA and Koedam score indicate worse cognitive function in dementia. Future study is needed to delineate these findings as prognostic markers of dementia severity.
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Affiliation(s)
- Noor Alia Susianti
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Astuti Prodjohardjono
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia
| | - Amelia Nur Vidyanti
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia.
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia.
| | - Indarwati Setyaningsih
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia
| | - Abdul Gofir
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia
| | - Cempaka Thursina Srie Setyaningrum
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia
| | - Christantie Effendy
- Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Nurhuda Hendra Setyawan
- Department of Radiology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
| | - Ismail Setyopranoto
- Department of Neurology, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, 55281, Indonesia
- Department of Neurology, Dr. Sardjito General Hospital, Yogyakarta, 55281, Indonesia
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Setyawati MB, Parsons J, Laing B, Effendy C. "Embracing The Faith": The Contribution of Islamic Beliefs on the Provision of Care for People with Parkinson's Disease in New Zealand and Indonesia. J Relig Health 2023; 62:4260-4277. [PMID: 37978099 DOI: 10.1007/s10943-023-01948-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
This study examines the impact of Islamic beliefs on the caregiving practices of individuals diagnosed with Parkinson's disease in Indonesia and New Zealand. The study sample comprised seventeen caregivers who participated in semi-structured interviews which were analysed using the method of inductive thematic analysis. The study delineated three overarching themes: value-driven caregiving, comprehensive care and caregivers strengthened by faith and practice. This study examined the practical applications of the Quran, Hadith and Muslim beliefs in caregiver experiences. Further research is necessary to enhance the support systems for Muslim caregivers in various circumstances, facilitating the advancement of solutions to contemporary social problems.
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Affiliation(s)
- Martyarini Budi Setyawati
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland, 1142, New Zealand.
- School of Nursing, Faculty of Health Sciences, Harapan Bangsa University, Banyumas, Purwokerto-Central Java, Indonesia.
| | - John Parsons
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland, 1142, New Zealand
- Department of Exercise Sciences, Faculty of Science, The University of Auckland, Auckland, New Zealand
| | - Bobbi Laing
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Level 2, Building 505, 85 Park Road, Grafton, Auckland, 1142, New Zealand
| | - Christantie Effendy
- Departement of Nursing, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
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Rimayanti UP, Mizuno M, Kadar K, Madjid A, Sahraeny S, Effendy C, Setiyarini S, Mayers T. Ensuring reliability and cultural validity of the Indonesian version of the Quality Of Life Index for patients with cancer. Res Nurs Health 2023; 46:527-537. [PMID: 37596709 DOI: 10.1002/nur.22334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 06/16/2023] [Accepted: 08/05/2023] [Indexed: 08/20/2023]
Abstract
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.
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Affiliation(s)
- Ummi Pratiwi Rimayanti
- Doctoral Program in Nursing Science, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Michiyo Mizuno
- Health Innovation and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Kusrini Kadar
- Department of Community, Family, and Gerontological Nursing, Faculty of Nursing, Universitas Hasanuddin, Makassar, Indonesia
| | - Abdul Madjid
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Hasanuddin, Makassar, Indonesia
| | - Sitti Sahraeny
- Department of English, Faculty of Cultural Sciences, Universitas Hasanuddin, Makassar, Indonesia
| | - Christantie Effendy
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jakarta, Indonesia
| | - Sri Setiyarini
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jakarta, Indonesia
| | - Thomas Mayers
- Health Innovation and Nursing, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
- Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
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Effendy C, Margaretha SEPM, Helmi M, Ferhonika A, Masdar M. The Relationship Between Social Support, Fear, and Psychological Distress Among Frontline Nurses During the COVID-19 Pandemic in Indonesia. J Psychosoc Nurs Ment Health Serv 2023; 61:53-58. [PMID: 36720068 DOI: 10.3928/02793695-20221122-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The current cross-sectional study aimed to examine the relationship between social support, fear, and psychological distress among frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic. Participants from 20 wards for adult patients from public and private hospitals in Indonesia were recruited. The Fear of COVID-19 Scale, Job Stress Scale, and Perceived Social Support Questionnaire were used to measure outcomes of interest. Questionnaires were completed by a total of 211 nurses. High risk working unit, higher fear score, younger age, less working experience, and less social support were significant influences on nurses' psychological distress. Social support as a modifiable factor is a potential target for intervention strategies to manage psychological issues among nurses. Findings can help policymakers and managers better understand how to support frontline nurses' psychological health and maintain well-engaged nursing staff. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].
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Effendy C, Kristanti MS. Open and structured assessment in addressing hospitalized cancer-related problems: The perception of patients and nurses in Indonesia. Progress in Palliative Care 2022. [DOI: 10.1080/09699260.2022.2148196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Christantie Effendy
- Department of Medical-Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Lotus Care, Wound and Palliative Homecare Center, Private Clinic, Yogyakarta, Indonesia
| | - Martina Sinta Kristanti
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Martina D, Kustanti CY, Dewantari R, Sutandyo N, Putranto R, Shatri H, Effendy C, van der Heide A, van der Rijt CCD, Rietjens JAC. Advance care planning for patients with cancer and family caregivers in Indonesia: a qualitative study. BMC Palliat Care 2022; 21:204. [DOI: 10.1186/s12904-022-01086-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 10/25/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Background
Individuals’ willingness to engage in advance care planning is influenced by factors such as culture and religious beliefs. While most studies on advance care planning in Asia have been performed in high-income countries, Indonesia is a lower-middle-income country, with a majority of strongly collectivist and religiously devout inhabitants. We studied the perspectives of Indonesian patients with cancer and family caregivers regarding advance care planning by first exploring their experiences with medical information-disclosure, decision-making, and advance care planning and how these experiences influence their perspectives on advance care planning.
Methods
We conducted semi-structured interviews among 16 patients with cancer and 15 family caregivers in a national cancer center in Jakarta and a tertiary academic general hospital in Yogyakarta. We performed an inductive thematic analysis using open, axial, and selective coding. The rigor of the study was enhanced by reflective journaling, dual coding, and investigator triangulation.
