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All Journal NERS Jurnal Keperawatan
Ni Luh Dwi Indrayani
Faculty of Health, Institute of Technology and Health Bali, Denpasar, Bali, Indonesia
Nursing

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Analisis Konsep Perawatan Paliatif pada Pasien Kanker: Pendekata Walker dan Avant Ni Luh Putu Inca Buntari Agustini; Ni Wayan Ayu Widia Setiawati; Dwi Fitri Genisti; I Kadek Agus Andika Adi Putra; Komang Ngurah Suputra Prasetya; Ni Luh Gede Eka Wahyuni Sudiarsa; Putu Ria Laksmi Handayani; Ni Luh Dwi Indrayani; I Gede Putu Darma Suyasa
NERS Jurnal Keperawatan Vol. 22 No. 2 (2026): NJK Volume 22, Number 2
Publisher : Fakultas Keperawatan Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/njk.v22i2.427

Abstract

Palliative care aims to optimize the quality of life of people living with cancer and their families through the prevention and alleviation of multidimensional suffering. However, it is frequently mis conceptualized as care limited to the terminal phase, resulting in delayed integration into oncology services. This study aimed to clarify the concept of palliative care in cancer patients using Walker and Avant’s concept analysis framework. A PRISMA-guided literature search was conducted in the PubMed and ScienceDirect databases for articles published between 2020 and 2025. The last search was conducted on 06 January 2026. Twenty eligible studies were systematically reviewed to examine the use of the palliative care concept and to identify its defining attributes, antecedents, consequences, and empirical referents. Five defining attributes of palliative care in oncology were identified: holistic care addressing physical, psychological, social, and spiritual dimensions; a primary focus on quality of life and patient dignity; interprofessional collaborative practice; empathic therapeutic communication; and spiritual existential support. Key antecedents included advanced or progressive cancer, high symptom burden, emotional and spiritual distress, diminishing benefits of curative treatments, complex decision making, and the need for advance care planning. The consequences included improved quality of life, better symptom control, reduced psychological distress, enhanced spiritual well-being, increased patient and family satisfaction, and clearer goals of care aligned with patient values. This analysis was limited to English- language articles indexed in two databases. Clarifying the concept of palliative care supports earlier referral, strengthens interprofessional practice, and informs oncology nursing education, clinical decision making, and future research. Across the entire cancer care trajectory and service continuum.
Treatment Adherence in Low Back Pain Self-Management Care: A Concept Analysis Using the Walker and Avant Method Ni Putu Sri Rahayu Dirantini; I Nyoman Purna Wijaya; Ni Made Yuniari Artini; Ni Putu Mira Pratami; Ni Wayan Indah Purnama Sari; Ni Wayan Putri Erlina; Ni Luh Dwi Indrayani; Ni Luh Putu Inca Agustini Buntari
NERS Jurnal Keperawatan Vol. 22 No. 2 (2026): NJK Volume 22, Number 2
Publisher : Fakultas Keperawatan Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/njk.v22i2.431

Abstract

One of the musculoskeletal conditions that can affect physical function, work productivity, and quality of life is low back pain (LBP). Management of LBP commonly requires individuals to continue recommended care and self-management activities beyond healthcare settings. However, treatment adherence in the context of LBP self-management has not always been conceptually distinguished from related constructs. This study aimed to clarify the concept of treatment adherence in self-management of LBP by identifying its defining attributes, antecedents, consequences, and empirical referents. A concept analysis was conducted using the Walker and Avant framework. A literature search was performed in PubMed, ScienceDirect, and Web of Science selected for their relevant biomedical, clinical, and health-care coverage. Publications from 2020 to 2025 were screened using MeSH terms and keywords. The literature was examined for descriptions of adherence, self-management behaviors, treatment implementation, and maintenance of recommended care in people with LBP. Eligible English full-text articles were synthesized following Walker and Avant, with PRISMA used to report the screening process. Nine relevant studies were identified and analyzed. The defining attributes of treatment adherence were active involvement and personal responsibility. Antecedents included knowledge and understanding of the condition and treatment goals. Consequences included improved symptom control, physical function and activity, maintenance of self-management behaviors, and potentially reduced healthcare utilization. Empirical referents included observable implementation and maintenance of recommended behaviors, exercise participation, activity management, medication use when prescribed, and clinical or functional outcomes. Treatment adherence in self-management of low back pain is a sustained behavioral process characterized by active engagement, consistency, maintenance of recommended treatment behaviors, self-efficacy, and motivation, providing a clear conceptual basis for nursing practice and future adherence measurement.
Co-Authors Dwi Fitri Genisti I Gede Putu Darma Suyasa I Kadek Agus Andika Adi Putra I Nyoman Purna Wijaya Komang Ngurah Suputra Prasetya Ni Luh Gede Eka Wahyuni Sudiarsa Ni Luh Putu Inca Agustini Buntari Ni Luh Putu Inca Buntari Agustini Ni Made Yuniari Artini Ni Putu Mira Pratami Ni Putu Sri Rahayu Dirantini Ni Wayan Ayu Widia Setiawati Ni Wayan Indah Purnama Sari Ni Wayan Putri Erlina Putu Ria Laksmi Handayani