Claim Missing Document
Check
Articles

Management of lymphedema and pleural efusion in patients with breast cancer stadium IV: a case study Novriyanti, Sukma; Effendy, Christantie; Fitriana, Nazula
Journal of health research and technology Vol. 1 No. 1 (2023): Journal of health research and technology
Publisher : Sahabat Publikasi Kuu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58439/jhrt.v1i1.49

Abstract

Background: Metastasis of breast cancer to distant organs occurs as a result of cancer cells spreading through the lymphatic system or blood flow. Pleural effusion and lymphedema are manifestations due to metastasis of cancer cells. Management is needed to relieve suffering, reduce complications, and improve quality of life. Methods: Case study was conducted using observation, interviews, physical examination, and tracing of patient medical records. Informed consents were given before the case study started. Case: Mrs. S, 67 years old, was diagnosed with breast cancer in 2021. The patient was only treated with herbal treatment before being admitted to the hospital in June 2022 with shortness of breath which later found metastases to the lungs. Clinical findings include pitting edema in the right upper extremity, pleural effusion, ulcer cancer from the breast to the right armpit, and a closed fracture of the right clavicle. Swelling in the right arm has occurred since March 2022 slowly spreading throughout the arm. The patient is on bed rest in a semi-fowler's position, limited range of motion, and all activities are assisted by the family. Intervention: The patient is given oxygen therapy with nasal cannula 3lpm and 30o semi-fowler positioning. Skin care intervention is used to treat lymphedema problem. Patient’s family also received education to prevent and reduce the occurrence of swelling in the contralateral arm. Conclusion: Shortness of breath management with oxygen therapy and positioning can help facilitate adequate breathing along with drainage of pleural fluid. Treatment of lymphedema focuses on reducing swelling and minimizing complications. Treatment options are adjusted to the patient's clinical condition.
Psychological Distress, Uncertainty Intolerance, and Quality of Life of Patients with Cancer and Their Caregivers: A Comparative Study Rahma, Ainur; Effendy, Christantie; Lismidiati, Wiwin
Indonesian Journal of Cancer Vol 19, No 2 (2025): June
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i2.1300

Abstract

Background: Psychological distress and uncertainty intolerance in cancer patients are linked to various physical consequences and negative psychological impacts, such as increased symptom severity, disruption in daily life, and reduced quality of life. These issues also affect family caregivers of cancer patients. This study aims to describe the psychological distress, uncertainty intolerance, and quality of life in cancer patients and their family caregivers. Methods: This was a cross-sectional study with 57 cancer patients and 57 caregivers at Dr. Sardjito Hospital, Yogyakarta-Indonesia, in July-August 2023. Psychological distress was measured by using the Kessler Scale (K-10), uncertainty using the Intolerance Uncertainty Scale (IUS-12), and quality of life using the EORTC QLQ-C30 and SF-36. Data were analyzed using Mann-Whitney and Kruskal-Wallis tests. Results: Significant differences were found in uncertainty intolerance between patients and caregivers (p=0.001) and caregivers’ marital status (p=0.045). Quality of life varied among patients based on age, gender, marital status, cancer type, and treatment (p0.05). Caregivers’ quality of life differed by age in physical and emotional roles (p≤0.005). Conclusions: There is a significant difference between the intolerance uncertainty of cancer patients and family caregivers. Meanwhile, the quality of life of cancer patients and the quality of life of family caregivers have differences in each scale and domain in several of their demographic characteristics. Longitudinal studies are needed to understand the trajectory of psychological distress and uncertainty intolerance over time.
Remote Patient Monitoring Pada Pasien Kanker: Analisis Konsep Prima, Ashar; Gayatri, Dewi; Afiyanti, Yati; Effendy, Christantie
Media Kesehatan Politeknik Kesehatan Makassar Vol 20 No 1 (2025): Media Kesehatan
Publisher : Direktorat Politeknik Kesehatan Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32382/medkes.v20i1.1424

