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"Latar Belakang. Malnutrisi pada pasien kanker ginekologi merupakan masalah besar yang dapat mempengaruhi tingkat kelangsungan hidup pasien. Sayangnya, belum banyak penelitian yang dilakukan. Tujuan. Tujuan dari penelitian ini adalah untuk mengetahui perubahan status gizi pasien kanker ginekologi sebelum dan sesudah perawatan di Rumah Sakit Cipto Mangunkusumo. Metode. Studi yang dilakukan adalah dengan kohort prospektif yang melibatkan pasien kanker ginekologi yang dirawat di bangsal ginekologi Rumah Sakit Cipto Mangunkusumo Jakarta. Penelitian dilakukan dari bulan Juni 2016 sampai Mei 2017. Kami menggunakan teknik sampling konsekutif, food record, dan pengukuran antropometri lengkap untuk pengumpulan data. Kami menggunakan parameter indeks massa tubuh IMT untuk menilai kategori malnutrisi, dan pemeriksaan antropometri dan laboratorium untuk parameter status nutrisi lainnya. Untuk menganalisis data nutrisi, kami menggunakan NutriSurvey 2007 dan untuk data lain yang kami gunakan SPSS IBM 21.0. Hasil. Ada 96 subyek yang menjalani dan menyeselesaikan semua pemeriksaan dan data untuk penelitian ini. Proporsi malnutrisi berdasarkan IMT adalah 24 , sedangkan berdasarkan Malnutrisi Skrining Alat MST , prevalensi malnutrisi adalah 62,5 . Berdasarkan penurunan IMT, 20,8 pasien mengalami penurunan IMT setelah pengobatan. Lingkar Lengan Atas LILA dan serum albumin pasien menurun secara signifikan setelah pengobatan. Kesimpulan. Lingkar Lengan Atas LILA dan serum albumin pasien menurun secara signifikan setelah perawatan.

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Background. Cancer malnutrition in gynecologic cancers cases were big problem that can affect survival rate. Unfortunately, not many studies has been done. Objective. The aim of this study is to find out the nutritional status changes of gynecologic cancer patients before and after treatment in Gynecology Ward Cipto Mangunkusumo Hospital. Method. This is a prospective cohort study on gynecologic cancer patients treated in Gynecology Ward Cipto Mangunkusumo Hospital Jakarta. The study was done from June 2016 to May 2017. We used consecutive sampling techniques, food record, and complete anthropometric measurement for data collection. We used body mass index BMI parameter for appraising malnutrition categories, and anthropometric and laboratory examination for other parameters. For analysing data, we used NutriSurvey 2007 for nutritional data and SPSS IBM 21.0.for other data. Results. There were 96 subjects underwent all examination and data completion for the study. Proportion of malnutrition with BMI was 24 , while based on Malnutrition Screening Tool MST was 62,5 . There were 20,8 patients that experience reduction of BMI after treatment. Mid upper arm circumference MUAC and albumin serum of patients decrease significantly after treatment. Conclusion. Mid upper arm circumference MUAC and albumin serum of patients decrease significantly after treatment."

"ABSTRAKKanker merupakan salah satu penyakit dengan angka kematian yang tinggi. Kasuskanker di dunia tiap tahun terus meningkat. Kekambuhan akan kanker sendiri inimenimbulkan ketakutan pada pasien. Takut kekambuhan kanker adalah salah satumasalah psikologis yang paling penting diantara pasien kanker. dukungan sosialmerupakan strategi koping penting untuk dimiliki keluarga saat mengalami stress.Dukungan sosial keluarga dapat berfungsi sebagai strategi preventif untukmengurangi stress dan konsekuensi negatifnya. Metode penelitian menggunakandesain kuantitatif dengan pendekatan cross sectional, dengan jumlah sampel 153penyintas kanker ginekologi menggunakan kuesioner ILES dan FCRI dandianalisis menggunakan korelasi pearson. Hasil penelitian diperoleh adanyahubungan yang signifikan antara dukungan sosial dengan ketakutan kambuhpenyintas kanker ginekologi dengan p value 0,001 dengan dukungan emosionalyang paling besar diterima oleh penyintas kanker. Kesimpulan semakin besardukungan sosial semakin berkurang ketakutan kambuh kanker, sehinggadiharapkan dukungan sosial lebih ditingkatkan pada penyintas kanker ginekologi.

