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"Tumor merupakan benjolan yang dapat terbentuk di bagian tubuh mana pun, disebabkan oleh pertumbuhan sel di dalam dan sekitar jaringan yang tidak normal dan tidak terkendali. Pasien tumor otak akan merasakan emosi seperti syok, agitasi, kemarahan, kesedihan, dan penarikan diri. Penarikan diri muncul karena ketakutan terhadap kemungkinan akibat yang terjadi, seperti perubahan citra tubuh atau kematian sehingga terjasi distress pada pasien tumor otak. Distress adalah pengalaman tidak menyenangkan multifaktorial yang berasal dari berbagai faktor, termasuk aspek psikologis (seperti kognitif, perilaku, dan emosional), aspek sosial, spiritual, dan fisik yang dapat mengganggu kemampuan seseorang untuk mengatasi kanker secara efektif, gejala fisik dan pengobatannya. Salah satu cara untuk menurunkan distress adalah dengan aromaterapi. Penelitian ini bertujuan untuk mengetahui efektifitas aromaterapi terhadap nilai distress pada pasien tumor otak. Penelitian ini menggunakan desain penelitian kuasi eksperimen (quasi experimental) dengan rancangan non- randomized pre-test-post-test with control. Besar sampel pada penelitian ini menggunakan porpusif random sampling yang berjumlah 15 responden kelompok intervensi dan 15 responden kelompok kontrol. Analisa data diperoleh nilai p value = 0.000 (p<0,05) yang artinya terdapat perbedaan yang signifikan nilai distress pada kelompok intervensi dan kelompok kontrol. Pemberian aromaterapi terbukti efektif menurunkan nilai distress pada pasien tumor otak di bandingkan dengan kelompok kontrol yang mendapatkan sesuai standar RS. Peningkatan pemberian terapi komplamenter seperti aromaterapi dapat menurunkan distress pada pasien tumor otak.

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Tumor are a lump that can form in any part of the body, caused by abnormal and

uncontrolled cell growth in and around tissue.Brain tumor patients will feel emotions

such as shock, agitation, anger, sadness, and withdrawal. Withdrawal arises due to fear

of possible consequences that occur, such as body image changes or death resulting in

distress in brain tumor patients. DistressIt is a multifactorial unpleasant experience that stems from a variety of factors, including psychological aspects (such as cognitive, behavioral, and emotional), social, spiritual, and physical aspects that can interfere with a person's ability to effectively manage cancer, its physical symptoms and treatment. One way to reduce distress is with aromatherapy. This study aims to determine the effectiveness of aromatherapy on distress values in brain tumor patients. This study uses a quasi-experimental research design with a non-randomized pre-test-post-test with control design. The sample size in this study used random sampling which amounted to 15 participants in the intervention group and 15 respondents in the control group. Data

analysis obtained a value of p value = 0.000 (p<0.05) which means that there is a difference in

significant distress values in the intervention group and control group. The

administration of aromatherapy was proven to be effective in reducing the distress value

in brain tumor patients compared to the control group that received according to hospital

standards. Increased delivery of complementary therapiessuch as aromatherapy can

reduce distress in brain tumor patients"

"ABSTRAKLatar Belakang. Pasien tumor otak sangat berpotensi mengalami distres karena tumor otak menimbulkan disabilitas, menurunkan kualitas hidup bahkan menyebabkan kematian. Kerentanan dalam mengalami distres dipengaruhi kemampuan koping pasien. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan terjadinya distres dan gambaran strategi koping pada pasien tumor otak sebelum mendapatkan terapi.Metode. Desain penelitian analitik observasional dengan rancangan studi potong lintang cross sectional , subyek penelitian pasien tumor otak yang belum mendapatkan terapi, berjumlah 140 orang. Pengambilan sampel menggunakan teknik non probability sampling berupa consecutive sampling. Instrumen penelitian menggunakan self report questionnaire: Distress Thermometer DT dan instrumen Coping Orientation to the Problem Experienced COPE yang telah diadaptasi di Indonesia. DT terdiri dari penilaian subyektif mengenai distres dan domain distres. Instrumen COPE termasuk Religious Coping Scale, terdiri dari 61 pernyataan dengan skala likert 1 sampai 4. Data dianalisis menggunakan SPSS versi 20. Tingkat kemaknaan yang digunakan untuk uji statistik adalah p< 0,05. Hasil. Proporsi distres pada pasien tumor otak sebelum mendapatkan terapi sebesar 68,6 . Domain distres banyak dilaporkan adalah masalah fisik 95,7 , masalah emosional 88,3 , dan masalah praktis 77,9 . Domain terkait gejala khas tumor otak yaitu nyeri kepala 78,6 , kelemahan di kaki atau lengan 54,3 dan pandangan/penglihatan ganda 50,7 . Subyek yang mengalami distres memiliki rerata active coping dan religious focused coping lebih rendah serta rerata emotion focused coping dan avoidance coping lebih tinggi dibandingkan yang tidak mengalami distres. Korelasi emotion focused coping dan avoidance coping dengan distres r=0,3 dan 0,2 ; p< 0,05 . Korelasi religious focused coping dengan distres r=-0,2 ; p< 0,05 Simpulan. Proporsi distres pasien tumor otak 68,6 . Domain distres antara lain masalah fisik 95,7 , masalah emosional 88,3 , dan masalah praktis 77,9 . Emotion focused coping memiliki korelasi positif sedang dan avoidance coping memiliki korelasi positif lemah dengan distres. Religious focused coping memiliki korelasi negatif lemah dengan distres. Kata Kunci: tumor otak, distres, strategi koping

