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"ABSTRAK Peningkatan angka morbiditas dan mortalitas akibat penyakit kanker di Indonesia menunjukkan bahwa permasalahan kanker ini semakin besar dan kompleks Salah satunya adalah adanya keterlambatan pasien kanker untuk mendapatkan terapi definitif yang disebabkan oleh faktor faktor yang berasal dari pasien sendiri Penelitian ini merupakan studi analisis deskriptif menggunakan metode campuran kuantitatif dan kualitatif untuk mengetahui data insidens keterlambatan terapi karena keterlambatan pasien pada pasien kanker yang dirujuk ke Departemen Radioterapi RSUPN Dr Cipto Mangunkusmo pada bulan Mei Agustus 2015 serta mengevaluasi faktor faktor apa saja yang mempengaruhi keterlambatan pasien tersebut Terdapat 294 orang pasien yang diikutsertakan dalam penelitian ini setelah mendapatkan persetujuan tertulis Sebagian besar pasien 71 4 adalah perempuan dan 141 orang 48 bekerja sebagai ibu rumah tangga Rentang umur terbanyak adalah 36 50 tahun yaitu sebanyak 132 pasien 44 9 dan hampir seluruh pasien 91 8 telah menikah Keterlambatan terapi didapatkan pada 153 orang pasien 52 dan 67 orang di antaranya 43 8 memiliki riwayat pengobatan alternatif yang dilakukan dalam interval waktu setelah timbul keluhan pertama kali dan atau setelah pasien melakukan konsultasi medis pertama kali Analisis statistik menunjukkan adanya hubungan yang signifikan antara faktor usia p 0 047 pendidikan p 0 047 dan riwayat pengobatan alternatif p 0 0001 dengan keterlambatan terapi Adanya rasa takut untuk berobat secara medis atau menjalani tindakan medis menjadi alasan 51 orang pasien untuk memilih pengobatan alternatif Oleh karena itu diperlukan pengawasan dan evaluasi terhadap pengobatan alternatif terutama yang menyangkut kualitas efikasi dan keamanannya ABSTRACT Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety ;Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety ;Increased morbidity and mortality due to cancer in Indonesia showed that this problem has become more complex and significant One of the problems pointed out is regarding a delay in cancer patients to receive definitive therapy caused by factors derived from the patients themselves This study is a descriptive analysis using combination of quantitative and qualitative methods to determine the incidence of treatment delay due to patient delay in cancer patients who were referred to Radiotherapy Department Dr Cipto Mangunkusmo hospital during May August 2015 and to evaluate factors that influence the patient delay There are 294 patients enrolled in this study after obtaining a written consent Most of the patients 71 4 were women and 141 48 work as a housewife The largest age range was 36 50 years with 132 patients 44 9 and almost all patients 91 8 were married Delay in treatment obtained in 153 patients 52 and 67 of them 43 8 had a history of alternative medicine that is performed in a time interval after the patients experienced first complaints and or after patients had their first medical consultation Statistical analysis showed a significant relationship between age p 0 047 educational level p 0 047 and history of alternative medicine p 0 0001 with the treatment delay The fear of being treated medically or undergo a medical procedure has become the major reasons found in 51 patients to choose the alternative treatment Therefore it is necessary to conduct monitoring and evaluation of alternative medicine especially concerning the quality efficacy and its safety "