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ABSTRACTCancer is one disease with a high mortality rate. Cases of cancer in the worldeach year continue to increase. This recurrence of cancer itself creates fear in thepatient. The fear of cancer recurrence is one of the most important psychologicalproblems among cancer patients. social support is an important coping strategyfor the family when it comes to stress. Family social support can serve as apreventive strategy to reduce stress and its negative consequences. The researchmethod used a quantitative design with cross sectional approach, with the numberof samples of 153 survivors of gynecological cancer using the ILES and FCRIquestionnaires and analyzed using Pearson correlation. The result of the researchshowed that there was a significant correlation between social support and fear ofrelapse of gynecological cancer survivors with p value 0,001 with the greatestemotional support received by survivors of cancer. Conclusions The greater thesocial support the less the fear of recurrence of cancer, so it is expected moreenhanced social support in survivors of gynecological cancer."

"ABSTRAKNama : Patiyus Agustiansyah/NPM 1506706023Program Studi : Kajian Administrasi Rumah SakitJudul : Analisis dan Implementasi Lean pada Persiapan OperasiKanker Ginekologi di RSUP dr. Mohammad HoesinPalembangIndonesia saat ini memiliki beban kanker ginekologi besar yaitu insidensi,morbiditas dan mortalitasnya. Salah satu penanganan kanker ginekologi adalahpembedahan yang akan membantu kesintasan pasien. Waktu tunggu penjadwalanoperasi kanker ginekologi hendaklah memperhatikan progresifitas kankersehingga waktu tunggu operasinya tidak melebihi 2 minggu. Waktu tungguoperasi menggambarkan mutu pelayanan rumah sakit.Tujuan penelitian ini adalah,untuk menganalisis waktu tunggu penjadwalan operasi kanker ginekologi diRSUP dr. Moehammad Hoesin Palembang dengan menggunakan prinsip Lean.Hasil penelitian menunjukan penegakan diagnosis selama 43.844 menit dan waktutunggu operasi selama 66.700 menit, dengan menerapkan prinsip lean makapenegakan diagnosis 10.328,5 menit dan waktu tunggu operasi 10.325 menit.Kesimpulan penelitian, pada current state terdapat 26 aktifitas; 12 aktifitas VA value added ratio / VAR waktu 0,46 ; VAR jarak 89,6 dan 14 aktifitas NVA waste pasien dan 4 waste aktifitas petugas. Aliran proses yang menghambat bottle neck terdapat di pendaftaran, di poliklinik, di pemeriksaan penunjang dandi bagian praoperatif waktu tunggu paling lama . Future State memiliki 15aktifitas VA VAR waktu 33 ; VAR jarak 95,8 dengan 8 aktifitas NVA waste aktifitas pasien dan 0 waste aktifitas petugas, dengan waktu tunggudiagnosis 10.328,5 menit sedangkan waktu tunggu penjadwalan operasi 10.325menit. Hasil perbandingan current state dengan future state didapatkanpeningkatan aktifitas value added sebanyak 7,7 dengan penurunan waktutunggu 81,3 dan penurunan jarak tempuh 0,42 . Analisis akar masalahpenyebab waktu tunggu lama penjadwalan operasi kanker ginekologi di RSMHdikarenakan kekurangan SDM registrasi, rekam medis, DPJP dan keterbatasaninfrastruktur CT scan, kamar operasi dan instrumen dan kelemahan mengelolaproses penjadwalan operasi tersebut. Saran peneliti adalah peningkatan kinerjadan penambahan SDM, membuat regulasi untuk memprioritaskan pelayananpasien kanker ginekologi, serta integrasi Sistem Informasi Manajemen RumahSakit di setiap unit pelayanan.Kata Kunci : prinsip lean, value added VA , non value added NVA , waste,waktu tunggu penegakan diagnosis, waktu tunggu operasi, kanker ginekologi