Results
Twenty-six of 31 participants were younger than 60 years old, 20 were Muslim and Javanese, and 17 were college or university graduates. Four major themes emerged as important in advance care planning: (1) participants’ perceptions on the importance or harmfulness of cancer-related information, (2) the importance of communicating bad news sensitively (through empathetic, implicit, and mediated communication), (3) participants’ motives for participating in medical decision-making (decision-making seen as patients’ right or responsibility, or patients’ state of dependency on others), and (4) the complexities of future planning (e.g., due to its irrelevance to participants’ religious beliefs and/or their difficulties in seeing the relevance of future planning).
Conclusions
Culturally sensitive approaches to advance care planning in Indonesia should address the importance of facilitating open communication between patients and their families, and the various perspectives on information provision, bad news communication, and decision-making. Advance care planning should focus on the exploration of patients’ values, rather than drafting treatment plans in advance.
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Effendy C, Yodang Y, Amalia S, Rochmawati E. Barriers and facilitators in the provision of palliative care in adult intensive care units: a scoping review. Acute Crit Care 2022; 37:516-526. [DOI: 10.4266/acc.2022.00745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/28/2022] [Indexed: 11/05/2022] Open
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Mumtaz DF, Effendy C, Haryani H. Impact of Pre-Chemotherapy Education with Audio Visual Methods on the Self-Efficacy of Symptom Management in Patients with Cancer. J Cancer Educ 2022; 37:1546-1552. [PMID: 33880720 DOI: 10.1007/s13187-021-02006-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
This study aimed to identify the effects of pre-chemotherapy education with audio visual methods on the self-efficacy of symptom management in patients with cancer who received chemotherapy. The various side effects of chemotherapy could affect the self-efficacy of symptom management. Providing pre-chemotherapy education is important to improve the self-efficacy of symptom management. Nowadays, pre-chemotherapy education is only given by using print media, which can restrict transferring information to patients with cancer. This study was based on pre- and post-test, 2 group, quasi-experimental design. A total of 80 respondents were recruited with consecutive sampling between January and March 2019. Participants in the intervention group received video pre-chemotherapy education, while participants in the control group received education with a booklet (usual care). Patients completed self-efficacy symptom management questionnaires before and 1-2 weeks after chemotherapy. The analysis used the Wilcoxon and Mann-Whitney tests and by counting Cohen's d effect size. The mean scores of pre- and post-test self-efficacy of symptom management increased in the intervention group to 1.77 (p = 0.000) and in the control group to 0.64 (p = 0.001). The comparative test between the two groups showed p = 0.005 (p < 0.05) with an effect size of 0.4 (66%). This result indicates that pre-chemotherapy education had medium effect on the self-efficacy of symptom management. Pre-chemotherapy education with audio visual methods can increase the self-efficacy of symptom management in patients with cancer.
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Affiliation(s)
- Dzakiyatul Fahmi Mumtaz
- Faculty of Health Science, Universitas 'Aisyiyah Yogyakarta, Yogyakarta, Indonesia
- Magister of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- Department of Surgical Medical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Haryani Haryani
- Department of Surgical Medical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.
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Martina D, Kustanti CY, Dewantari R, Sutandyo N, Putranto R, Shatri H, Effendy C, van der Heide A, Rietjens JAC, van der Rijt C. Opportunities and challenges for advance care planning in strongly religious family-centric societies: a Focus group study of Indonesian cancer-care professionals. Palliat Care 2022; 21:110. [PMID: 35729537 PMCID: PMC9215088 DOI: 10.1186/s12904-022-01002-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Most studies on advance care planning in Asia originate in high-income Asian countries. Indonesia is a middle-income Asian country characterized by its religious devoutness and strong family ties. This study aims to explore the perspectives and experiences of Indonesian healthcare professionals on advance care planning for cancer patients. Methods Focus-group discussions were conducted in July and August 2019 and were analysed using thematic content analysis enhanced by dual coding and exploration of divergent views. Purposive sampling of physicians and nurses actively engaged in cancer care in a national cancer centre and a national general hospital. Results We included 16 physicians and 16 nurses. These participants were open to the idea of advance care planning. We further identified four aspects of this planning that the participants considered to be important: 1) the family’s role in medical decision-making; 2) sensitivity to communication norms; 3) patients’ and families’ religious beliefs regarding the control and sanctity of life; and 4) the availability of a support system for advance care planning (healthcare professionals’ education and training, public education, resource allocation, and formal regulation). Participants believed that, although family hierarchical structure and certain religious beliefs may complicate patients’ engagement in advance care planning, a considerate approach to involving family and patients’ religious perspectives in advance care planning may actually facilitate their engagement in it. Conclusion Indonesian healthcare professionals believed that, for culturally congruent advance care planning in Indonesia, it was essential to respect the cultural aspects of collectivism, communication norms, and patients’ religious beliefs. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-022-01002-6.
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Affiliation(s)
- Diah Martina
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands. .,Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands. .,Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Universitas Indonesia, Jakarta, Indonesia. .,Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia.