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ABSTRACTBackground. Brain tumor patients are potentially prone to distress because of the disability directly caused by the tumor. Vulnerability to distress affected by patients rsquo coping skills. The purpose of this study is to determine the factors associated with the occurrence of distress and coping strategies overview on brain tumor patients before therapy.Method. The study design was observational analytic with cross sectional design. The subjects were brain tumor patients who have not received treatment, amounted to 140 people. Sampling was done using non probability sampling in the form of consecutive sampling. The research instruments used were self report questionnaire Distress Thermometer DT and Coping Orientation to Problems Experienced COPE , which has been adapted to Indonesia. DT consisted of a subjective assessment of the distress and distress domains. COPE instrument, including the Religious Coping Scale, consisting of 61 statements with Likert scale of 1 to 4. Data were analyzed using SPSS version 20. The level of significance used for the statistical tests was p"

"ABSTRAKLatar belakang: Stratifikasi risiko terhadap pembedahan sangat membantu dalam pengambilan keputusan klinis perioperatif, edukasi, evaluasi, dan audit klinis. Kraniotomi pada tumor otak sebagai tindakan pembedahan berisiko tinggi belum memiliki stratifikasi risiko yang akurat di RSUPNCM karena masih menggunakan ASA yang bersifat subjektif dan kurang informatif. P-POSSUM terbukti tepat dalam prediksi mortalitas pascabedah kraniotomi di India dan Inggris, namun belum diketahui ketepatannya di Indonesia, khususnya di RSUPNCM. Tujuan: Penelitian ini bertujuan untuk mengetahui ketepatan P-POSSUM dalam prediksi mortalitas pascabedah kraniotomi pada tumor otak di RSUPNCM. Metode: Disain penelitian adalah deskriptif analitik retrospektif terhadap seluruh pasien dewasa dengan tumor otak yang menjalani kraniotomi di RSUPNCM selama periode Januari 2015 - Desember 2016. Hasil: Sebanyak 196 subjek dilibatkan dalam analisis risiko mortalitas. Didapatkan rasio O:E 1,68 secara keseluruhan dengan rasio O:E 1,91 pada jangkauan risiko 0-5 dan 1,69 pada jangkauan risiko 11-20 . Hasil uji Hosmer-Lemeshow menunjukkan perbedaan yang signifikan antara angka mortalitas prediksi dan aktual p=0,006 . Simpulan: P-POSSUM tidak tepat dalam prediksi mortalitas pascabedah kraniotomi di RSUPNCM. Diperlukan kajian dan penyesuaian lebih lanjut sebelum P-POSSUM dapat digunakan pada populasi bedah saraf di RSUPNCM.

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ABSTRACTBackground Risk stratification in surgery helps in perioperative clinical decision making, education, evaluation, and clinical audit. Craniotomy on brain tumor as a high risk surgery does not have an accurate risk stratification in RSUPNCM because they still use ASA, which is subjective and not informative. P POSSUM had been proven to be accurate in predicting postoperative mortality after craniotomy in India and England, but it has not been studied in Indonesia, especially in RSUPNCM. Aim This study was done to gain knowledge about the accuracy of P POSSUM for predicting mortality after craniotomy in brain tumor in RSUPNCM. Methods This was a retrospective descriptive analytic study on adults with brain tumor scheduled to have elective craniotomy in RSUPNCM between January 2015 ndash December 2016. Result 196 subjects were analyzed in this study. Overall O E ratio was 1.68 with O E ratio of 1.91 in the risk range of 0 5 and 1.69 in the risk range of 11 20 . Hosmer Lemeshow test showed significant difference between predicted and actual mortality rate p 0.006 . Conclusion P POSSUM was not accurate for predicting mortality after craniotomy in RSUPNCM. Further studies and adjustments are needed before P POSSUM can be used in neurosurgery population in RSUPNCM."