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ABSTRACTName Patiyus Agustiansyah NPM 1506706023Program Studi Hospital Administration StudyTitle Lean Analysis and Implementation of Gynecology CancerOperative Scheduling in General Hospital dr. MohammadHoesin RSMH PalembangIndonesia currently has gynecologic cancer burden in the incidence, morbidityand mortality. One of gynecological cancer treatment is surgery which will helpthe survival rate of patients. The waiting time of gynecological cancer surgeryscheduling should bu focused to cancer progression so the waiting time should notexceed 2 weeks. The waiting time operation illustrates the quality of hospitalservices.The purpose of this study was to analyze the waiting time of gynecologiccancer surgery scheduling in RSMH by using the principles of Lean. The resultsshowed that establishing diagnosed need 43,844 minutes and the waiting timeoperation was 66,700 minutes. By applying Lean then the diagnosis establishing10,328.5 minutes, and operations waiting times 10,325 minutes. The studyconclusion showing for 26 activities of current state with 12 VA activities VARtime 0.46 VAR range for 89.6 and 14 NVA activities with 14 patient rsquo swastes activities and 4 employee wastes activities. The process flow whichinhibits bottle neck were lies in the stage of registration, at the outpatient clinic,at the laboratory examination and at the preoperative division the longest waitingtime . The waiting time for diagnosis process were 43.844 minutes, while thewaiting time scheduling of operation process were 66.700 minutes. Future Statehas 15 VA VAR time of 33 VAR range of 95.8 with 8 NVA activities and 8patients waste activity and 0 employee waste activities. The waiting time for adiagnosis process were 10328.5 minutes, while the waiting time for operationscheduling process were 10.325 minutes. The comparison between the currentstate to the future state resulted increasement of the VA activity for 7.7 with areduction in waiting time for 81.3 and mileage decrease of 0.42 . Analysis ofroot problems revealed that the long waiting times for scheduling process ofgynecologic cancer surgery in RSMH were due to lack of human resourcesquantity registration, medical records, doctor in charge and the lack ofinfrastructure CT scan, operating rooms and instruments and managerialweaknesses in managing the process of scheduling the surgery. Researcherssuggest to improve the performance of existing recruitment human resources,make regulations of a priority of gynecologic cancer patients, as well as theintegration of Hospital Management Information System in each unit.Keywords lean principles, values added VA , non value added NVA , waste,value added ratio, waiting time for establishing diagnosis, surgery waiting times,gynecological cancer"

"Objectives: This study aimed to gain insight into the unmet care needs and health care service barriers experienced by Indonesian gynecological cancer survivors after cancer therapy.Data Sources: Twenty purposively selected women who had completed gynecological cancer therapy for at least 1 year participated in a descriptive qualitative study. Data were collected through in-depth interviewsand thematically analyzed.Conclusion: The analysis constructed two themes and seven subthemes: (a) unmet care needs (subthemes: late side effects; cancer recurrence; stigma of cancer transmission; social-economic concerns), (b) deficientfunctions of health care services (subthemes: short consultation time; unempathetic health professionals; and inefficient time and cost for the health care services). The gynecological cancer survivors experiencedshortages of informational, psychological, and socioeconomic support after cancer therapy because of the deficient quality of the health care services.Implication for Nursing Practice: Nursing interventions couldmitigate the unmet care needs of gynecological cancer survivors after cancer therapy through patient-centered care services and multidisciplinary collaboration."