| | | | - Rahajeng Dewantari
- Department of Neuro-Psychiatry, Dharmais National Cancer Center, Jakarta, Indonesia
| | - Noorwati Sutandyo
- Department of Hematology and Medical Oncology, Dharmais National Cancer Center, Jakarta, Indonesia
| | - Rudi Putranto
- Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Universitas Indonesia, Jakarta, Indonesia.,Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Hamzah Shatri
- Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, Universitas Indonesia, Jakarta, Indonesia.,Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Agnes van der Heide
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Judith A C Rietjens
- Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - Carin van der Rijt
- Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, the Netherlands
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Effendy C, Uligraff DK, Sari SH, Angraini F, Chandra L. Experiences of family caregivers of children with cancer while receiving home-based pediatric palliative care in Indonesia: a qualitative study. BMC Palliat Care 2022; 21:104. [PMID: 35668398 PMCID: PMC9171947 DOI: 10.1186/s12904-022-00986-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caring for children living with life-threatening and life-limiting illnesses can be challenging. Parents' roles as the main caregivers can be complex with extensive responsibilities. The experiences of family caregivers can provide key insights into the provision of home-based Pediatric Palliative Care (PPC) for seriously ill children. This study is aimed at exploring the experiences of family caregivers of children diagnosed with cancer while receiving home-based PPC. METHODS This was a qualitative study. This study used semi-structured interviews which were audio-recorded with family caregivers of twelve children diagnosed with cancer who had received home-based PPC. The interviews were transcribed verbatim. The data were analyzed using qualitative content analysis. The reporting of the study was based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. RESULTS Three main themes emerged: (1) The implementation of home-based PPC; (2) The benefits of home-based PPC; and (3) The family caregivers' hopes of the home-based PPC service and their impressions of home-based PPC. The implementation of home-based PPC described the experiences of family caregivers in receiving home-based PPC provided by nurses with particular attention to the bio-psychosocial-spiritual aspects. Family caregivers experienced several benefits from the home-based PCC service, where holistic care was provided for both the patient and the family. Family caregivers shared their hopes prior to receiving support from competent health care professionals to care for their sick child at home and improve the child's quality of life. They confirmed that these hopes were fulfilled through the home-based PPC service delivered by Rachel House. CONCLUSIONS Home-based PPC provides several benefits with a positive impact for both the children diagnosed with cancer as well as their families. Nurses involved in the home-based PPC service provide holistic care with a family-centered approach. We believe that children with terminal illnesses and their families need and deserve home-based PPC during difficult times.
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Affiliation(s)
- Christantie Effendy
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas, Gadjah Mada, Yogyakarta, Indonesia.
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Visnu J, Effendy C, Laksono PM, Trisnantoro L. Philanthropic Institutions’ Perspectives Regarding Challenges in the Indonesian Health Sector: A Qualitative Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: The Indonesian Social Health Security Agency has a key role in improving the community’s quality of life by providing financial access to all citizens to fulfill basic health needs. The society has received government funding for basic health needs through direct costs. On the other hand, there are also indirect costs for non-medical needs that may potentially become problems for some people. The concept of philanthropy was developed and became a significant and concrete utility in responding to Indonesian health problems.
AIM: Our study aimed to explore challenges faced by the Indonesian philanthropic institutions in managing charitable giving to the health sector.
METHODS: We conducted a qualitative study to explore challenges faced by the Indonesian philanthropic institutions in managing charitable giving to the health sector.
RESULTS: As a result, we found that internal and external support and synchronous collaboration become a common theme of challenges in managing health philanthropy in Indonesia.
CONCLUSION: Cross-sectorial partnerships in the health sector might improve national welfare as we work toward achieving the sustainable development goals.
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Abstract
Participatory action research (PAR) is a method of inquiry that promotes a collaborative approach to knowledge creation. This article examined areas of research interest that included PAR methods, highlighting the areas of improvement that such approaches might offer to researchers and scientists in the nursing field. Among the 20 included studies, participatory concepts are more likely used to direct research design than to select participants. About two-thirds of the studies reviewed used PAR principles in designing projects. Although only a few research collaborative efforts involved partners in selecting participants, 70% involved participants in data gathering. Participatory approaches to data processing and interpretation were found in over 60% of articles assessed across all content categories. Approximately half of the studies included suggestions for participatory implementation approaches; a quarter discussed participatory ways to disseminate results. The findings demonstrate how researchers are incorporating PAR principles into a variety of areas of nursing research. Promises to fully include participants and promises of reciprocal benefit are essential in order to pursue meaningful PAR.
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Effendy C, Silva JFDS, Padmawati RS. Identifying palliative care needs of patients with non-communicable diseases in Indonesia using the SPICT tool: a descriptive cross-sectional study. Palliat Care 2022; 21:13. [PMID: 35073869 PMCID: PMC8785499 DOI: 10.1186/s12904-021-00881-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/16/2021] [Indexed: 01/08/2023] Open
Abstract
Abstract
Background
In Indonesia, Non-Communicable Diseases (NCD) are a contributing factor to mortality with most cases involving heart disease, cancer, chronic lung disease and diabetes. Accordingly, the identification of palliative care needs is very important as a first step in providing palliative care for these patients with NCD. However, currently there is no national standardized tool nor guidance system for identifying palliative care needs of NCD patients in Indonesia. The Supportive and Palliative Care Indicators Tool (SPICT) has been used worldwide for screening palliative care needs. This study aimed to identify palliative care needs in NCD patients using the SPICT tool.
Methods
This descriptive study used a cross-sectional design. Sampling technique used convenience sampling with a total sample of 124 adult patients with NCD in Dr. Sardjito Hospital Yogyakarta. Data collection used the Indonesian version of the SPICT. Data analyses used descriptive statistics and chi-square tests with p < 0,05 set as significant. Additionally, the prevalence of patients requiring palliative care was also calculated.
Results
The patients with NCD requiring palliative care who were screened using the SPICT tool were 61.3%. The nurses identified only 17.7%, while the physicians identified only 9.7%. The overall agreement of the clinician’s assessments to the researchers was < 32%. Meanwhile, agreement with nurses was 31 and 25% with the physicians.
Conclusions
These results highlight that by using the SPICT tool, recognition of hospitalized patients with NCD needing palliative care increased from 10 to 18% to > 61%. The Indonesian version of the SPICT tool can help the clinicians to reach meet agreement in identifying hospitalized patients who need palliative care as the first step in addressing palliative interventions for patients with NCD. It can provide several benefits in screening patients with NCD from the beginning of diagnosis.
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Effendy C, Kurianto E, Darmayanti ARI, Noviana U, Nurjannah I. Palliative Care Education to Enhance Informal Caregivers’ Skills in Caring for Patients with Cancer: A Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Living with cancer causes stress for both patients and caregivers. Empowering family caregivers is critical in palliative care. It is well known that a lack of proper knowledge and training of informal caregivers is a barrier to palliative care provision at home.
Objectives: This scoping review aimed to explore palliative care education to enhance informal caregiver skills in caring for cancer patient.
Methods: A scoping literature review was conducted with systematic searches in multiple databases – PubMed, Cochrane, PsycINFO and SCOPUS (2000 to 2021). Studies were selected based on programmes content and its impact evaluation.