"Insiden tumor otak tertinggi dilaporkan di Asia sebanyak 156,217 kasus atau 52.6%. Tumor otak adalah jenis kanker yang langka namun mematikan dengan tingkat kelangsungan hidup yang rendah. Pasien dengan tumor otak dengan keluhan gangguan penglihatan, kesulitan berbicara serta gangguan neurologis akan mengalami masalah disfungsi kognitif, neuropsikiatri dan fungsional. Hal ini tidak hanya berdampak kepada pasien, namun juga pada keluarga. Kejadian kanker padaanggota keluarga meningkatkan beban caregiver yang merawat.Perawat memiliki peran penting dalam pemberian asuhan kepaerawatan tidak hanya pada pasien, namun juga pada keluarga sebagai caregiver. Dalam melaksanakan perannya sebagai caregiver akan banyak mengalami masalah fisik, psikologis, sosial dan ekonomi. Salah satu pendekatan teori keperawatan yang sesuai untuk diterapkan pada kondisi ini adalah teori Chronic Sorrow yang membahas fenomena spesifik tentang masalah-masalah yang timbul dari penyakit kronis mencakup proses berduka, kehilangan, faktor pencetus dan metode manajemennya. Residen mengaplikasikan Evidence-Based Practice Nursing (EBPN) psikoedukasi yang bertujuan menurunkan burden caregiver pasien dengan tumor otak. Psikoedukasi dalam pengelolaan lima kasus kelolaan berpengaruh signifikan dalam menurunkan burden caregiver yang dinilai dengan menggunakan instrumen Zarit BurdenInterview (ZBI).

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The highest incidence of brain cancer was reported in Asia with 156,217 cases or 52.6%. Brain cancer is a rare but deadly type of cancer with a low survival rate. This not only impacts the patient, but also the family. The incidence of cancer in family members increases the burden on caregivers. Nurses have an important role in providing nursing care not only to patients, but also to families. One of the emergence theory approaches that is suitable to be applied to this condition is the theory of chronic grief which discusses the specific phenomenon of problems arising from chronic illness including the process of depression, loss, precipitating factors and methods of management. Residents apply Psychoeducation intervention as Evidence-Based Practice Nursing (EBPN) which aims to reduce the caregiver burden of patients with brain tumors. The result of five managed cases is provides that psychoeducation has significant effect on reducing the burden of caregivers assessed using the Zarit Burden Interview (ZBI) instrument."

"ABSTRAKMual dan muntah merupakan komplikasi yang sering terjadi pada tahap postoperasi dengan menggunakan anestesi umum. Penanganan mual dan muntah postoperasi menggunakan terapi farmakologi dan non farmakologi. Aromaterapi dapatdijadikan sebagai salah satu terapi non farmakologi. Penelitian ini bertujuanmengetahui pengaruh aromaterapi terhadap mual dan muntah post operasi dengananestesi umum. Desain penelitian ini menggunakan quasi eksperimen dengan posttest-only non equivalent control group, dengan dua kelompok masing-masingterdiri atas 26 responden. Hasil analisis bivariat dengan Chi Square menunjukkanadanya perbedaan kejadian mual dan muntah pada kelompok kontrol dankelompok intervensi, dimana kelompok intervensi mempunyai tingkat kejadianmual dan muntah lebih rendah dibanding kelompok kontrol (p=0,001). Pemberianaromaterapi dapat dipertimbangkan sebagai salah satu terapi non farmakologipada pasien mual dan muntah post operasi.

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ABSTRACTSurgery with general anesthesia can cause complication afterward. One of thecomplications is nausea and vomiting. Pharmacology and non-pharmacologytherapy can be given to ease nausea and vomiting. Aromatherapy is one of thenon-pharmacology therapies for nausea and vomiting. This study is aimed todetermine the influence of aromatherapy on nausea and vomiting of post-surgerypatient with general anesthesia. This is quasi experiment post test-only nonequivalent control group. Samples consist of 26 respondents on each group.Bivariate analysis shows significant different on nausea and vomiting betweenintervention and control groups, where nausea and vomitinglower on interventiongroup (p=0,001). It is suggested that aromatherapy can be considered as one ofcomplementary therapy to decrease nausea and vomiting on post-surgery patient."