"Tujuan : Mengetahui kepatuhan panduan terapi terhadap angka keberhasilan terapi kanker nasofaring. Metode : Penelitian kohort retrospektif terhadap 269 pasien kanker nasofaring yang berobat di RSCM periode Januari 2017-Juli 2018. Analisis bivariate, log regression dan kesintasan hidup Kaplan Meier dilakukan pada 140 pasien yang memenuhi kriteria inklusi. Hasil : Didapatkan 67,1% pasien lelaki, median usia 48 (18-73) tahun, rujukan internal RSCM 52,9% dengan 57,1% dari Departemen THT-KL. Sekitar 49,3% pasien datang dengan stadium IV A (49,3%), tipe histopatologi WHO III (90%), dan mendapatkan kemoradiasi (60,7%). Angka kepatuhan terhadap PPK dari interna dan RSCM adalah 21,6% dan 6,1%. Ketidakpatuhan penggunaan modalitas terapi dan penegakkan diagnosis kerja internal dan eksternal RSCM adalah 6,8%-4,06% dan 13,6%-31,8%. Ketidakpatuhan pemberian jumlah siklus kemoterapi neoajuvan dan ajuvan sebesar 29,27% dan jumlah siklus pada kemoterapi konkuren sebesar 70,71%. Sekitar 2,14% pasien mendapatkan dosis radiasi <70Gy. Durasi waktu dimulainya terapi adalah 92,5 (14-830) hari, dimulainya kemoradiasi paska kemoterapi neoajuvan adalah 146 (SB 10,04) hari, dimulainya kemoterapi ajuvan paska kemoradiasi adalah 121,88 (SB 18,35) hari. Durasi radiasi / kemoradiasi adalah 48 (39-77) hari. Kesintasan hidup satu dan dua tahun pada masing-masing stadium I, II, III, IV A, dan IV B secara berurutan adalah 100%, 85%, 85%, 84%, 87% dan 100%, 85%, 77%, 69%, 46%. Dosis radiasi dan kemoterapi neoajuvan berpengaruh terhadap angka kesintasan hidup pasien (P < 0,01 dan P < 0,03). Kepatuhan terhadap modalitas dan durasi waktu terapi secara statistik tidak bermakna namun memiliki trend perbedaan dalam memperngaruhi kesintasan. Kesintasan hidup satu dan dua tahun pada kelompok yang patuh PPK adalah 94,1% dan 80,5%. Pada kelompok yang tidak patuh PPK, didapatkan 82,6% dan 64,2% (P <0,19)

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Objective: The purpose of this study was to determine adherence to therapeutic guidelines and their effects on the success rates of nasopharyngeal cancer therapy. Methods: A retrospective cohort study was performed to 269 nasopharyngeal cancer patients treated at Dr. Cipto Mangunkusumo General Hospital (RSCM) from January 2017 to July 2018. Bivariate analysis, logistic regression and Kaplan-Meier survival analyses were conducted to assess the 140 patients who met the inclusion criteria. Results: In our cohort, approximately 67.1% of male patients, median age was 48 years (18-73 years old ), and RSCM internal referrals were 52.9% with 57.1% from the ENT Department. The majority of patients came with stage IV A (49.3%) with WHO III (90%) histopathological type and chemoradiation was the main modality used (60.7%). The compliance rate for PPK from the RSCM internally was 21.6% and the RSCM external was 6.1%. Non-compliance of the usage of therapeutic modalities and the diagnosis from internal and external referrals of the RSCM is 6.8%-4.06% and 13.6%-31.8%. Non-compliance with the number of cycles of neoadjuvant and adjuvant chemotherapy was 29.27% ​​and the number of cycles in concurrent chemotherapy was 70.71%. About 2.14% of patients get a radiation dose under 70 Gy. Duration of commencement therapy was 92.5 (14-830) days, the commencement of chemoradiation after neoadjuvant chemotherapy was 146 (SD 10.04) days, the commencement of adjuvant chemotherapy after chemoradiation was 121.88 (SD 18.35) days. Radiation / chemoradiation duration is 48 (39-77) days. The survival of one and two years for each stage I, II, III, IV A and IV B sequentially was 100%, 85%, 85%, 84%, 87% and 100%, 85% , 77%, 69%, 46%. In general, radiation doses and neodjuvant chemotherapy affect the survival of patients (P<0,01 and P<0,03). Compliance with modalities and duration of therapy is not statistically significant but has a trend of difference in influencing survival in groups that are obedient and not obedient to PPK. The survival of one and two years in the PPK-compliant group was 94.1% and 80.5%. In the PPK non-adherent group, 82.6% and 64.2% were found (P<0.19)"

