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"Kanker serviks menjadi salah satu penyebab kematian perempuan di dunia, dimana insiden kanker serviks dilaporkan meningkat dari tahun ke tahun. Proses pengobatan kanker serviks adalah rangkaian yang panjang, sehingga sering menyebabkan klien menjadi stres, depresi, yang akan memengaruhi kualitas hidup pasien. Proses perawatan pada lima kasus kanker serviks telah diterapkan menggunakan integrasi teori adaptasi Roy dengan konsep dukungan sosial. Model adaptasi Roy merupakan model keperawatan yang mencakup aspek biologis, psikologis, sosial, kultural dan spiritual, bertujuan untuk memaksimalkan kemampuan adaptasi pasien terhadap krisis yang dihadapi dengan peran dukungan sosial keluarga di dalamnya. Tujuan dari laporan ini adalah memberikan gambaran tentang pelaksanaan praktik residensi ners spesialis dalam pengelolaan kasus klien dengan kanker serviks dengan pendekatan studi kasus yang menerapkan teori adaptasi Roy dan konsep dukungan sosial.

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Cervical cancer is one of the causes of death of women in the world, where the incidence of cervical cancer is reported to increase from year to year. The treatment therapy for women diagnosed with cervical cancer is a long series, so it often causes clients to become stressed, depressed, greatly affects the quality of life of patients. The treatment therapy in five cases of cervical cancer has been applied using the integration of Roy's theory of adaptation with the concept of social support. Roy's adaptation model is a nursing model, includes biological, psychological, social, cultural and spiritual aspects, aimed at maximizing the patient's adaptive ability to the crisis faced with the role of family social support. The purpose of this report is to provide an overview of specialist nurses residency practices in managing client with cervical cancer cases. The case study approach applies Roys adaptation theory and the concept of social support.

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"[ABSTRAKPermasalahan kesehatan di Indonesia diantaranya seputar kesehatan ibu dan kesehatan perempuan. Ners spesialis keperawatan maternitas yang memiliki peran dan fungsi pada kesehatan perempuan diharapkan dapat berperan dalam mengatasi permasalahan kesehatan perempuan. Karya ilmiah akhir ini bertujuan untuk memberikan gambaran pelaksanaan praktek residensi ners spesialis keperawatan maternitas dengan fokus penerapan teori keperawatan "need for help Wiedenbach" pada fase akut dan "conservation Levine" pada fase pemeliharaan dalam asuhan keperawatan tujuh kasus perdarahan akibat kanker serviks. Masalah keperawatan prioritas pada tahap akut adalah resiko hipovolemi. Masalah pada tahap konservasi adalah gangguan perfusi jaringan, gangguan nutrisi dan kelemahan. Evaluasi pada tahap akut adalah tidak terjadi syok hipovolemi. Evaluasi pada tahap konservasi adalah gangguan perfusi jaringan teratasi, klien dapat meningkatkan asupan nutrisi dan dapat meningkatkan kemampuan beraktifitas. Kompetensi selama pelaksanaan praktek keperawatan maternitas dapat dicapai. Ners spesialis keperawatan maternitas diharapkan mampu menerapkan teori model keperawatan dalam pelaksanaan asuhan keperawatan sesuai dengan kondisi dan kebutuhan pasien.