"Objective: The number of gynecological cancer survivors isincreasing in Indonesia, and these women often require physicaland emotional support from their male partners as primarycaregivers. However, the male caregiver`s need for biological,psychological, and social support is often neglected. This studyaims to assess the demographic and clinical determinantsaffecting the unmet supportive care needs of the gynecologicalcancer survivors` husbands in Indonesia. Methods: Thiscross‑sectional survey involved 152 husbands of survivors whowere recruited by a consecutive sampling method in two nationalreferral hospitals. A self‑administered Cancer Survivors` PartnersUnmet Needs Questionnaire was used for data collection.Multiple linear regression was performed to analyze the data.Results: The majority of participants (97.4%) reported at least oneunmet need. The primary unmet needs were legal services (71.1%),financial support (70.4%), cancer recurrence concerns (69.7%), andongoing health support (66.4%). These needs were significantlyassociated with the wife`s radio‑chemotherapy and lowerhousehold income (P < 0.01) and also related to the husband`seducation level, duration of caregiving, and wife`s cancer stage.Conclusions: Husbands of gynecological cancer survivors inIndonesia reported a need for legal, financial, and health‑careinformation and assistance. Multidisciplinary professionalsshould be involved in developing policy and interventions whichfacilitate the social‑economic protection of survivors and theirhusbands, as well as comprehensive care needs to enhance thewomen`s survival rate."

"ABSTRAK Pendahuluan: Pembesaran Prostat Jinak merupakan salah satu penyakit yangumum ditemukan pada pria lanjut usia, berakibat pada pembesaran prostat, obstruksi muara buli dan gejala saluran kemih bawah. Namun gejala dan obstruksi yang terjadi tidak seluruhnya bergantung pada ukuran prostat. Protrusi prostat intravesika telah ditemukan berkorelasi dengan obstruksi buli. Pada tulisan ini akan dibahas mengenai hubungan antara protrusi prostat intravesika, prostat specific antigen, dan volume prostat, serta mana dari ketiganya yang merupakan prediktor terbaik untuk menunjukkan adanya obstruksi muara buli yang disebabkan oleh pembesaran prostat jinak.Metode: Sebuah studi prospektif pada 118 pasien pria diperiksa antara Januari 2012 sampai Juli 2012. Pasien pria berusia lebih dari 40 tahun yang datang dengan LUTS dan dicurigai menderita BPH dipilih untuk mengikuti studi. Mereka dievaluasi dengan digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), serum total PSA, uroflowmetri, pengukuran urin residu postvoid, Intravesical Protrusion Prostate (IPP) dan Prostate Volume (PV), menggunakan USG transabdominal.Hasil: PV, IPP dan PSA menunjukkan korelasi paralel. Ketiga indikator menunjukkan korelasi yang baik dalam mendeteksi obstruksi muara buli yang disebabkan oleh pembesaran prostat jinak. Analisis statistik menggunakan tes Chi square dan Spearman?s Rank correlation test. Kurva Receiver Operator Characteristic (ROC) digunakan untuk membandingkan korelasi PSA, PV dan IPP dengan BOO. Angka rerata PSA ditemukan lebih tinggi signifikan pada pasien yang mengalami obstruksi (8.6 ng/mL;0.76-130) dibandingkan dengan yang tidak mengalami obstruksi (6.44 ng/ml;1.0-40.6). Angka rerata volume protat juga ditemukan lebih tinggi pada pasien dengan obstruksi (50.33 mL±24.34) dibandingkan yang tidak mengalami obstruksi (50.33 mL ±24.34). Angka rerata IPP juga ditemukan lebih tinggi signifikan pada pasien obstruksi (7.29±2.78) dibandingkan dengan yang tidak mengalami obstruksi (6.59±2.93). Koefisien korelasi rho spearman adalah 0.617, 0.721 dan 0.797 untuk PSA, PV, dan IPP.Dengan menggunakan kurva karakteristik receiver-operator, daerah di bawah kurva ditempat secara berturut-turut oleh PSA, PV, dan IPP yaitu 0.509, 0.562, dan 0.602. Nilai prediktif positif dari PV, PSA dan IPP adalah 59.7%, 55.6%, dan 60.2%. Menggunakan model regresi nominal, IPP tetap menjadi indeks independen utama untuk menentukan BOO yang disebabkan oleh pembesaran prostat jinak. Kesimpulan: Prostat Specific Antigen, Prosat Volume dan Intravesical Prostatic Protrusion diukur dengan menggunakan ultrasonografi transabdominal, merupakan metode yang noninvasif dan mudah didapat yang sangat berkorelasi dengan obstruksi muara buli (bladder outlet obstruction/BOO) pada pasien dengan pembesaran prostat jinak, dan korelasi IPP lebih kuat dibandingkan PSA dan PV.Ketiga indikator non invasif ini berkorelasi satu dengan lainnya. Studi ini menunjukkan bahwa IPP merupakan prediktor yang lebih baik untuk BOOdibandingkan PSA atau PV.