"Kanker Nasofaring KNF merupakan salah satu kasus keganasan paling sering di Indonesia dengan karakteristik yang unik secara epidemiologi, patologi dan klinis. Faktor prognosis KNF telah menjadi fokus penelitian yang cukup penting dalam sejumlah studi yang telah dilakukan. Penelitian ini bertujuan mengetahui karakteristik pasien KNF yang terdiagnosis di Poli THT RSCM serta angka kesintasan dengan melakukan analisis terhadap faktor yang berperan terhadap prognosis. Penelitian ini merupakan suatu penelitian kohort retrospektif dengan subjek penelitian bersifat total sampling pasien KNF yang terdiagnosis di Poli THT. Sebanyak 561 subjek penelitian ini, pria memiliki prevalensi sebanyak 2.8 kali daripada wanita. WHO tipe 3 dan WF tipe A menjadi jenis histopatologi paling dominan. Stadium IV A didapatkan pada 30.1 subjek dan 18.9 subjek sudah berada dalam kondisi metastasis jauh. Nilai tengah untuk waktu tunggu radiasi adalah 91 12-344 hari dengan durasi radiasi 53 39-95 hari. Stadium IVC, p= 0,000 , N3 p= 0,018 , metastasis jauh p= 0,000 , dan drop out atau tidak mendapat terapi p= 0,000 menjadi faktor yang memberikan kesintasan lebih buruk pada penelitian ini.

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Nasopharyngeal Cancer NPC is one of the most frequent cancer in Indonesia which has a unique characteristic in epidemiology, pathology and clinical features. Prognostic factors are recently became the most important research foci, and a large number of investigation in this area have been performed. The objective of this study is to know the characteristics of NPC patients that have been diagnosed in ENT Department of RSCM and analyzed some factors that might have role in overall survival. This is the retrospective cohort study with total sampling subject. From 561 subjects, Male has 2.8 higher prevalence than female. WHO type 3 92,3 and WF type A 97,1 are the majority hisopathological result. Stage IV A is found in 30,1 subjects and 18,9 subjects were already in metastatic state. The median value of radiation waiting time was 91 12 344 days, duration time of radiation was 53 39 95 days. Stage IVC p 0,000 , N3 p 0,018 , distant metastatic p 0,000 , and drop out or no treatment p 0,000 are found to be the factors that give a negative impact in overall survival."

"ABSTRAKPenyakit kanker merupakan penyakit yang sangat kompleks sehingga memerlukan pendekatan multidisiplin baik dalam diagnostik maupun terapi. Durasi penegakkan diagnosis dan terapi pada pasien kanker mempengaruhi hasil akhir pasien tersebut. Keterlambatan terapi dapat disebabkan oleh keterlambatan dokter dalam merujuk pada pelayanan kesehatan primer dan keterlambatan sistem pelayanan kesehatan pada proses penegakkan diagnosis dan dimulainya terapi definitif pada kanker. Penelitian ini merupakan studi analisis deskriptif menggunakan metode campuran kuantitatif dan kualitatif untuk mengetahui data insidens keterlambatan terapi pada pasien kanker yang dirujuk ke Departemen Radioterapi RSUPN Dr. Cipto Mangunkusmo pada bulan Mei - Agustus 2015 serta mengevaluasi faktor yang mempengaruhi keterlambatan tersebut. Terdapat 294 orang pasien yang diikutsertakan dalam penelitian ini setelah mendapatkan persetujuan tertulis. Pada keterlambatan terapi akibat keterlambatan dokter, dari 62 pasien yang dirujuk dari pelayanan kesehatan primer didapatkan 18 pasien (29%) mengalami keterlambatan rujukan. Keterlambatan diagnosis terjadi pada 78 pasien (26,5%). Sedangkan pada keterlambatan tindakan pengobatan terjadi pada 172 pasien (58,5%). Dari seluruh pasien didapatkan 132 pasien (45%) mengalami keterlambatan dokter dan sistem. Berdasarkan analisis statistik menunjukkan adanyan hubungan yang signifikan antara keterlambatan rujukan (p<0,01), keterlambatan diagnosis (p<0,01) dan keterlambatan tindakan pengobatan (p<0,01) dengan keterlambatan terapi akibat keterlambatan dokter dan system. Tingginya angka keterlambatan terapi kanker pada penelitian ini ditemukan akibat keterlambatan dokter dan sistem, khususnya pada keterlambatan pada penegakkan diagnosis dan tindakan pengobatan.