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ABSTRACTHealth problems in Indonesia are including maternal and women's health. Maternity nursing specialists who have the role and function on the women's health are expected to play a role in addressing women's health problems. This final scientific work aimed to describe the implementation of maternity nursing specialist residency practice focused on the application of Wiedenbach Need for Help Theory which was performed in the acute phase and Levine Conservation Theory which was done in the maintenance phase in nursing care of cervical cancer bleeding was performed on seven patients. The prior nursing problem in the acute phase was risk for hypovolemic. The problems in the conservation stage were tissue perfusion disorder, altered nutrition, and weakness. The evaluation in the acute phase was hipovolemic shock did not occur. The evaluations in the conservation phase were the tissue perfusion disorder was resolved, as well as the client can increase the nutritional intake and the ability to do the activity. The maternity nursing specialist competencies were achieved during the residency practice. The maternity nursing specialists are expected to be able to apply the nursing model theory in the implementation of nursing care in accordance with the patient's conditions and needs., Health problems in Indonesia are including maternal and women's health. Maternity nursing specialists who have the role and function on the women’s health are expected to play a role in addressing women's health problems. This final scientific work aimed to describe the implementation of maternity nursing specialist residency practice focused on the application of Wiedenbach Need for Help Theory which was performed in the acute phase and Levine Conservation Theory which was done in the maintenance phase in nursing care of cervical cancer bleeding was performed on seven patients. The prior nursing problem in the acute phase was risk for hypovolemic. The problems in the conservation stage were tissue perfusion disorder, altered nutrition, and weakness. The evaluation in the acute phase was hipovolemic shock did not occur. The evaluations in the conservation phase were the tissue perfusion disorder was resolved, as well as the client can increase the nutritional intake and the ability to do the activity. The maternity nursing specialist competencies were achieved during the residency practice. The maternity nursing specialists are expected to be able to apply the nursing model theory in the implementation of nursing care in accordance with the patient’s conditions and needs.]"

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Pasien penyintas kanker ginekologi mengalami masalah kesehatan yang kompleks dan memiliki kebutuhan-kebutuhan yang tidak terpenuhi. Kebutuhan tersebut meliputi kebutuhan fisik, psikologis, sosial, dan spiritual. Pasien penyintas kanker dengan masalah kekambuhan kanker mengharuskan pasien beradaptasi secara adaptif dan mendapatkan kenyamanan dalam menjalani kondisinya saat ini. Teori yang dapat digunakan pada kasus dengan kekambuhan adalah teori adaptasi Roy dan kenyamanan Kolcaba. Penerapan teori keperawatan pada lima pasien kelolaan yang mengalami kekambuhan dengan berbagai diagnosis kanker yang berbeda-beda. Dua orang didagnosis kanker serviks, dua orang lainnya kanker ovarium dan satu orang lainnya kanker vagina. Karena respon yang berbeda dari setiap pasien terhadap asuhan keperawatan yang diberikan, maka dilakukan modifikasi intervensi keperawatan. Kedua teori ini sesuai untuk diterapkan pada pasien penyintas kanker ginekologi dalam meningkatkan kenyamanan dan membantu klien beradaptasi secara fisiologis dengan kondisi yang dialaminya.

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Penerapan teori keperawatan Roy Adaptation dan Comfort Kolcaba pada Kanker Ginekologi. Kasus pasien kanker Ginekologi mengalami masalah kesehatan yang tidak terduga dan kebutuhan yang tidak terpenuhi. Kebutuhan tersebut antara lain fisik, psikologis, sosial, dan spiritual. Penderita masalah kekambuhan kanker dituntut untuk beradaptasi secara adaptif dan merasa nyaman dalam menjalani kondisi mereka saat ini. Teori-teori yang dapat digunakan dalam kasus-kasus berulang adalah adaptasi Roy dan kenyamanan Kolcaba. Penerapan teori keperawatan pada lima pasien yang dirawat yang mengalami kekambuhan dengan berbagai diagnosa kanker yang berbeda. Dua orang didiagnosis menderita kanker serviks, dua lainnya menderita kanker ovarium dan satu lagi menderita kanker vagina. Karena setiap pasien memberikan respon yang berbeda terhadap asuhan keperawatan yang diberikan, maka modifikasi intervensi keperawatan harus dilakukan.

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"Kanker Ovarium adalah pertumbuhan sel - sel yang abnormal pada satu atau dua bagian indung telur. Kanker ovarium merupakan penyakit ganas ginekologi kedua diseluruh dunia, pada tahun 2013 ditemukan 22240 pasien dimana 14.030 (15%) meninggal dunia akibat kanker ovarium tersebut. Laporan ini bertujuan memberikan gambaran tentang pelaksanaan praktik spesialis keperawatan maternitas dalam menjalankan perannya sebagai pendidik, pelindung, pengelola, kolaborator, komunikator, konselor, koordinator, agen perubah dan peneliti dalam memberikan asuhan keperawatan pada klien kanker ovarium dengan menggunakan teori adaptasi Roy. Model teori keperawatan adaptasi Roy efektif dilakukan pada kedua kasus ibu dengan kanker ovarium, aplikasi teori tersebut membantu menyelesaikan masalah keperawatan di fase akut maupun di fase pemulihan. Pada klien kanker ovarium perlu adanya pengabungan teori Loss and Griving dengan adaptasi Roy untuk membantu klien mempertahankan keadaan psikologis klien dalam tahap menerima. Penulis mampu mencapai target kompetensi dalam praktik klinik keperawatan maternitas residensi dengan baik.