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ABSTRAK Introduction: Benign prostatic hyperplasia (BPH) is one of the most common diseases in elderly men. Benign prostatic hyperplasia may lead to prostatic enlargement, bladder outlet obstruction (BOO) and lower urinary tract symptoms (LUTS). But the symptoms and obstruction do not entirely depend on the size of prostate. In contrast, intravesical prostatic protrusion (IPP) has been found to correlate with BOO. This study will define the relationship between intravesical prostatic protrusion (IPP), prostate specific antigen (PSA) and prostate volume (PV) and also determine which one of them is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement.Method: A prospective study of 118 male patients examined between Januari 2012 until July 2012 was performed. Male patients aged more than 40 yearspresenting with LUTS and suggestive of BPH were selected for the study. They were evaluated with digital rectal examination (DRE), International Prostate Symptoms Score (IPSS), serum total PSA, uroflowmetry, postvoid residual urine measurement, Intravesical Protrusion Prostate (IPP) and Prostate Volume (PV) using transabdominal ultrasound.Results: PV, IPP and PSA showed parallel correlation. Although all three indices had good correlation in detecting bladder outlet obstruction caused by benign prostate hyperplasia. Statistical analysis included Chi square test and Spearman?s Rank correlation test. Receiver Operator Characteristic (ROC) curves were used to compare the correlation of PSA, PV and IPP with BOO. Mean prostate specific antigen was significantly higher in obstructed patients (8.6 ng/mL; 0.76-130) compared to non-obstructed patients (6.44 ng/mL; 1.0-40.6). Mean prostatevolume was significantly larger in obstructed patients (50.33 mL ± 24.34) compared to non-obstructed patients (45.39 mL ± 23.43). Mean IPP was significantly greater in obstructed patients (7.29 ± 2.78) compared to nonobstructed patients (6.59 ± 2.93). The Spearman rho correlation coefficients were 0.617, 0.721 and 0.797 for PSA, PV and IPP, respectively. Using receiveroperator characteristic curves, the areas under the curve for PSA, PV and IPP were 0.509, 0.562 and 0.602, respectively. The positive predictive values of PV, PSA and IPP were 59.7%, 55.6% and 60.2%, respectively. Using a nominalregression model, IPP remained the most significant independent index to determine BOO caused by benign prostate hyperplasia. Conclusion: Prostate Specific Antigen, Prostate volume & intravesical prostatic protrusion measured through transabdominal ultrasonography are noninvasive and accessible method that significantly correlates with bladder outlet obstruction in patients with benign prostatic hyperplasia and the correlation of IPP is much more stronger than PSA and PV. All three non-invasive indices correlate with one another. The study showed that IPP is a better predictor for BOO than PSA or PV."

"Pendahuluan dan tujuan: Keganasan ginekologis adalah salah satu penyebab kematian tersering pada perempuan. Hidronefrosis atau uropati obstruktif merupakan salah satu temuan tersering pada pasien dengan keganasan ginekologis. Penelitian ini bertujuan menjelaskan profil pasien uropati obstruktif yang disebabkan oleh keganasan ginekologis yang ditatalaksana di Rumah Sakit Cipto Mangunkusumo tahun 2019 sampai 2021 Metode: Dari Januari 2019 sampai Januari 2021, pasien uropati obstruktif dengan keganasan ginekologis yang menjalani prosedur pemasangan DJ stent atau nefrostomi dimasukkan dalam studi prospektif ini. Pasien dengan riwayat diversi urin maupun penyakut lain yang mungkin menyebabkan obstruksi saluran kemih dieksklusi dari penelitian. Hasil: Terdapat 121 pasien keganasan ginekologis dengan uropati obstruktif yang diteliti pada penelitian ini. Persentase pasien dengan pemasangan DJ stent bilateral, kanan, dan kiri adalah 72%, 18%, dan 10%. Mayoritas kasus adalah pasien dengan hidronefrosis grade 3 atau grade 4. Nefrostomi dilakukan pada 69,4% kasus, dan hanya 17% diantaranya yang mengalami episode polyuria. Kesimpulan: Mayoritas kasus uropati obstruktif disebabkan oleh keganasan serviks, dengan dominansi obstruksi bilateral. Nefrostomi adalah metode diversi urin pilihan pada penelitain ini.