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ABSTRACTCancer is a very complex disease that requires a multidisciplinary approach both in diagnostics and therapy. The duration of the diagnosis and treatment of cancer patients affect the outcome of these patients. Delay in treatment may be caused by the delay in referring physicians in primary health care and health care system delay in the commencement of the process of diagnosis and definitive therapy in cancer. This study was a descriptive analytical study using a mix of quantitative and qualitative methods to determine the incidence of therapy delays in cancer patients who were referred to the Department of Radiotherapy RSUPN Dr. Cipto Mangunkusmo in May to August for 2015 and evaluate the factors that influence the delay. There were 294 patients included in this study after obtaining written consent. Doctor's delay due to delayed treatment, from 62 patients referred from primary health care is obtained for 18 patients (29%) experienced a delay in referral. Delay in diagnosis occurred in 78 patients (26.5%). While the delay in treatment action occurred in 172 patients (58.5%). From all patients had 132 patients (45%) experienced doctor and system delay. Statistical analysis showed a significant correlation between the reference delay (p <0.01), late diagnosis (p <0.01) and delays in treatment measures (p <0.01) with a delay due to delayed therapy and doctor system. The high number of delays in cancer therapy in this study was found as a result of delays doctor and systems, in particular on the delay in diagnosis and treatment.eterlambatan terapi akibat keterlambatan dokter dan system. Tingginya angka keterlambatan terapi kanker pada penelitian ini ditemukan akibat keterlambatan dokter dan sistem, khususnya pada keterlambatan pada penegakkan diagnosis dan tindakan pengobatan."

"ABSTRAKKasus kanker terbanyak kedua di Indonesia adalah kanker payudara yangkesembuhannya sulit untuk diprediksi. Penderita kanker payudara mengalamiketidakpastian, depresi, dan tekanan psikologis. Kondisi ini menyebabkanoptimisme terhadap kesembuhan pasien menurun. Penelitian ini bertujuanmengetahui faktor-faktor yang mempengaruhi optimisme terhadap kesembuhanpada pasien kanker payudara. Desain penelitian menggunakan cross sectionalpada 96 responden. Faktor-faktor yang mempengaruhi secara signifikan terhadapoptimisme kesembuhan responden adalah dukungan sosial (p value = 0,015) danstres (p value = 0,022). Faktor yang paling mempengaruhi adalah dukungan sosial(β = 0,055). Rekomendasi untuk penelitian selanjutnya agar lebih fokus padaintervensi keperawatan yang digunakan untuk meningkatkan dukungan sosialpada pasien kanker payudara.

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ABSTRACTThe second most common cancer case in Indonesia is breast cancer which itshealing is difficult to be predicted. The breast cancer sufferers undergouncertainty, depression, and psychological pressure. This condition decreases thepatient’s optimism of healing. This research aimed to identify factors affecting thebreast cancer patients’ optimism of healing. This study applied cross sectionaldesign with 96 respondents. Factors affecting significantly against respondents’healing optimism were social support (p value = 0,015) and stress (p value =0,022). The most influencing factor was social support (β = 0,055). It isrecommended that the further research will be more focused on the nursingintervention that used to raise social supports for breast cancer patients"