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Ovarian cancer is the growth of abnormal cells in one or two parts of the ovary. Ovarian cancer is the second gynecological malignant disease throughout the world. In 2013 there were 22,240 patients that 14,030 (15%) died from the ovarian cancer. This report aimed to provide an overview of the implementation of maternity nursing specialist practice in carrying out its role as an educator~ a protector, a manager, a collaborator, a communicator, a counselor, a coordinator, an agent of change and a researchers in providing nursing care to the ovarian cancer clients using Roy adaptation theory. Roy adaptation nursing theory model was effectively performed in both cases of women with ovarian cancer, the application of the theory helped to solve the nursing problem in the acute phase and in the recovery phase. The combination of Loss & Grieving and Roy Adaptation Theory could help ovarian cancer clients to maintain their psychological state in the receiving phase. The author was able to achieve the target competencies in maternity nursing residency clinical practice successfully."

"Laporan ini merupakan rangkuman laporan praktek keperawatan maternitas residen selama satu tahun. Residen menjalankan peran dan fungsi sebagai pemberi pelayanan keperawatan, konselor, advokad, edukator, koordinator, pengelola, kolaborator, dan peneliti dalam upaya meningkatkan kesehatan reproduksi perempuan selama melaksanakan praktek di rumah sakit dan komunitas. Diantara sekian banyak masalah kesehatan reproduksi perempuan, kanker serviks stadium lanjut merupakan fokus of interest residen dengan menerapkan teori keperawatan adaptasi Roy. Diagnosa kanker selalu menimbulkan krisis yang menuntut klien dan keluarga untuk selalu beradaptasi dengan perubahan status kesehatannya. Penerapan teori ini terbukti dapat memberikan asuhan keperawatan pada klien secara komprehensif. Selama menjalani praktek residen banyak mendapatkan dukungan dan beberapa hambatan yang menjadi wahana pembelajaran untuk pendewasaan diri residen.

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This report is a summary of residential practice report of maternity nursing specialist during one year. The resident performed the role and function as a maternity care provider, a counselor, an advocate, an educator, a coordinator, a manager, a collaborator, and a researcher to improve the women reproductive health during implementing nursing practice in the hospital and community. Among many female reproductive health problems, the late-stage cervical cancer was the resident's focus of interest with the application of Roy’s Adaptation Nursing Theory. A cancer diagnosis always causes a crisis demanding a client and the family to adapt to the changes of his/her health status. It is proved that the application of this theory could provide a comprehensive nursing care to a client. During the practice period the resident obtained much supports and some obstacles that educated the resident to be a mature person."

"Perawat maternitas memiliki kompetensi yang berkontribusi dalam pencapaian tujuan Millennium Development Goals melalui pengembangan fungsi dan peran perawat sebagai Spesialis Keperawatan Maternitas. Tujuan penulisan laporan ini untuk memberikan gambaran pelaksanaan praktek Spesialis Keperawatan Maternitas dalam menjalankan perannya sebagai care giver, konselor, advokat, edukator, koordinator, kolaborator, komunikator, peneliti, dan agen pembaharu dalam memberikan asuhan keperawatan pada perempuan sepanjang periode kehidupannya dengan menerapkan teori keperawatan. Fokus laporan juga pada penerapan teori Adaptasi Roy dan Symptom Management Humphreys digunakan pada klien kanker ovarium post operasi sitoreduktif dengan kemoterapi. Kedua teori ini sesuai diterapkan untuk meningkatkan kualitas hidup klien melalui peningkatan respon adaptif setelah operasi sitoreduktif dan pengelolaan gejala saat kemoterapi.