Findings: The remaining 181 citations were examined at full-text level; 173 studies did not meet inclusion criteria, yielding eight included papers. Four papers focused on palliative care educational programs for family caregivers, and four papers included patients and caregivers. There was a diverse variation in the mode of delivery and duration of educational input. The programs offered an insight into the main elements of working with individuals at a palliative care bundle. Most studies reported that participants improved their knowledge, self-efficacy, and competency and prepared for their roles.
Conclusion: The findings indicate the need of family caregivers for more regular and reliable palliative education programs. Randomized controlled trials with rigorous randomization processes, more significant sample numbers and more appropriate control groups focused explicitly on caregiver education may improve the evidence.
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Setyawati A, Wahyuningsih MSH, Nugrahaningsih DAA, Effendy C, Fneish F, Fortwengel G. Piper crocatum Ruiz & Pav. ameliorates wound healing through p53, E-cadherin and SOD1 pathways on wounded hyperglycemia fibroblasts. Saudi J Biol Sci 2021; 28:7257-7268. [PMID: 34867030 PMCID: PMC8626332 DOI: 10.1016/j.sjbs.2021.08.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 08/10/2021] [Accepted: 08/12/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Piper crocatum Ruiz & Pav (P. crocatum) has been reported to accelerate the diabetic wound healing process empirically. Some studies showed the benefits of P. crocatum in treating various diseases but its mechanisms in diabetic wound healing have never been reported. In the present study we investigated the diabetic wound healing activity of the active fraction of P. crocatum on wounded hyperglycemia fibroblasts (wHFs). METHODS Bioassay-guided fractionation was performed to get the most active fraction. The selected active fraction was applied to wHFs within 72 h incubation. Mimicking a diabetic condition was done using basal glucose media containing an additional 17 mMol/L D-glucose. A wound was simulated via the scratch assay. The collagen deposition was measured using Picro-Sirius Red and wound closure was measured using scratch wound assay. Underlying mechanisms through p53, αSMA, SOD1 and E-cadherin were measured using western blotting. RESULTS We reported that FIV is the most active fraction of P. crocatum. We confirmed that FIV \(7.81 µg/ml, 15.62 µg/ml, 31.25 µg/ml, 62.5 µg/ml, and 125 µg/ml) induced the collagen deposition and wound closure of wHFs. Furthermore, FIV treatment (7.81 µg/ml, 15.62 µg/ml, 31.25 µg/ml) down-regulated the protein expression level of p53 and up-regulated the protein expression levels of αSMA, E-cadherin, and SOD1. DISCUSSION/CONCLUSIONS Our findings suggest that ameliorating collagen deposition and wound closure through protein regulation of p53, αSMA, E-cadherin, and SOD1 are some of the mechanisms by which FIV of P. crocatum is involved in diabetic wound healing therapy.
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Key Words
- CHCl3, Chloroform
- DMEM, Dulbecco's Modified Eagle's Medium
- Diabetic wound healing
- E-cadherin
- ETOAc, Ethyl acetate
- HFs, Hyperglycemia fibroblasts
- MTT, 3-[4,5-dimethylthiazole-2-yl]-2,5-diphenyltetrazolium bromide
- MeOH, Methanol
- Mechanism
- NFs, Normal fibroblasts
- Piper crocatum Ruiz & Pav
- ROS, Reactive oxygen species
- SOD1
- SOD1, superoxide dismutase 1
- TLC, Thin layer chromatography
- WB, Washed benzene
- p53
- p53, tumor suppressor protein
- wHFs, wounded hyperglycemia fibroblasts
- αSMA, alpha smooth muscle actin
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Affiliation(s)
- Andina Setyawati
- Lecturer of Department of Surgical and Medical Nursing, Faculty of Nursing, Universitas Hasanuddin, Jl. Perintis Kemerdekaan km 10, Kampus Tamalanrea, Makassar 90245, Indonesia
- Student of Department of Medicine and Health Science Doctorate Program, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta 55281, Indonesia
| | - Mae Sri Hartati Wahyuningsih
- Lecturer of Department of Pharmacology and Therapy, Centre for Herbal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta 55281, Indonesia
| | - Dwi Aris Agung Nugrahaningsih
- Lecturer of Department of Pharmacology and Therapy, Centre for Herbal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta 55281, Indonesia
| | - Christantie Effendy
- Lecturer of Department of Surgical and Medical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jl. Senolowo, Sekip Utara, Depok, Sleman, Yogyakarta 55281, Indonesia
| | - Firas Fneish
- Lecturer of Department of Biostatistics, Gottfried Wilhelm Leibniz Universität, Postfach 6009, 30060 Hannover, Germany
| | - Gerhard Fortwengel
- Lecturer of Department of Clinical Research and Epidemiology, Hochschule Hannover University of Applied Sciences & Arts, Expo Plaza 12, 30539 Hannover, Germany
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Effendy C, Kristanti MS. The importance of providing palliative care for patients with severe COVID-19 in Indonesia. Belitung Nurs J 2021; 7:438-442. [PMID: 37496509 PMCID: PMC10367976 DOI: 10.33546/bnj.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/09/2021] [Accepted: 07/02/2021] [Indexed: 07/28/2023] Open
Abstract
Patients with Coronavirus Disease 2019 (COVID-19), particularly those with a severe condition, might not survive. Pandemic situation challenges the healthcare providers in addressing palliative care to the patients. This paper aimed to describe the importance of providing palliative care for patients with severe COVID-19 in Indonesia. We used a case scenario to illustrate the common condition experienced by a patient with severe COVID-19. Health care providers in Indonesia could address palliative care for patients with COVID-19 by focusing on controlling the symptoms, avoiding futile intervention, and connecting the patients and their families. Nurses need to consider the patients' needs for family supports, even though not in physical or psychosocial support, and help the patients who need end-of-life care to be dying with dignity. Communication technology must be utilized optimally by healthcare providers to realize the communication among the patients, families, and health workers.