"Pendahuluan: Di Indonesia, kanker rektum menempati urutan kedua kanker gastrointestinal dengan jumlah kasus baru 14.122 (4,65 %) dari semua kasus kanker, dengan jumlah kematian sebanyak 6.827 jiwa. Hal ini menunjukkan perlunya suatu terapi terstandar dalam tatalaksana kanker rektum. KPKN pada tahun 2016 telah mengeluarkan Pedoman Nasional Pelayanan Kedokteran Kanker kolorektal sebagai panduan dalam terapi, yang diterapkan di RSCM sebagai Pedoman Praktis Klinis (PPK) Kanker kolorektal. Penelitian ini bertujuan menilai kepatuhan terapi dalam tatalaksana Kanker rektum dan hubungannya dengan kesintasan pasien.Metode: Studi kohort retrospektif ini menilai pasien kanker rektum yang menjalani radioterapi di RSCM periode Januari 2017-Juni 2018, dengan kriteria inklusi pasien non metastasis, menjalani terapi radiasi neoajuvan di RSCM, dan menggunakan BPJS. Kepatuhan terapi dinilai dengan menggunakan PPK kolorektal 2016 sebagai acuan dengan variabel kepatuhan sequence/urutan terapi, kepatuhan interval waktu terapi, dan kepatuhan kesesuaian terapi dari masing masing modalitasHasil: Terdapat 30 pasien yang masuk kriteria inklusi, dengan usia rerata 48 ± 12 tahun. Mayoritas pasien terdiagnosa stadium IIIC. Kesintasan hidup keseluruhan pasien dalam 2 tahun adalah 43,3 %. Proporsi kesintasan 2 tahun pada kelompok yang mendapatkan kepatuhan terapi adalah 50% sedangkan Kelompok yang tidak mendapat kepatuhan terapi adalah 42,3 % (p=1), Kepatuhan keseluruhan adalah 13,3%, terdapat tren kesintasan yang terlihat lebih baik untuk kelompok yang patuh dibandingkan kelompok yang tidak patuh, meskipun secara statistik tidak bermakna (p=0.317).

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Aims: Rectal cancer cases are the second highest gastrointestinal cancer with a total of 14,122 and new cases (4.65%) of all cancer cases, with 6,827 fatalities in Indonesia. A standardized treatment in the management of rectal cancer in Indonesia is needed. In 2016, The National cancer control committee (KPKN) issued the National Guidelines for Colorectal Cancer Medicine Services as a guide in therapy, which was implemented in A National health center (RSCM) as a Clinical Practical Guide (PPK) for Colorectal Cancer. This study objected to assess adherence in the management of rectal cancer and its relationship with patient survival.

Method: This retrospective cohort study assessed the rectum cancer patients undergoing radiotherapy in the RSCM period January 2017-June 2018, with the criteria of non-metastatic patient inclusion, undergoing Neoadjuvant radiation therapy in RSCM, and using government insurance. Adherence to guidelines is assessed using PPK Colorectal 2016 as a reference to compliance therapeutic sequence, compliance interval therapy time, and compliance with therapeutic conformity of each modality.

Results: There are 30 patients include this study, with an average age of 48 ± 12 years. The majority of patients diagnosed with stage IIIC. The overall survival of the patient in 2 years is 43.3%. The proportion of 2 years in the group receiving therapeutic adherence is 50% while the group who did not get therapeutic adherence was 42.3% (P = 1), overall compliance was 13.3%, there is a trend of survival that looks better for the adherence group than the disobedient group, although statistically not significant (P = 0.317)."