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Maternity nurses contributes to achieve the MDGs goals by improving role and function as maternity nursing specialist. The purpose of this report is to describe the implementation of Maternity Nursing Specialist practices in their role as care giver, counselor, advocate, educator, coordinator, collaborator, communicator and innovator by applying nursing theory in nursing care of women througout their life. The Roy Adaptation Theory and the Symptom Management was used to apply nursing care of client with ovarian cancer post cytoreductive surgery and chemotherapy. Both theory are suitable to use in ovarian cancer patients post cytoreductive surgery with chemotherapy to achieve quality of life."

"ABSTRAK Karya Ilmiah Akhir ini disusun sebagai laporan akhir dari praktik residensi ners spesialis keperawatan Maternitas yang berfokus pada penerapan teori keperawatan Konservasi Levin dan Comfort Kolkaba pada asuhan keperawatan pasien yang mengalami kanker serviks sadium IIIB. Tujuan penulisan pelaporan ini adalah untuk memberikan gambaran kegiatan tentang pelaksanaan praktik residensi Ners Spesialis Keperawatan Maternitas dengan fokus penerapan teori keperawatan Levine dan Comfort Kolkaba pada pasien dengan kanker serviks stadium IIIB dalam menjalankan perannya sebagai direct care provider, konselor, advokat, edukator, koordinator, kolaborator, komunikator, change agent dan peneliti. Apliaksi teori keperawatan Konservasi Levin dan Comfort Kolkaba efektif dilakukan pada lima kasus pasien dengan kanker serviks stadium IIIB. Teori keperawatan Konservasi Levin menjadi pilihan pada pasien dengan kanker serviks di ruang perawatan untuk memperbaiki keadaan umum pasien sesuai kemampuan adapatasi pasien terhadap konservasi energi, integritas struktural, integritas personal dan integritas sosial . Kenyamanan adalah kebutuhan dasar manusia oleh karena itu perawat menggabungkan teori konservasi Levine dengan kenyamanan Kolkaba pada pada tiga pasien kanker serviks stadium IIIB yang sudah dilakukan nefrostomi. Kata kunci: Asuhan keperawatan, kanker serviks stadium IIIB, teori keperawatan Levin, teori keperawatan Kolkaba ABSTRACT Final scientific report of clinical practice maternity nursing specialist which focus on the application of Nurisng Theory Conservation Levin and Comfort Kolkaba in Nursing Care of patients with Cerviks cancer thirtd stadium. xv 55 pages. 1 table 2 scheme 8 appendixes ABSTRACTThis final scientific paper is prepared as a final report of residency practice of nursing specialist of Maternity nursing which focuses on applying the nursing theory of Levin Conserve and Comfort Kolkaba on nursing care of patients who have cervical cancer IIIB. The purpose of this report is to provide an overview of activities on the implementation of residency practice Ners Maternity Nursing Specialist with a focus on the application of Levin and Comfort Kolkaba nursing theory in patients cervical cancer with stage IIIB in performing its role as a direct care provider, counselor, advocate, educator, coordinator, collaborator, communicators, change agents and researchers. Application of nursing theory Conservation of Levin and Comfort Kolkaba was effective in five cases of patients with stage IIIB cervical cancer. The Levin Conservation Nursing Theory becomes an option in patients with cervical cancer in the treatment room to improve the general state of the patient according to the patient 39 s ability to adapt the conservation energy, structural integrity, personal integrity and social integrity . Convenience is a basic human need therefore nurses combine Levine conservation theory with Kolkaba comfort in three patients with stage IIIB cervical cancer who have done nephrostomy. Keyword Nursing process, Cervical cancer, Levin rsquo s nursing theory, Kolkaba nursing theoryReferences 15 2006 2017 "