Abstract

Background. Remote Patient Monitoring (RPM) has emerged as an innovative approach in healthcare, particularly for monitoring patients with chronic conditions such as cancer. Variations in approaches in research and clinical practice can lead to differences in interpretation among healthcare professionals and researchers. Research Objectives. This study aims to explore the concept of remote patient monitoring. Method. Concept analysis was conducted following the eight-step approach by Walker and Avant: selecting the concept, determining the purpose of the analysis, identifying all uses of the concept, determining defining attributes, identifying model cases, identifying borderline and contradictory cases, identifying antecedents (preceding factors) and consequences, and defining empirical referents. A literature review was conducted using the Google Scholar, Scopus, ScienceDirect, EBSCOhost, and ProQuest databases to identify articles published between 2018 and 2024. Results. The analysis identified five main attributes of RPM: continuous monitoring, technology integration, multidisciplinary collaboration, service accessibility, and patient-centered care. These attributes are theoretically associated with positive consequences such as early detection of complications, improved health outcomes, cost-effectiveness, and patient empowerment and quality of life. Preceding factors include the availability of digital technology and infrastructure, the healthcare needs of cancer patients, challenges in accessing healthcare services, and patients' digital literacy and readiness. Conclusion. This study contributes theoretically by providing a conceptual model of RPM that can serve as a foundation for developing digital nursing practices and RPM implementation policies in oncology services. Standardizing the definition and conceptual modeling of RPM is crucial to ensuring consistent and effective integration within cancer patient care systems, where nurses play a central role in data interpretation and interprofessional coordination. Keywords: Remote Patient Monitoring; Cancer Patients
Palliative care outcomes in adult intensive care units: A scoping review of potential quality indicators Suwardianto, Heru; Setiyarini, Sri; Effendy, Christantie
Physical Therapy Journal of Indonesia Vol. 6 No. 1 (2025): January-June 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i1.284

Abstract

Background: While critical care focuses on survival, it may unintentionally overlook aspects of comfort, dignity, and communication that are essential to quality end-of-life care. This scoping review aimed to identify existing outcome indicators, highlight gaps, and propose potential quality indicators for palliative care in ICU settings. Methods: Fifty-seven databases were searched for relevant publications published between January 2000 and December 31, 2024. The inclusion criteria were full-text, peer-reviewed journal articles in English, consisting of final versions of original or review studies conducted in adult ICUs. Case studies, perspectives, editorials, and reports were excluded. This study used the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) approach. We reviewed the literature across multiple databases, including PubMed, ProQuest, EBSCOhost, Scopus, ScienceDirect, and BASE. We carried out the ScR according to the structure suggested by Arksey and O'Malley. Results: This review included 57 studies, with a total of 158 codes representing 122 unique codes, which were grouped into 29 sub-themes (categories of palliative care outcomes) within five main themes: communication and palliative care consultation, end-of-life care decisions, symptom management and comfort, psychosocial well-being of patients and families, and ethics and the role of clinicians in palliative care. Additionally, unique categories were identified to reflect each of these themes. Conclusion: Outcomes have been highlighted as unique and significant palliative care outcomes for adult patients in ICU critical care settings, potentially becoming candidate quality indicators. The candidate outcome indicators for palliative care in the ICU in the future will contribute to more measurable and standardized outcome assessments.
Manajeman Syok Hipovolemia pada Pasien Plasenta Akreta dengan Tindakan Caesarean Hysterectomy di Kamar Operasi Nurhasanah, Erna; Effendy, Christantie; Shodiq, Abror; Hapsari, Elsi Dwi
Jurnal Persatuan Perawat Nasional Indonesia (JPPNI) Vol 10, No 2 (2025)
Publisher : Persatuan Perawat Nasional Indonesia (JPPNI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32419/jppni.v10i2.691