"ABSTRAKNama : MegawatiProgram Studi : EpidemiologiJudul : Kesintasan Pasien Kanker Payudara Berdasarkan Keterlambatan Pengobatandi Rumah Sakit Umum Cipto MangunkusumoPembimbing : Prof. Dr. dr. Bambang Sutrisna, MHSc Epidemiology AbstrakKanker payudara masih mendominasi penyakit kanker pada wanita di duniatermasuk di Indonesia. Rumah Sakit Cipto Mangunkusumo sebagai rumah sakitrujukan nasional dengan jumlah kasus terus meningkat setiap tahunnya.Sebagian besar kasus ditemukan pada stadium lanjut dan mengalamiketerlambatan pengobatan lebih dari 60 hari setelah didiagnosis. Keterlambatanpengobatan diduga berpengaruh terhadap kesintasan pasien kanker payudara.Oleh karena itu penelitian ini dilakukan untuk menilai hubungan keterlambatanpengobatan dengan kesintasan pasien kanker payudara di RSCM. Desain studipenelitian adalah kohort retrospektif dengan mengamati 584 pasien yangmemenuhi kriteria inklusi. Pengamatan dilakukan mulai dari 1 Januari 2011sampai Desember 2017. Data dianalisis secara univariat, bivariat dengan ujilogrank, dan multivariat dengan cox regresi. Hasil penelitian menunjukkan dari584 pasien yang dianalisis ditemukan besarnya risiko terjadinya kematiansebesar 1,27 kali lebih cepat pada pasien yang mengalami keterlambatanpengobatan lebih dari 60 hari dibandingkan dengan pasien yang mendapatkanpengobatan kurang dari 60 hari HR=1,27; 95 CI;0,99 ndash; 1,64 setelah dikontrolstadium klinis, status pernikahan, dan status hormon reseptor estrogen.Perbedaan kesintasan antara pasien yang terlambat lebih dari 60 hari setelahdidiagnosis adalah sebesar 7 pada tahun kelima. Berdasarkan penelitian inidapat disimpulkan bahwa keterlambatan pengobatan lebih dari 60 hari setelahdidiagnosis mempengaruhi kesintasan pasien kanker payudara sehinggapentingnya edukasi kepada pasien dan keluarga untuk tidak menundapengobatan setelah didiagnosis.Kata kunci: keterlambatan pengobatan; kesintasan; kanker payudara

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ABSTRACTName MegawatiStudy Program EpidemiologiTitle Survival of Breast Cancer based on Delay treatment at CiptoMangunkusumo HospitalCounsellor Prof. Dr. dr. Bambang Sutrisna, MHSc Epidemiology Breast cancer still dominates cancer in women in the world including inIndonesia. Cipto Mangunkusumo Hospital as a national referral hospitalwith the number of cases continues to increase every year. Most of the caseswere found at an advanced stage and experienced treatment delays morethan 60 days after diagnosis. Treatment delays are thought to affect thesurvival of breast cancer patients. Therefore, this study was conducted toassess the relationship of delayed treatment with survival of breast cancerpatients at RSCM. The study design was a retrospective cohort by observing584 patients who met the inclusion criteria. Observations were done from 1January 2011 to December 2017. Data were analyzed univariat, bivariatewith logrank test, and multivariate with cox regression. The results of thestudy showed that the 584 patients analyzed found that the risk of death was1.27 times faster in patients who experienced treatment delay more than 60days compared with patients who received treatment less than 60 days HR 1.27 95 CI 0,99 1.92 after controlled marital status, hormonereceptor estrogen, and clinical stage. The difference in survival betweentheir patients who were late more than 60 days after the diagnosis was 7 in the fifth year. Based on this research, it can be concluded that the delayof treatment influences survival of breast cancer patients so that theimportance of education to the patient and family to immediately performtreatment after diagnosis.Keywords Delay treatment Survival Breast Cancer"

"Di Indonesia kebanyakan pasien kanker serviks datang pada stadium lanjut (62%) yang merupakan 66% dari penyebab kematian ginekologik. Pemeriksaan Pap Smear merupakan salah satu cara untuk mendeteksi secara dini kanker serviks sehingga penanganan kanker serviks dapat dilakukan sebelum menyebar ke luar rahim.Tujuan penelitian ini adalah untuk mengetahui peranan faktor-faktor yang menyebabkan mereka terlambat memeriksakan diri di RSUPN Dr. Cipto Mangunkusumo Jakarta. Penelitian ini memadukan metoda kuantitatif dan kualitatif. Data primer diambil dengan menggunakan kuesioner, wawancara mendalam dan membaca catatan dokumen.Hasil penelitian menunjukkan bahwa variabel-variabel yang berhubungan seeara statistik dengan keterlambatan pasien kanker serviks memeriksakan diri adalah pengetahuan, sikap, ketersediaan pelayanan Pap Smear dan dorongan suami. Biaya dan dorongan petugas kesehatan tidak berhubungan secara statistik tetapi penting khususnya penghasilan untuk membayar biaya pemeriksaan. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan mempengaruhi variabel dependen.Berdasarkan wawancara mendalam dapat disimpulkan bahwa memang tidak tersedianya pelayanan Pap Smear disamping kurangnya pengetahuan yang menjadi penyebab informan terlambat memeriksakan diri dengan alasan tidak ada satupun petugas kesehatan atau orang lain yang menyampaikan informasi mengenai Pap Smear dan kanker serviks.Mempertimbangkan hasil penelitian maka disarankan kepada semua pihak yang terkait untuk meningkatkan upaya penanganan kanker serviks melalui KIE secara terkoordinir lintas sektoral kepada masyarakat umumnya, terutama kepada wanita masa reproduksi dan lansia agar memperhatikan pelayanan deteksi dini (Pap Smear).