"Wanita yang menderita kanker serviks stadium lanjut mengalami malodor yang akan mengganggu kualitas hidupnya. Perawat memiliki kewajiban untuk membantu pasien dengan menggunakan pendekatan teori Unpleasant Symptom dan Self Care. Dengan menggunakan teori Unpleasant Symptom pasien dibimbing untuk mengenali keluhan dan dampak yang mungkin terjadi pada dirinya, sedangkan dengan teori Self Care pasien dibimbing untuk mengenali potensi dirinya dalam mengatasi keluhannya secara mandiri sesuai dengan kemampuan diri dan support systemnya. Dengan berdasar kepada dua konsep yang dikolaborasikan, dilakukan implementasi evidence based practice nursing (EBPN) menggunakan intervensi perawatan luka kanker dengan menggunakan formula topikal standar dengan melibatkan pasien dan keluarga. Hasil menunjukan bahwa perawatan luka kanker dengan formula topikal standar dapat mengurangi instensitas malodor dan meningkatkan gambaran diri pasien.

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Woman with advance cervical cancer will experience malodour which would influence their quality of life. Nurses has a responsibility to help patient by using the Unpleasant Symptom and Self Care theory approaches. Using the Unpleasant Symptom theory, the patient is guided to recognize symptom and the effect that may occur to herself, whereas with the self care theory the patient is hint to know her own potential and manage her symptom independently according to her abilities and support system. Based on two colaborative concepts, evidence based practice nursing is implemented. Intervention given by nurse involved patients and families in giving a cancer wound care using standard topical formulas. The result show that wound care with standard topical formula effective to reduce malodour and improving patient self image."

"Serviks atau leher rahim merupakan salah satu bagian dari sistem alat reproduksi wanita. Salah satu penyakit yang dapat menyerang serviks adalah kanker. Di dunia, kanker serviks adalah salah satu kanker yang menyebabkan kematian dan keganasan yang paling umum terjadi pada wanita. Kanker serviks merupakan penyakit yang memiliki peluang sembuh cukup besar jika terdeteksi sejak dini. Seiring dengan perkembangan teknologi dalam berbagai bidang, termasuk dalam bidang medis, maka pendeteksian dini kanker serviks dapat dilakukan dengan klasifikasi menggunakan bantuan dari metode klasifikasi machine learning. Pada penelitian ini, metode klasifikasi machine learning yang digunakan untuk mengklasifikasikan kanker serviks adalah metode Naïve Bayes (NB) dan Support Vector Machine (SVM) dengan seleksi fitur Grey Wolf Optimization (GWO). Seleksi fitur GWO merupakan seleksi fitur metode wrapper yang digunakan pada penelitian ini untuk mengeliminasi fitur-fitur tidak relevan dalam mengklasifikasikan data kanker serviks, agar NB dan SVM dapat mengklasifikasi dengan lebih akurat. Sehingga, metode ini disebut sebagai metode NB–GWO dan SVM–GWO. Data kanker serviks yang digunakan pada penelitian ini merupakan data numerik dari hasil citra MRI yang diperoleh dari Departemen Radiologi RSUPN Dr. Cipto Mangunkusumo. Berdasarkan hasil penelitian dengan seleksi fitur GWO, metode NB–GWO menghasilkan rata-rata akurasi, recall, dan f1-score tertinggi masing-masing sebesar 96,30%, 96,08%, 97,93%, dan 96,30%, sedangkan metode SVM–GWO menghasilkan rata-rata akurasi dan f1-score tertinggi masing-masing sebesar 95,37% dan 95,36% dengan kernel Linier, rata- rata presisi tertinggi sebesar 97,56% dengan kernel Polinomial, serta rata-rata recall tertinggi sebesar 99,75% dengan kernel RBF. Kemudian, berdasarkan hasil klasifikasi tanpa seleksi fitur GWO, metode NB menghasilkan rata-rata akurasi, presisi, recall, dan f1-score tertinggi masing-masing sebesar 91,98%, 95,21%, 92,90%, 91,95%, sedangkan metode SVM menghasilkan rata-rata akurasi, recall, dan f1-score tertinggi sebesar 92,13%, 99,24%, dan 92,19% dengan kernel RBF, serta rata-rata presisi tertinggi sebesar 93,59% dengan kernel Polinomial. Dengan demikian, metode seleksi fitur GWO dapat meningkatkan kinerja dari NB dan SVM dalam mengklasifikasikan data kanker serviks. Selanjutnya, berdasarkan hasil perbandingan kinerja dari NB–GWO dan SVM–GWO, maka secara keseluruhan metode NB–GWO menghasilkan kinerja yang lebih baik dalam mengklasifikasikan data kanker serviks dibandingkan dengan SVM–GWO.

