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Abstrak :
ABSTRAK
Pada tahun 2016, hasil penelitian The Tobacco Atlas melaporkan bahwa 66 pria di Indonesia adalah perokok. Penelitian epidemiologi telah melaporkan bahwa merokok tembakau berhubungan dengan nyeri pada gangguan muskuloskeletal. Beberapa penelitian telah melaporkan bahwa merokok tembakau berhubungan dengan temporomandibular disorders TMD , yang memiliki gejala diantaranya nyeri musculoskeletal, clicking, dan keterbatasan buka mulut. Namun, penelitian seperti ini belum pernah diteliti di Indonesia. Tujuan penelitian ini adalah untuk menganalisis hubungan kebiasaan merokok tembakau dan derajat keparahan nyeri pada pasien TMD. Sejumlah 54 subjek diperiksa dan dibagi menjadi dua kelompok: merokok tembakau dan tidak merokok; kemudian, perokok dibagi menjadi tiga kelompok menjadi: perokok ringan, perokok sedang, dan perokok berat. Diagnosis ditegakkan berdasarkan Diagnostic Criteria for Temporomandibula Disorders DC/TMD aksis I dan derajat keparahan nyeri TMD diukur melalui Visual analog scale VAS . Data dianalisis menggunakan Kruskal Wallis dan Post Hoc Mann-Whitney. Hasil penelitian menunjukan terdapat perbedaan bermakna dari derajat keparahan nyeri TMD yaitu pada kelompok perokok dibandingkan kelompok tidak merokok, dan terdapat hubungan yang bermakna antara derajat keparahan nyeri TMD dan jumlah rokok yang dikonsumsi. Kebiasaan merokok tembakau merupakan faktor yang mempengaruhi derajat keparahan nyeri TMD, sehingga kontrol terhadap kebiasaan merokok tembakau harus dipertimbangkan dalam merawat TMD pada pasien perokok.

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ABSTRACT
In 2016, The Tobacco Atlas reported that 66 of males in Indonesia were cigarettes smoker. Epidemiologic studies have suggested that smoking might be associated with musculoskeletal pain. Some studies have reported that there was a relationship between cigarettes smoking and Temporomandibular Disorders TMD , since the sysmptom could be musculoskeletal pain, clicking, and limitation on opening. But this kind of study have not yet been done in Indonesia. The aim of this study was to evaluate the relationship of cigarette smoking on pain severity in TMD patients. Study was done on 54 TMD patients. They were first divided into two groups smokers and non smokers. Then, smokers were further divided into three subgroups light, moderate, and heavy smokers. The subjects were diagnosed according to the Diagnostic Criteria for Temporomandibula Disorders DC TMD Axis I and the TMD pain was derived from Visual Analog Scale VAS . All the collected data were analysed using Kruskal Wallis and Post Hoc Mann Whitney. It has been shown that the TMD pain severity was significant higher in smokers compared to non smokers, and a significant relationship was found between pain severity and the number of cigarettes smoked in a day by each subject. Smoking seems to be a relevant factor affecting the TMD pain severity, thus, control of smoking habits should be considered when treating TMD patients.

Abstrak :
ABSTRAK
Angka kejadian kanker payudara di Indonesia tertinggi diantara jenis kanker pada wanita dengan prevalensi nyeri diperkirakan 40-89%. Tujuan penelitian ini adalah mengembangkan model pengelolaan nyeri berbasis kenyamanan dengan strategi coaching dan mengidentifikasi pengaruhnya terhadap derajat nyeri, kenyamanan, dan kualitas hidup pasien kanker payudara. Penelitian ini dilakukan melalui dua tahap, yaitu tahap 1 berupa penelitian deskriptif kualitatif dan pengembangan model, serta tahap 2 berupa penelitian kuasi eksperimen pre-post test control group design. Metode sampling tahap 1 digunakan purposive sampling dengan 11 partisipan. Tahap 2 sampel dipilih secara consecutive sampling dengan jumlah 64 responden (32 pasien kelompok intervensi dan 32 pasien kelompok kontrol). Hasil penelitian tahap satu teridentifikasi 12 tema dan dihasilkan model pengelolaan nyeri berbasis kenyamanan beserta perangkatnya. Hasil penelitian tahap dua membuktikan bahwa ada pengaruh yang signifikan dari model pengelolaan nyeri berbasis kenyamanan dengan strategi coaching terhadap penurunan derajat nyeri, peningkatan kenyamanan, peningkatan status fungsional dan perbaikan status gejala pasien kanker payudara. Namun, tidak ada pengaruh pada status kesehatan/kualitas hidup global. Rekomendasi penelitian hendaknya perawat menerapkan model pengelolaan nyeri berbasis kenyamanan sebagai bentuk nyata pengelolaan nyeri kanker secara holistik dalam pelayanan keperawatan.

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ABSTRACT
Incidence of breast cancer in Indonesia is still the highest among the other type of cancer deseases on women with the prevalence of pain estimated from 40 ? 89 per cent. The purpose of this research was to develop model of pain management based on comfort with coaching strategy and identify its effect on pain severity, comfort, and quality of life patient breast cancer. This study was conducted in two stages. The first stage was descriptive qualitative research and the development of model. The second stage was quasi-experimental research with pre - post test control group design. The sampling method that used to stage 1 was purposive sampling with 11 partisipants. Sampling method on stage 2 this study was consecutive sampling with 64 breast cancer patients (32 respondents as intervention group and 32 respondents as control group). The first stage of the study resulted 12 themes and has resulted the model of pain management based on comfort and its devices. The second stage of research proved that there were significance effects from the model of pain mnagement based on comfort with coaching strategy toward decreasing pain severity, increasing comfort and functional status, and repairing symptom status for breast cancer patients. However, there was no effect on global health status/quality of life. This study recommends that nurse should apply the model of pain management based on comfort as a concrete holistic cancer pain management in setting practice of nursing care.