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An Analysis on the Delay of Cervix Cancer Patient in Examining Their selves in The National Hospital of Dr. Cipto Mangunkusumo, JakartaIn Indonesia most of the cervix cancer patients come to see doctors after advanced stadium (62 %) which 66 % ended with gynecological death. The smear test is a method to detect the cervix cancer earlier before spreading outside the uterus.

The purpose of this research is to identify factors related to the delay of the health examination in The National Hospital of Dr. Cipto Mangunkusumo, Jakarta. This research combines quantitative and qualitative methods by using questionnaire, in-depth interview and examine medical records to supplement the primary data.

The research result indicates variables related statistically with the cancer patient delay are; knowledge, attitudes, the availability of the Pap smears service, and the husband's support. Financial problem and encouragement from the health providers are not related statistically but it is important especially the income. The availability of Pap smear service plays as a dominant variable in affecting the dependent variable.

Based on depth interview it is concluded that the unavailability of Pap smear services despite the lack of knowledge has caused the informant did not use the early detection service (Pap smear) with reason there was no health provider or other people gave information about the Pap smear and cervix cancer.

Considering the research result, it is suggested that all related parties improve the handling of the cervix cancer through Communication, Information and Education (KIE), which is coordinated through cross sector way to the public, especially KIE should be focused on women during their reproductive term and the elder women so that they will pay more attention to early detection service (Pap smear)."

"Transplantasi ginjal TG merupakan salah satu terapi pilihan utama pada pasien Gagal Ginjal Terminal GGT . TG dapat meningkatkan kualitas hidup pasien GGT. Kualitas hidup dapat dipengaruhi oleh berbagai faktor, seperti faktor fisik, psikologis dan mental.Tujuan penelitian ini adalah untuk mengetahui faktor- faktor yang mempengaruhi kualitas hidup pasien TG. Desain Penelitian menggunakan Cross Sectional Study, Sampel dalam penelitian ini berjumlah 110 pasien TG dengan tehnik pengambilan sampel menggunakan metode purposive sampling. Instrumen penelitan menggunakan kuesioner kualitas hidup WHOQoL ndash; BREF, yaitu kuesioner yang telah banyak digunakan dalam mengukur kualitas hidup di dunia dan secara validitas dan reabilitas merupakan kuesioner yang valid dan reliabel. Analisi data menggunakan: proporsi, chi- square dan regresi logistik ganda.Hasil penelitian menunjukkan bahwa kualitas hidup pasien TG di RSUPN Dr. Cipto Mangunkusumo adalah baik 71, 8 . Faktor yang mempengaruhi kualitas hidup pasien adalah: usia p = 0,002 , pendidikan p = 0,001 pekerjaan p = 0,010 , dukungan keluarga p = 0,024 , dan kepatuhan pasien dalam mengkonsumsi obat immunosupressant p = 0,009 , faktor yang dominan mempengaruhi kualitas hidup adalah: pendidikan OR= 11, 490 dan kepatuhan dalam mengkonsumsi obat immunosuppressant OR= 10, 530.Kesimpulan: Kualitas hidup pasien TG dipengaruhi oleh, usia, pendidikan, pekerjaan, dukungan keluarga dan kepatuhan pasien dalam mengkonsumsi obat immunosupressant Rekomendasi: Penelitian lebih lanjut terkait dimensi kualitas hidup: dimensi fisik, psikologis, hubungan sosial dan lingkungan dan pemberian intervensi keperawatan berupa edukasi sebelum dan sesudah TG.