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Cervix is one part of the female reproductive system. One of the diseases that can attack the cervix is cancer. In the world, cervical cancer is one of the cancers that cause death and malignancy that is most common in women. Cervical cancer is a disease that has a considerable chance of recovery if detected early. Along with the development of technology in various fields, including in the medical field, the early detection of cervical cancer can be done by classification using the help of machine learning classification methods. In this study, the machine learning classification method used to classify cervical cancer was Naïve Bayes (NB) and Support Vector Machine (SVM) with Grey Wolf Optimization (GWO) feature selection. GWO feature selection is a wrapper feature selection method used in this study to eliminate irrelevant features in classifying cervical cancer data, so that NB and SVM can classify more accurately. Thus, this method is referred to as the NB–GWO and SVM–GWO. Cervical cancer data used in this study is numerical data from MRI obtained from the Department of Radiology RSUPN Dr. Cipto Mangunkusumo. Based on the results of the study with GWO feature selection, NB– GWO produced the highest average accuracy, recall, and f1-score of 96.30%, 96.08%, 97.93%, and 96.30% respectively, while SVM–GWO produced the highest average accuracy and f1-score of 95.37% and 95.36% respectively with Linear kernel, the highest precision average of 97.56% with Polynomial kernel, and the highest recall average of 99.75% with RBF kernel. Then, based on the results of classification without GWO feature selection, the NB produced the highest average accuracy, precision, recall, and f1- score of 91.98%, 95.21%, 92.90%, 91.95% respectively, while SVM produced the highest average accuracy, recall, and f1-score of 92.13%, 99.24%, and 92.19% with RBF kernel, and the highest average precision of 93.59% with Polynomial kernel. Thus, GWO feature selection method was able to improve the performance of NB and SVM in classifying cervical cancer. Furthermore, based on the results of performance comparison from NB– GWO and SVM–GWO, the overall method of NB–GWO resulted in better performance in classifying cervical cancer data compared to SVM–GWO."

"Kanker serviks merupakan salah satu jenis kanker dengan kejadian tertinggi pada perempuan di Indonesia. Tesis ini bertujuan untuk mengkaji hubungan antara dukungan sosial dengan koping dan resiliensi serta faktor demografi yang memengaruhi pada pasien kanker serviks. Penelitian ini menggunakan desain cross-sectional dengan 213 responden dari RSK Dharmais. Instrumen yang digunakan meliputi Edmonton Symptom Assessment System, Multidimensional Scale of Perceived Social Support, Cancer Coping Questionnaire, dan Connor-Davidson Resilience Scale. Analisis data dilakukan secara univariat dan bivariat menggunakan chi-square, dan uji multivariat dilakukan untuk melihat faktor yang paling memengaruhi hubungan koping dan resiliensi. Hasil penelitian menunjukkan bahwa dukungan sosial berpengaruh positif terhadap koping dan resiliensi pasien kanker serviks, dengan faktor seperti status perkawinan dan dukungan sosial yang berkontribusi dalam hubungan ini.

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Cervical cancer is one of the most common types of cancer among women in Indonesia. This thesis aims to examine the relationship between social support, coping, and resilience, as well as the demographic factors influencing cervical cancer patients. The research employs a cross-sectional design with 213 respondents from Dharmais Hospital. The instruments utilized include the Edmonton Symptom Assessment System, the Multidimensional Scale of Perceived Social Support, the Cancer Coping Questionnaire, and the Connor-Davidson Resilience Scale. Data analysis is conducted using univariate and bivariate methods with chi-square tests, while multivariate analysis is performed to identify the most influential factors in the relationship between coping and resilience. The findings indicate that social support positively impacts coping and resilience among cervical cancer patients, with factors such as marital status and social support was contributing to this relationship."