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Affiliation(s)
- Christantie Effendy
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Lotus Care, Wound and Palliative Homecare Center, Private Clinic, Yogyakarta, Indonesia
| | - Martina Sinta Kristanti
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Damhudi D, Kertia N, Effendy C. The Effect of Modified Diabetes Self-management Education and Support on Self-care and Quality of Life among Patients with Diabetic Foot Ulcers in Rural Area of Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND: Diabetes self-management education and support (DSMES) programs are patient-centered, holistic solution that enables it one of the best approaches for improving medication adherence enhanced coping, empowerment and self-efficacy, quality of life (QoL), and lower rates of depression, in people with type 2 diabetes mellitus (T2DM). In isolation, DSME strategies have not shown significant improvements to self-care and/or reduction of diabetic foot ulcer (DFU).
AIM: This study sought to determine the effect of modified DSMES on self-care, DFU severity, and QoL in rural Indonesian patients with DFUs.
METHODS: A quasi-experimental design with pre-test and post-test control group design, in Singkawang, West Kalimantan, Indonesia, with a total sample of 60 patients consisting of 30 patients in the intervention group and 30 patients in the control group. The DSMES has been adapted to cover 2 h of content for a period of 8 weeks and the eight-core components of DSMES. The curriculum was culturally adapted revised to incorporate culturally appropriate nature similarities, such as a prominent change to represent changes in glucose counts; to incorporate photos; to incorporate culturally relevant eating habits, such as fish and fruit; to communicate in detail the significance of medication adherence, with an emphasis on metformin’s organic, plant-based characteristics; and to emphasize engagement. Intention-to-treat analyses were conducted to determine the effect of modified DSMES on self-care, DFU severity, and QoL.
RESULTS: The DSMES program improved outcomes in three of the three outcome indicators when compared to the control group at T1: In this study, (1) the DFU degree increased by 3.3% points (95% confidence interval [CI]: 0.018–0.194), (2) the diabetes foot self-care behavior score increased by a modest 8.8% points (95% CI: 0.021–0.203), and (3) the QoL increased by 32.7% points (95% CI: 00.075–0.689). The degree of DFU (difference-in-difference [DID] coef. 0.350, 95% CI 0.084–0.572), diabetes foot self-care behavior (DID coef. 0.085, 95% CI 0.065–0.405), and QoL (DID coef. 0.343, 95% CI 0.078–0.436) are all still significantly improved compared to the control at T2.
CONCLUSION: The primary outcome analyses indicate that the adapted DSMES was more effective than standard care at improving self-care and QoL and decreasing DFU degree in this sample of Indonesians with DFU, both immediately after and 3 months after the intervention. As nurse educators, it is our responsibility to ensure that we evaluate all of the support options accessible to the patients in our care.
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Kristanti MS, Kusmaryanto, Effendy C. Common ethical dilemmas of family caregivers of palliative patients in Indonesia. Belitung Nurs J 2021; 7:246-250. [PMID: 37469338 PMCID: PMC10353594 DOI: 10.33546/bnj.1457] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/01/2021] [Accepted: 06/02/2021] [Indexed: 07/21/2023] Open
Abstract
Family caregivers, especially in Asian countries, have a profound role in caring for a sick family member. However, there are wide variations between the Asian and western world in terms of culture and facilities. Therefore, the problems and needs of family caregivers between those two regions may also be distinct, and it is important to explore and elaborate based on our empirical evidence. In Indonesia, motives and values in caregiving and religion become the wheel-power of the family caregivers in providing care. This affects action and consequences for caregivers. This paper attempts to elaborate on common ethical dilemmas that usually face by family caregivers in Indonesia. Unfortunately, family caregivers typically are not prepared to make those challenging decisions. Therefore, we recommend not only that family caregivers need to be involved in the caring process, but also their issues and ethical dilemmas should be assessed and addressed by health care professionals, especially nurses, who have the most frequent contact with patient and family caregiver.
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Affiliation(s)
- Martina Sinta Kristanti
- Department of Basic and Emergency Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Kusmaryanto
- Faculty of Philosophy – Divinity, Sanata Dharma University, Indonesia
| | - Christantie Effendy
- Department of Medical Surgical Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Endah Purnamaningsih Maria Margaretha S, Mulatsih S, Effendy C, Kusnanto H. Qualitative Analysis of Family-centered Care for Children with Cancer in Palliative Wards: An Evaluation of Needs and Barriers in Resource-limited Settings. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Many children with cancer are faced with fatal diagnosis and unbearable pain, and palliative care is highly needed. In Indonesia, the provision of palliative care is only accessible in a few major cities where most cancer treatment facilities are located and development has been slow. While, the implementation of family center care identified a number of challenges related to family empowerment to be included in the development and implementation of interventions.
Objectives: This study aimed to assess the perspectives of nurses regarding family-centered treatment in Indonesia’s palliative wards for children with cancer.
Methods: A qualitative approach to content analysis was employed. The study participants were 10 primary nurses in pediatric units who worked with cancer patients regularly. These participants were purposefully chosen. The interview session included 10 study participants. Participants’ work experience ranged from 2 to 11 years, and their age ranged from 27 to 51 years. Data were collected via face-to-face, semi-structured interviews that lasted for an average of 30 to 45 minutes. The interviews were performed to explore the participants’ understanding about the definition of family-centered palliative care, including the needs and obstacles to implementation. These were analyzed using content analysis methodology that includes five main segments: introduction, coding, theme creation, thematic classification, and reporting.
Results: The themes from the study included an appreciation of palliative and family-centered care, palliative care capability and family-centered care, and multidisciplinary cooperation under three principles concerning needs and barriers.
Conclusion: Integrating family-centered care approaches in providing palliative care for children with cancer as well as the resources required for such programs to be implemented by hospital management in working toward improved quality care for patients. Communication and continuity of care remain a challenge; training and equipping clinicians with skills and confidence to carry out family-centered care approaches and palliative care for children with cancer can aid in this process.