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Kidney transplantation KT is one of the major therapies in terminal renal failure. KT can increase Quality of Life QoL of the patients with terminal renal failure. QoL can be affected by several factors, such as physical, psychological and mental factors.The aim of this research is to identify the factors that affects QoL of KT patients. The research design used Cross Sectional Study, with purposive sampling. The samples of study is 110 KT patients. The research instrument uses WHOQoL ndash BREF, instrument WHOQoL ndash BREF has been widely used in measuring the QoL in the world and the validity and reliability is a valid and reliable questionnaire. Data analysis uses proportion, chi square and multiple logistic regression.The results of this research showed that the QoL of KT patients at General Hospital Cipto Mangunkusumo is good 71, 8 . The Factors influencing of the QoL of the patients were age, p 0,002, education p 0,001 occupation p 0,010 , family p 0,024 , and patient adherence to taking immunosuppressant drugs p 0,009.Conclusions The QoL of patients affected by age, education, occupation, family and patient adherence to taking immunosuppressant drugs. Recommendations Further research related to the dimensions of the Qol with are physical, psychological, social and environmental dimensions and Intervention of Nursing through prre and post opertif education of KT."

"Latar belakang: Insidens metastasis otak lebih tinggi dibanding tumor primer otak dan berisiko menimbulkan kematian dengan penyebab terbanyak berasal dari kanker paru (36,5%) di RSUPN Cipto Mangunkusumo (RSCM). Keterlambatan diagnosis berisiko menyebabkan herniasi otak, sehingga terjadi kecacatan dan kematian. Dibutuhkan data mengenai durasi penegakan diagnosis di RSCM.Metode penelitian: Penelitian ini merupakan studi deskriptif analitik dengan rancangan kohort retrospktif untuk mengetahui kesesuaian antara durasi penegakan diagnosis tumor otak metastasis akibat kanker paru dengan pedoman praktik klinis (durasi ≤2 minggu). Subjek merupakan pasien rawat inap di RSCM pada Januari 2019 s/d Desember 2021.Hasil: Terdapat 12 subjek (30%) dapat ditegakkan dalam waktu ≤2 minggu dengan  median durasi 18,5 hari (IQR (12-34 hari). Selain itu didapatkan durasi 7 hari (IQR 4-11 hari) untuk sampai didapatkannya massa di paru,  durasi 8 hari (IQR 4.5-13 hari) sampai dilakukannya biopsi, dan 6 hari (IQR 3.5-7 hari) sampai keluarnya hasil patologi anatomi. Tidak terdapat hubungan yang bermakna secara statistik antara variabel yang dinilai dengan durasi penegakan diagnosis ≤2 minggu (14 hari).Kesimpulan: Hanya 30% subjek dengan durasi yang sesuai dengan panduan praktik klinis di RSCM. Dibutuhkan diseminasi hasil dan kolaborasi antar bagian agar penegakan diagnosis lebih cepat.

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Background: Incidence of brain metastases is higher than primary brain tumors, with lung cancer as common etiology (36.5%) at Cipto Mangunkusumo General Hospital (RSCM). Delay in diagnosis can cause brain herniation, resulting in disability and death. Data is needed regarding the duration of diagnosis in RSCM.

Method: This is a descriptive analytic study with a retrospective cohort design to determine the conformity between the duration of diagnosis of metastatic brain tumors due to lung cancer in daily clinical practice with clinical practice guidelines (duration 2 weeks). Subjects were inpatients at RSCM from January 2019 to December 2021

Results: There were 12 subjects (30%) who could be diagnosed within 2 weeks with a median duration of 18.5 days (IQR (12-34 days). Duration of 7 days (IQR 4-11 days) to obtain a lung mass, 8 days (IQR 4.5-13 days) until a biopsy was performed, and 6 days (IQR 3.5-7 days) until anatomic pathology results were released. There is no statistically significant relationship between the variables assessed and the duration of diagnosis 2 weeks.

Conclusion: Only 30% of subjects with the duration matched the clinical practice guidelines at RSCM. Dissemination of results and collaboration between departments is needed to make diagnosis faster."