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Introduction and Objectives: Gynecological malignancies are one of the most common causes of death from cancer in women. Hydronephrosis or obstructive uropathy is the most common finding in patients with gynecological malignancy. This study aimed to describe the profile of obstructive uropathy patients causes of gynecology malignancies treated in our center from 2019 to 2021. Method: From January 2019 to January 2021, obstructive uropathy patients with gynecological malignancies who underwent DJ stent or nephrostomy insertion procedures at Cipto Mangunkusumo Hospital were included in this prospective study. Patients with a history of urinary diversion or other diseases that may cause urinary tract obstruction were excluded. Results: One hundred and twenty-one patients with gynecological malignancies with obstructive uropathy were included. The percentages of bilateral, right-, and left-sided stent positions were 72%, 18%, and 10%, respectively. Most of them were grade 3 or grade 4 hydronephrosis. Percutaneous nephrostomy was mainly used for 69,4%, and only 17% of patients experienced a polyuria episode. Conclusion: Most cases of obstructive uropathy were caused by cervical malignancies, with bilateral obstruction due to cervical cancer occurring in most cases. Nephrostomy is the method of choice for urinary drainage in our center."

"ABSTRAKKehamilan pada perempuan mempengaruhi seluruh anggota keluarga dan pasangan. Pada kehamilan terjadi perubahan pola seksual yang mempengaruhi keharmonisan rumah tangga. Penelitian ini bertujuan mengetahui gambaran fungsi seksual laki-laki dan fungsi seksual perempuan selama masa kehamilan. Pengambilan sampel dari pasangan suami-istri yang mengalami kehamilan terbagi menjadi dua kelompok. Kelompok 1 laki-laki berjumlah 102 responden dan kelompok 2 perempuan sebanyak 102 responden, dilakukan di Kecamatan Rancabungur Kabupaten Bogor dengan menggunakan desain deskriptif, teknik nonprobability sampling, pendekatan consecutive sampling. Instrumen yang digunakan Brief Male Sexual Function Inventory dan Female Sexual Function Index. Analisis fungsi seksual laki-laki dan fungsi seksual perempuan menggunakan analisis deskriptif. Hasil penelitian menunjukan gambaran fungsi seksual laki-laki dan fungsi seksual perempuan selama periode kehamilan. Responden pada kedua kelompok, usia sebagian besar berada pada fase dewasa awal yaitu 20-40 tahun. Suami mengalami penurunan dorongan seksual 57 dan kepuasan seksual 56 sedangkan istri mayoritas tidak mengalami penurunan gairah seksual, rangsangan seksual, lubrikasi, orgasme, kepuasan seksual serta mengeluhkan peningkatan nyeri saat berhubungan seksual.

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ABSTRACTFemales pregnancy effects all of family members and life partner. In pregnancy, there are some changes that happened in sexual patterns which affect household harmony. This study aims to determine the description both of males and females sexual function during pregnancy. Sampling of married couples with pregnancy is divided into two groups. The total number of both of males and females group is 120 respondents and 102 respondents. The research was conducted in Rancabungur district, Bogor regency by using descriptive design, nonprobability sampling technique, consecutive sampling approach. The instruments used are Brief Male Sexual Function Inventory and Female Sexual Function Index. An analysis of both of males and females sexual function use descriptive analysis. The result shows a picture of both of male and female sexual function during the period of pregnancy. The range of respondents in both of the groups is mostly in the early adult phase of 20 40 years. The husband experienced a decrease in 57 sexual willingness and 56 sexual satisfaction while the majority wife did not experience a decrease in sexual desire, sexual stimulation, lubrication, orgasm, sexual satisfaction and complain of increased pain during intercourse."