Abstract

Latar Belakang: Plasenta akreta merupakan komplikasi obstetrik yang jarang, tetapi sangat berisiko karena berpotensi menimbulkan perdarahan masif intraoperatif yang dapat meningkatkan angka morbiditas dan mortalitas. Oleh sebab itu, penanganan syok hipovolemia sangat penting untuk mempertahankan kestabilan hemodinamik dan mendukung hasil pembedahan yang optimal. Laporan ini membahas penanganan syok hipovolemia pada pasien plasenta akreta yang menjalani operasi caesarean hysterectomy/histerektomi sesar. Keluhan Utama Pasien:  Pasien perempuan usia 27 tahun mengalami perdarahan 4.000 ml selama histerektomi sesar hingga mengalami syok hipovolemik. Tindakan keperawatan meliputi pemasangan tiga IV-line besar (16G, 14G, 18G), pemasangan kateter, resusitasi cairan, dan transfusi 7 PRC, 5 FFP, 5 TC, pemberian norepinefrin dan asam traneksamat. Hasil: Setelah perdarahan masif berhasil diatasi, total cairan yang masuk dan keluar selama prosedur operasi dihitung untuk mengevaluasi efektivitas terapi cairan yang diberikan. Total cairan masuk 6.750 ml, cairan keluar 6.352 ml, dengan keseimbangan +398 ml. Monitoring hemodinamik dilakukan ketat, urine output 0,877 ml/kg/jam. Kesimpulan: Manajemen cairan terintegrasi dengan pemantauan intensif dan kolaborasi tim sangat penting untuk menghindari komplikasi syok dan disfungsi organ.Kata Kunci: cairan intraoperatif, perdarahan masif, plasenta akreta, syok hipovolemiaABSTRACTBackground: Placenta accreta is a rare but high-risk obstetric condition due to the potential for massive intraoperative hemorrhage, which can significantly increase maternal morbidity and mortality. Effective management of hypovolemic shock is essential to maintain hemodynamic stability and ensure optimal surgical outcomes. This case report discusses the management of hypovolemic shock in a patient with placenta accreta undergoing cesarean hysterectomy. Methods: This case report describes intraoperative fluid management in a patient with placenta accreta who experienced massive hemorrhage during surgery. The data include the type and volume of fluids administered—crystalloids, colloids, and blood components—as well as total fluid output during the procedure. Results: A 27-year-old female experienced 4,000 ml of blood loss during cesarean hysterectomy, resulting in hypovolemic shock. Nursing interventions included insertion of three large-bore IV lines (16G, 14G, 18G), urinary catheterization, fluid resuscitation, and administration of 7 PRC, 5 FFP, 5 TC, norepinephrine, and tranexamic acid. Total fluid intake was 6,750 ml (2,300 ml blood components, 3,200 ml crystalloids, 1,250 ml colloids), with an output of 6,352 ml and a positive balance of +398 ml. Hemodynamic parameters were closely monitored using invasive arterial pressure monitoring. Urine output reached 0.877 ml/kg/hr, indicating preserved renal function despite severe physiological stress. Conclusion: Intraoperative fluid management in placenta accreta requires a well-coordinated approach combining crystalloids, colloids, and blood components. Intensive monitoring and multidisciplinary collaboration are crucial to prevent complications such as hypovolemic shock and organ failure.Keywords: placenta accreta, hypovolemic shock management, massive hemorrhage, intraoperative fluid therapy
Evaluating a caregiver-focused safety culture model: Effects on caregivers’ safety perception, older adults’ quality of life, and the incidence of adverse events in Indonesia Solihin, Asri Handayani; Probosuseno; Effendy, Christantie
Belitung Nursing Journal Vol. 11 No. 5 (2025): September - October
Publisher : Belitung Raya Foundation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33546/bnj.3650

Abstract

Background: Older adults are increasingly vulnerable to health risks, particularly in home care environments with limited formal safety measures. In Indonesia, family caregivers play a central role in providing care; however, research on interventions to enhance the safety of older adults at home remains limited. Objectives: This study aimed to evaluate the impact of a caregiver-focused safety model, the Aging Safe from the Risk (ASRi) model, on caregivers’ perceptions of safety culture and assessed its indirect effects on older adults’ quality of life (QoL) and incidence of adverse events. Methods: A quasi-experimental study was conducted from July to November 2022, involving 135 older adult–caregiver pairs (intervention: n = 68; control: n = 67). Older adults’ QoL was measured using the modified WHO-QOL BREF (Indonesian version) and WHO-QOL OLD instruments. Family caregivers completed a Home Safety Culture (HSC) questionnaire and reported adverse events. Data were analyzed using descriptive statistics, chi-square tests, independent t-tests, Mann–Whitney U tests, Fisher’s exact tests, repeated-measures general linear models (GLM-RM), and exploratory ANCOVA within the intervention group. Results: Baseline characteristics were largely similar for older adults (age, comorbidities, fall risk, medication use) and caregivers (gender, age, education, marital status), although some imbalances were noted. Significant between-group differences were observed in the spiritual dimension (baseline p = 0.019, r = 0.202; fourth month p = 0.018, r = 0.204) and environmental dimension of safety culture (all time points p <0.001, r = 0.347-0.431), with a transient difference in the personal dimension at month one (p = 0.013, r = 0.215). QoL scores were consistently higher in the control group (p <0.001, Cohen’s d = 0.551-0.645), reflecting baseline imbalance. Adverse events decreased in the intervention group during follow-up (p <0.001, Cramér’s V = 0.343-0.364); however, the higher baseline incidence suggests that regression to the mean may have contributed to this reduction. Conclusion: The ASRi model was associated with modest improvements in caregivers’ perceptions of safety culture. Differences in QoL and adverse events should be interpreted cautiously due to baseline imbalances and potential regression to the mean. While these findings provide preliminary indications that caregiver engagement through the ASRi model may support safer home care practices, causal conclusions cannot be drawn. Randomized studies with longer follow-up are needed to confirm these effects. Trial Registry: NCT05487482 [clinicaltrials.gov]
Breaking Bad News: Flipped Calendar as a Patient Information Provision Education Media Using the Spikes Method a Universitas Gadjah Mada Academic Hospital Wirastuti, Fita; Effendy, Christantie; Adnan, Nur Fatimah; Satiti, Sekar
Academic Hospital Journal Vol 7, No 2 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i2.104337