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Witjaksono MA, Effendy C, Mulatsih S, Dwiprahasto I, Utarini A. Criteria for palliative care referral in oncology practice: An instrument development. Bali Med J 2021. [DOI: 10.15562/bmj.v10i1.2120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hertanti NS, Wicaksana AL, Effendy C, Kao CY. Palliative Care Quiz for Nurses-Indonesian Version (PCQN-I): A Cross-cultural Adaptation, Validity, and Reliability Study. Indian J Palliat Care 2021; 27:35-42. [PMID: 34035615 PMCID: PMC8121243 DOI: 10.4103/ijpc.ijpc_76_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/14/2020] [Accepted: 07/01/2020] [Indexed: 11/04/2022] Open
Abstract
Aim The study is aimed to perform a cross-cultural adaptation of the palliative care quiz for nurses in an Indonesian context to evaluate its psychometric properties. Methods A two-phase design was used in this study, including cross-cultural adaptation and psychometric testing. The PCQN-I was tested on a convenience sample of health-care providers recruited from 20 primary health-care (PHC) centers in Yogyakarta, Indonesia, from July to October 2017. Results The cross-cultural adaptation ultimately resulted in a total of 20 items from the PCQN-I. An expert committee revised the words in Item 4 from "adjuvant therapies" to "adjuvant therapies/additional therapies," in Item 5 from "bowel regimen" to "gastrointestinal therapies," and Item 16 from "Demerol" to "Pethidine" based on the Indonesian context. The experts retained Item 5 "It is crucial for family members to remain at the bedside until death occurs," although none of the participants (n = 40) involved in the pilot testing could answer it correctly, and Item 19 "The loss of a distant or contentious relationship is easier to resolve than the loss of one that is close or intimate" although few participants responded correctly. A total of 150 health-care providers consisting of 100 nurses and 50 physicians were involved in the psychometric testing. The scale-level content validity index/Ave of the PCQN-I was 97 and 93 in terms of its relevancy and clarity, respectively. The reliability was calculated as the Kuder-Richardson formula 20 score was 0.71. Conclusions The PCQN-I is a valid and reliable instrument for assessing palliative care knowledge among PHC providers. Further research is warranted to examine its reliability in different clinical settings.
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Affiliation(s)
- Nuzul Sri Hertanti
- Department of Biostatistics, Epidemiology, and Population Health, Yogyakarta, Indonesia.,Center for Tropical Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Anggi Lukman Wicaksana
- Department of Medical Surgical Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.,The Sleman Health and Demographic Surveillance System (HDSS), Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- Department of Medical Surgical Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Chi-Yin Kao
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Wahyuni S, Effendy C, Kusumaningrum FM, Dewi FST. Factors Associated with Independence for Elderly People in Their Activities of Daily Living. JBE 2021. [DOI: 10.20473/jbe.v9i12021.44-53] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Health in the elderly does not merely refer to a condition free from disease but should also have elements regarding functionality and independence. Purpose: This study aimed to measure Activities of Daily Living (ADLs) and to identify the factors affecting ADLs among the elderly population in Sleman District. Methods: A cross-sectional study was carried out using secondary data from the Multidimensional Elderly Care project, nested on the Health Demographic and Surveillance System in Sleman, involving 549 elderly participants. The independence of these elderly people was measured using an Activities of Daily Living Scale questionnaire. Factors measured were cognitive (using the Mini-Mental State Examination questionnaire), psychological (using the Geriatric Depression Scale or Cornell Scale for Depression in Dementia questionnaires), economic (using the Financial Management Behavior Scale questionnaire), and nutritional status (using the Mini Nutritional Assessment questionnaire). The data were analyzed using the chi-square test, Fisher test, and Poisson test for bivariate analysis, while multivariate analysis using a logistic regression test. Results: The prevalence of elderly dependence was 14.03%. Elderly dependence was significantly related to age, job, residence, financial management, dementia, depression, malnutrition, and stroke disease in the bivariate analysis. However, after multivariate analysis, only age (>86 years) (PR = 4.31; 95% CI = 1.91–9.72), malnutrition (PR = 6.62; 95% CI = 3.79–11.57), and stroke (PR = 3.06; 95% CI = 2.03–4.61) were still shown to be related to elderly dependence. Conclusion: Increasing age, malnutrition, and stroke in elderly people lead to higher dependency in their ADLs.
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Abstract
OBJECTIVE The aim of the study was to explore the experiences of Papuans living with HIV to take antiretroviral therapy (ART) from the patient and the healthcare providers (HCPs) perspective. DESIGN This was a qualitative study covering all five tribes located in Papua Provinces one of two Indonesian provinces on Papua Island. Semistructured interviews were conducted with Papuans living with HIV and their HCPs. Interviews were transcribed verbatim and coded to find themes. RESULTS Overall, we conducted interviews with 13 Papuans living with HIV (mean age: 33 years, 61% female) and 14 HCPs (mean age: 42 years, 64% female) within five customary areas. HCPs included three physicians, nine nurses, two others. Two main themes were identified: (1) personal factors and (2) healthcare environment-related factors. Personal factors were beliefs and knowledge of ART, stigma from family, community and HCPs as well as practical problems such as transportation because of long distance. Within the theme of healthcare environment, the competences and attitudes of HCPs were particularly relevant. The findings are important in refining HIV treatment strategies implemented in Papua, especially when extending HIV care provided by community centres. CONCLUSIONS Despite free access to ART, Papuans living with HIV struggle to remain on treatment. Considering local culture and religion in strategies to reduce stigma should be a priority.