"Fraktur mempengaruhi aspek kehidupan manusia secara fisik, psikososial, hingga ekonomi apabila terjadi kecacatan yang menetap karena tidak ditangani dengan baik. Gejala umumnya berupa rasa sakit yang tajam seperti menusuk yang semakin parah ketika menggerakan tulang. Tindakan pembedahan juga menimbulkan nyeri. Nyeri yang tidak ditangani dengan baik menyebabkan pasien tidak mampu berpartisipasi dalam proses pemulihan yang dapat meningkatkan kecacatan. Manajemen nyeri perlu dilakukan dalam memenuhi aspek kenyamanan dalam kebutuhan dasar manusia dan meningkatkan mutu pelayanan keperawatan. Terapi relaksasi Benson dan aromaterapi merupakan intervensi non farmakologis yang bertujuan untuk mengurangi nyeri. Metode yang digunakan berupa studi kasus pada pasien closed fracture of right humerus yang mengalami nyeri akut dan penelusuran literatur evidence based practice mengenai efektivitas relaksasi Benson dan aromaterapi pada pasien nyeri. Hasil studi kasus menunjukan bahwa terapi tersebut terbukti efektif menurunkan nyeri. Perawat dapat menerapkan terapi tersebut dalam asuhan keperawatan manajemen nyeri dan melatih pasien sehingga mampu melakukannya secara mandiri.

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The Effectiveness of Benson Relaxation Therapy and Aromatherapy in Reducing Pain on Pre and Post Operative ORIF Fracture Patients. Fractures permanent disability can be affected by the aspects of human life physically, psychosocially, and even economically because it is not handled properly. The common symptoms are intense stabbing pain that worsens in every bones movement. Surgery procedures also cause pain. Pain that is not treated properly causes patients to be unable to participate in the recovery process which can increase disability. Pain management needs to be done to fulfill the comfort aspect of basic human needs and improve health services. Benson relaxation therapy and aromatherapy are non-pharmacological interventions that aim to reduce pain. The method used was a case study of a closed right humerus fracture patient who experienced acute pain and a literature search based on practical evidence regarding the effectiveness of Benson relaxation and aromatherapy in pain patients. The results of the case study show that this therapy has proven effective in reducing pain. Nurses can apply this therapy in pain management treatments and train patients so they are able to do it independently."