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Affiliation(s)
- Elfride Irawati Sianturi
- Groningen Research Institute of Pharmacy Unit PharmacoTherapy, -Epidemiology & -Economics (PTEE), Groningen University, Faculty of Mathematics and Natural Sciences, Groningen, The Netherlands
- Department of Pharmacy,Faculty of Mathematics and Natural Sciences, University Cenderawasih, Jayapura, Indonesia
| | - Elmiawati Latifah
- Department of Pharmacy, Faculty of Health Science, Universitas Muhammadiyah Magelang, Magelang, Indonesia
| | - Ari Probandari
- Department of Public Health, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Jawa Tengah, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Katja Taxis
- Groningen Research Institute of Pharmacy Unit PharmacoTherapy, -Epidemiology & -Economics (PTEE), Groningen University, Faculty of Mathematics and Natural Sciences, Groningen, The Netherlands
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Fauzan A, Setiyarini S, Effendy C, Kristanti MS. PERCEPTION OF NURSES IN DECISION-MAKING PROCESS IN PALLIATIVE CARE FOR PATIENTS WITH CANCER IN PUBLIC HEALTH CENTERS. BNJ 2019. [DOI: 10.33546/bnj.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background: Nurses have a key role in promoting patients’ involvement in decision-making process of palliative care to improve their dignity and satisfaction. However, there is a dearth of studies exploring this involvement, especially in public health centers in Indonesia.Objective: This study aimed to explore the perception of nurses in decision-making process and to understand what type of decision-making made by health care providers in palliative care.Methods: This was a descriptive explorative study with qualitative approach. Participants were selected using purposive and snowball sampling. Data were collected using Focus Group Discussion (FGD) and in-depth interview. Content analysis method by inductive approach was used for data analysis. Consolidated criteria for reporting qualitative research (COREQ) was also used.Results: Eight themes emerged in this study, namely: (1) Collecting information about patients’ current physiological condition, (2) Creating alternative strategies according to the patients’ current physiological condition, (3) Establishing implementation type to be performed, (4) Providing information to the patients, (5) Discussing decision-making between patients and family, (6) Choosing/rejecting an action by patients, (7) Performing selected actions, and (8) Evaluating action. Three points that are different from the existing theory were: (i) there was a discussion between patients and family, (ii) the absence of the process of collecting information after a patient rejects to act, and (iii) there were three types of decision-making: paternalistic, shared, and informed decision-making.Conclusion: This study serves as an input for nurses to pay more attention in decision-making process in palliative care in patients with cancer, and to encourage patients to give contribution in decision-making as part of shared decision-making.
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Abstract
BACKGROUND Strong family bonds are part of the Indonesian culture. Family members of patients with cancer are intensively involved in caring, also in hospitals. This is considered "normal": a societal and religious obligation. The values underpinning this might influence families' perception of it. AIM To explore and model experiences of family caregivers of patients with cancer in Indonesia in performing caregiving tasks. DESIGN A grounded theory approach was applied. The constant comparative method was used for data analysis and a paradigm scheme was employed for developing a theoretical model. SETTING/PARTICIPANTS The study was conducted in three hospitals in Indonesia. The participants were family caregivers of patients with cancer. RESULTS A total of 24 family caregivers participated. "Belief in caregiving" appeared to be the core phenomenon. This reflects the caregivers' conviction that providing care is an important value, which becomes the will power and source of their strength. It is a combination of spiritual and religious, value and motivation to care, and is influenced by contextual factors. It influences actions: coping mechanisms, sharing tasks, and making sacrifices. Social support influences the process of the core phenomenon and the actions of the caregivers. Both positive and negative experiences were identified. CONCLUSION We developed a model of family caregivers' experiences from a country where caregiving is deeply rooted in religion and culture. The model might also be useful in other cultural contexts. Our model shows that the spiritual domain, not only for the patient but also for the family caregivers, should be structurally addressed by professional caregivers.
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Affiliation(s)
- Martina Sinta Kristanti
- Radboud University Medical Center, IQ Healthcare, Nijmegen, The Netherlands
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Adi Utarini
- Department of Health Policy and Management, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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Chayati N, Effendy C, Setyopranoto I. Modified Delphi Consensus on Developing Home Care Service Quality Indicator for Stroke Survivor in Yogyakarta, Indonesia. Open Access Maced J Med Sci 2019; 7:1712-1718. [PMID: 31210828 PMCID: PMC6560285 DOI: 10.3889/oamjms.2019.455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 05/17/2019] [Accepted: 05/18/2019] [Indexed: 11/05/2022] Open
Abstract
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. AIM To test the face validity of the home care quality indicator in stroke patients with the modified Delphi method. METHODS 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). RESULTS 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.
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Affiliation(s)
- Nur Chayati
- School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Indonesia.,Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Christantie Effendy
- Medical and Surgical Nursing Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
| | - Ismail Setyopranoto
- Neurology Department, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Indonesia
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Abstract
Background. Patients with advanced cancer require treatment and the fulfillment of their needs, based on the results of assessments regarding their physical symptoms, psychological and spiritual needs. Palliative care should be delivered with a person-centered care approach. It is important to consider the patients’ reports of their carings’ outcomes. Comparisons between the patients’ and nurses’ perceptions of palliative care outcomes can be used to improve the quality of palliative care.Objective. The purpose of this study is to compare the patients’ and nurses’ perceptions of palliative care outcomes during the patients’ hospitalization.Methods. This is a comparative descriptive study with a cross-sectional design. Data were collected from May to June 2018 from a total of 106 patients with advanced cancer, and 61 nurses. The versions of the Palliative care Outcome Scale (POS) for patients and nurses were used to measure the palliative care outcomes of the patients’ and nurses’ perceptions.Result. The study found a significant difference between the perceptions of the patients and nurses for the palliative care outcomes, particularly in the information availability domain (p = 0.001), the other symptoms domain (p = 0.029), and the anxiety feelings domain (p = 0.030), while the other seven domains had no significant differences between both groups (p > 0.05).Conclusion. The anxiety feelings, other symptoms and information availability domains are the aspects of palliative care which need more attention from health care providers, especially nurses, when caring for patients with advanced cancer.
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Abstract
Background: There have been various studies into the family caregivers’ experiences in taking care of advanced-cancer patients. But, a study exploring the burden among family caregivers has not yet been conducted in Indonesia, a country which has strong family bonds among family members.Objective: This present study aimed to identify the burden among family caregivers of advanced cancer patients.Methods: This study was a cross-sectional study conducted from December 2016 to February 2017 on 178 consenting family caregivers and advanced cancer patients, selected using a purposive sampling technique. The Caregiver Reaction Assessment (CRA) was used to measure their burden. Data were analyzed using descriptive analyzes and bivariate analyzes.Results: The burden among family caregivers was 2.38 ± 0.38 (mean range 1-5). The highest burden was in the disrupted schedule domain.Conclusion: Our findings identified that the burden among family caregivers was at the medium level. The length of care per day and family support are potential targets for preventative intervention strategies to reduce the burden among the family caregivers.