"[ABSTRAK Insomnia merupakan ganggguan tidur yang paling sering dikeluhkan. Angka kejadian insomnia dari tahun ke tahun semakin bertambah. Insomnia menyebabkan seseorang mengalami kelelahan, penurunan status kesehatan, bahkan menyebabkan kematian karena kecelakaan. Penanganan kasus insomnia masih difokuskan pada pemberian obat (agen hipnotik) yang terbatas pada terapi jangka pendek karena dapat menimbulkan efek samping yang cukup berbahaya sehingga perlu dicari solusi yang dianggap lebih baik dan lebih aman. Tujuan penelitian ini untuk melihat pengaruh pemberian kombinasi minyak atsiri pala (Myristica fragrans) dan kenanga (Cananga odorata) sebagai aromaterapi dalam menurunkan derajat insomnia. Penelitian menggunakan desain eksperimental acak, single-blind dan cross-over pada 26 wanita paruh baya yang dibagi dalam dua grup dengan pemberian aromaterapi secara inhalasi selama 4 minggu (1 minggu tanpa perlakuan, 1 minggu perlakuan pertama, 1 minggu washout dan 1 minggu perlakuan kedua). Hasil diukur menggunakan Pittsburgh Sleep Quality Index (PSQI) dan parameter fisik berupa pengukuran tekanan darah (MAP), frekuensi nadi dan frekuensi pernafasan yang akan dibandingkan dengan minyak atsiri lavender sebagai kontrol. Kombinasi pala dan kenanga memiliki perbaikan skor PSQI sebanyak 3,31 poin (p = 0,01) dan lavender sebanyak 2,54 poin (p = 0,30). Penelitian ini memperlihatkan bahwa pemberian kombinasi minyak atsiri pala dan kenanga ternyata lebih berpengaruh dalam menurunkan derajat insomnia pada wanita paruh baya dibandingkan dengan minyak atsiri lavender.ABSTRACT Insomnia is a sleep disruption are most often complained. The incidence of insomnia increased from year to year. Insomnia causes a person to experience fatigue, decreased health status and even cause death due to an accident. The current treatments of choice are drugs (conventional hypnotics agents) that is limited to short-term therapy because it can cause dangerous side effects. It is necessary to find a solution that is considered to be a better and safer. The purpose of this study to see the combination effect of nutmeg (Myristica fragrans) and cananga (Cananga odorata) essential oils as aromatherapy in reducing the degree of insomnia. This study used a randomized experimental, single-blind, cross-over design in 26 middle-aged women who were divided into two groups with aromatherapy administration by inhalation for 4 weeks (1 week without treatment, 1 week for the first treatment, 1 week washout and 1 week for the second treatment). Results were measured using Pittsburgh Sleep Quality Index (PSQI) and physical parameters such as the measurement of blood pressure (MAP), heart rate and respiratory rate which will be compared with lavender essential oil as a control. The combination of nutmeg and cananga created an improvement of 3.31 points (p = 0.01) and lavender of 2.54 points (p = 0.30) in PSQI. This study showed that administration of a combination of nutmeg and cananga essential oils were more influential in reducing the degree of insomnia in middle-aged women compared with lavender essential oils.;Insomnia is a sleep disruption are most often complained. The incidence of insomnia increased from year to year. Insomnia causes a person to experience fatigue, decreased health status and even cause death due to an accident. The current treatments of choice are drugs (conventional hypnotics agents) that is limited to short-term therapy because it can cause dangerous side effects. It is necessary to find a solution that is considered to be a better and safer. The purpose of this study to see the combination effect of nutmeg (Myristica fragrans) and cananga (Cananga odorata) essential oils as aromatherapy in reducing the degree of insomnia. This study used a randomized experimental, single-blind, cross-over design in 26 middle-aged women who were divided into two groups with aromatherapy administration by inhalation for 4 weeks (1 week without treatment, 1 week for the first treatment, 1 week washout and 1 week for the second treatment). Results were measured using Pittsburgh Sleep Quality Index (PSQI) and physical parameters such as the measurement of blood pressure (MAP), heart rate and respiratory rate which will be compared with lavender essential oil as a control. The combination of nutmeg and cananga created an improvement of 3.31 points (p = 0.01) and lavender of 2.54 points (p = 0.30) in PSQI. This study showed that administration of a combination of nutmeg and cananga essential oils were more influential in reducing the degree of insomnia in middle-aged women compared with lavender essential oils.;Insomnia is a sleep disruption are most often complained. The incidence of insomnia increased from year to year. Insomnia causes a person to experience fatigue, decreased health status and even cause death due to an accident. The current treatments of choice are drugs (conventional hypnotics agents) that is limited to short-term therapy because it can cause dangerous side effects. It is necessary to find a solution that is considered to be a better and safer. The purpose of this study to see the combination effect of nutmeg (Myristica fragrans) and cananga (Cananga odorata) essential oils as aromatherapy in reducing the degree of insomnia. This study used a randomized experimental, single-blind, cross-over design in 26 middle-aged women who were divided into two groups with aromatherapy administration by inhalation for 4 weeks (1 week without treatment, 1 week for the first treatment, 1 week washout and 1 week for the second treatment). Results were measured using Pittsburgh Sleep Quality Index (PSQI) and physical parameters such as the measurement of blood pressure (MAP), heart rate and respiratory rate which will be compared with lavender essential oil as a control. The combination of nutmeg and cananga created an improvement of 3.31 points (p = 0.01) and lavender of 2.54 points (p = 0.30) in PSQI. This study showed that administration of a combination of nutmeg and cananga essential oils were more influential in reducing the degree of insomnia in middle-aged women compared with lavender essential oils., Insomnia is a sleep disruption are most often complained. The incidence of insomnia increased from year to year. Insomnia causes a person to experience fatigue, decreased health status and even cause death due to an accident. The current treatments of choice are drugs (conventional hypnotics agents) that is limited to short-term therapy because it can cause dangerous side effects. It is necessary to find a solution that is considered to be a better and safer. The purpose of this study to see the combination effect of nutmeg (Myristica fragrans) and cananga (Cananga odorata) essential oils as aromatherapy in reducing the degree of insomnia. This study used a randomized experimental, single-blind, cross-over design in 26 middle-aged women who were divided into two groups with aromatherapy administration by inhalation for 4 weeks (1 week without treatment, 1 week for the first treatment, 1 week washout and 1 week for the second treatment). Results were measured using Pittsburgh Sleep Quality Index (PSQI) and physical parameters such as the measurement of blood pressure (MAP), heart rate and respiratory rate which will be compared with lavender essential oil as a control. The combination of nutmeg and cananga created an improvement of 3.31 points (p = 0.01) and lavender of 2.54 points (p = 0.30) in PSQI. This study showed that administration of a combination of nutmeg and cananga essential oils were more influential in reducing the degree of insomnia in middle-aged women compared with lavender essential oils.]"