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Kristanti MS, Setiyarini S, Effendy C. Enhancing the quality of life for palliative care cancer patients in Indonesia through family caregivers: a pilot study of basic skills training. BMC Palliat Care 2017; 16:4. [PMID: 28095837 PMCID: PMC5240385 DOI: 10.1186/s12904-016-0178-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 12/23/2016] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia. METHODS The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients' QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant. RESULTS The intervention showed a significant change in patients' global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient's had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients' dyspnea (p = 0.031). CONCLUSIONS Basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socio-economic and cultural challenges in the provision of palliative care in Indonesia.
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Affiliation(s)
| | - Sri Setiyarini
- School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Christantie Effendy
- School of Nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Claramita M, Tuah R, Riskione P, Prabandari YS, Effendy C. Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia. Nurse Educ Today 2016; 36:236-241. [PMID: 26586255 DOI: 10.1016/j.nedt.2015.10.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 10/10/2015] [Accepted: 10/26/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making. OBJECTIVE Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline. METHODS This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons. RESULTS There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients. CONCLUSIONS Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients.
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Affiliation(s)
- Mora Claramita
- Faculty of Medicine, Department of Medical Education, Universitas Gadjah Mada Yogyakarta, Indonesia
| | - Rodianson Tuah
- Faculty of Medicine, Department of Medical Education, Universitas Gadjah Mada Yogyakarta, Indonesia
| | - Patricia Riskione
- Faculty of Medicine, School of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Yayi Suryo Prabandari
- Faculty of Medicine, Department of Public Health, Universitas Gadjah Mada, Indonesia
| | - Christantie Effendy
- Faculty of Medicine, School of Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Effendy C, Vernooij-Dassen M, Setiyarini S, Kristanti MS, Tejawinata S, Vissers K, Engels Y. Family caregivers' involvement in caring for a hospitalized patient with cancer and their quality of life in a country with strong family bonds. Psychooncology 2014; 24:585-91. [DOI: 10.1002/pon.3701] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Christantie Effendy
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
- Kalorama Foundation; Beek-Ubbergen the Netherlands
| | - Sri Setiyarini
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
| | | | - Sunaryadi Tejawinata
- Center of Development for Palliative and Pain Relief; Dr. Soetomo Hospital; Surabaya Indonesia
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
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Effendy C, Vissers K, Tejawinata S, Vernooij-Dassen M, Engels Y. Dealing with symptoms and issues of hospitalized patients with cancer in indonesia: the role of families, nurses, and physicians. Pain Pract 2014; 15:441-6. [PMID: 24799294 DOI: 10.1111/papr.12203] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 02/21/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Patients with cancer often face physical, psychological, social, spiritual, and emotional symptoms. Our aim was to study symptoms and issues of hospitalized patients with cancer in Indonesia, a country with strong family ties, and how family members, nurses, and physicians deal with them. METHODS In 2011, 150 hospitalized cancer patients in 3 general hospitals in Indonesia were invited to fill in a questionnaire, which was based on the validated Problems and Needs of Palliative Care (short version) questionnaire. Descriptive statistics were performed. RESULTS Of 119 patients (79%) who completed the questionnaire, 85% stated that their symptoms and issues were addressed. According to these patients, financial (56%), autonomy (36%), and psychosocial (34%) issues were most often addressed by the family alone. Physical symptoms (52%) and spiritual issues (33%) were addressed mainly by a combination of family, nurses, and physicians. CONCLUSIONS Hospitalized patients with cancer in Indonesia felt that most of their symptoms and issues had been addressed, and the family was highly involved. The strong family ties in Indonesian culture may have contributed to this family role. More research is needed to clarify how this influences patient outcome, quality of care, and quality of life of both the patients and their families, along with the degree of partnership between families and professionals. This information might help answer the question what advantages and disadvantages the family role in caring for a hospitalized patient with cancer generates for the patient, the family, and professional caregivers.
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Affiliation(s)
- Christantie Effendy
- School of Nursing, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Sunaryadi Tejawinata
- Center of Development for Palliative and Pain Relief, Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.,Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.,Kalorama Foundation, Beek-Ubbergen, the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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Effendy C, Vissers K, Osse BHP, Tejawinata S, Vernooij-Dassen M, Engels Y. Comparison of problems and unmet needs of patients with advanced cancer in a European country and an Asian country. Pain Pract 2014; 15:433-40. [PMID: 24666769 DOI: 10.1111/papr.12196] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 01/12/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND Patients with advanced cancer experience problems and unmet needs. However, we assume that patients with advanced cancer will have more problems and unmet needs in a country with a lower economic status than in an economically stronger country. We studied whether patients with advanced cancer in Indonesia have more problems and unmet needs than a similar group of patients in the Netherlands. METHODS We performed a cross-sectional survey. We compared the data for 180 Indonesian and 94 Dutch patients relating to 24 items of the Problems and Needs in Palliative Care-short version questionnaire. We performed descriptive and χ(2) analysis with Bonferroni correction. RESULTS The prevalence of most physical problems, including pain, was similar in the 2 groups. In Indonesia, financial problems were the most common: 70 to 80% vs. 30 to 42% in the Netherlands. In Indonesia, 25 to 50% of the patients reported psychological and autonomy problems versus 55 to 86% in the Netherlands. The Indonesian group had many more unmet needs for each problem (> 54%) than the Dutch group (< 35%). CONCLUSION Apparently, economic and cultural differences hardly influence physical problems. Nonetheless, fewer Indonesian patients reported psychological and autonomy problems than Dutch patients. This difference contradicts our hypothesis. However, we found more unmet needs for professional attention in Indonesia than in the Netherlands, which is compatible with our hypothesis. These simple comparative data provide interesting insights into problems and unmet needs and give rise to our new hypothesis about cultural influences. This hypothesis should be studied in more depth.
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Affiliation(s)
- Christantie Effendy
- School of Nursing, Medical Faculty, Universitas Gadjah Mada, Yogyakarta, Indonesia.,Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
| | - Bart H P Osse
- Arentz en Osse Huisartsenpraktijk in Deventer, Deventer, the Netherlands
| | - Sunaryadi Tejawinata
- Center of Development for Palliative and Pain Relief, Dr. Soetomo Hospital, Surabaya, Indonesia
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.,Department of Primary and Community Care, Radboud University Nijmegen Medical Centre and Kalorama Foundation, Beek-Ubbergen, the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
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