Abstract

Background: The quality of Breaking Bad News (BBN) communication has a significant impact on patient treatment adherence, emotional condition, understanding, and satisfaction with medical care. Effective communication skills and appropriate communication techniques are essential for providing optimal care. The SPIKES protocol is a communication protocol used as a standard and strategy for delivering difficult patient communication, comprising several stages: setting up, perception, invitation, knowledge, emotions, strategy, and summary.Objective: This study aimed to determine the effect of using the BBN flip chart calendar as educational media, combined with the SPIKES method, at Universitas Gadjah Mada Academic Hospital (UGM Academic Hospital). The specific research objectives were: (a) to understand the perceptions and expectations of doctors and nurses when providing education related to BBN, and (b) to determine the effect of using the BBN flip chart calendar educational media on patients.Method: This study was an experimental investigation to assess the effectiveness of using the BBN flip chart calendar as educational media in conjunction with the SPIKES protocol. The type of research was a quantitative study to understand the implementation of the BBN flip chart educational media at UGM Academic Hospital.Result:  The intervention group and the control group do not show statistically significant differences. The primary reason for these outcomes could be that behavioral changes are difficult to modify with a single communication practice. Continuous evaluation and feedback are needed on the effectiveness of BBN to improve the quality of health workers.
A Healing Garden Therapy Program Exploration in a Hospital Using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Model: Qualitative Study Hastuti, Agustina Sri Oktri; Effendy, Christantie; Suminarhati, Herlina
Poltekita: Jurnal Ilmu Kesehatan Vol. 19 No. 2 (2025)
Publisher : Poltekkes Kemenkes Palu

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33860/jik.v19i2.4217

Abstract

Staying in the hospital for a long period can affect a patient's psychological condition and may cause stress that slows down recovery. Healing Garden Therapy is a hospital program that can help support recovery, especially for patients with non-communicable diseases.  Therefore, this study aims to explore the implementation of the Healing Garden Therapy program in hospitals using assessment model of Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM). This study used a qualitative exploratory design. The participants consisted of two groups: 10 nurses and 8 non-nursing staff who were involved in the implementation of Healing Garden Therapy Program (HGTP), selected using purposive sampling. Data were collected using recorded Focus Group Discussions (FGDs) and using semi-structured guiding questions. The data were analyzed using Colaizzi's method and presented using the COREQ checklist. The study found four main themes: 1) The main targets of the Healing Garden Therapy Program are patients, families, and visitors; 2) Delivering holistic care; 3) The Healing Garden program has positive impacts and therefore should be reactivated; 4) The Healing Garden Therapy program needs management supports and nurses involvement. The Healing Garden Therapy program has shown positive impacts and should be implemented to support holistic nursing care in hospitals.
Spiritual Therapy for Patients and Communities Reducing Anxiety during the COVID-19 Pandemic: A Literature Review Dimas Utomo Hanggoro Putro; Siti Nurjanah; Christantie Effendy
Journal Of Nursing Practice Vol. 9 No. 1 (2025): October
Publisher : Universitas STRADA Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30994/jnp.v9i1.911

Abstract

Background: COVID-19 poses high challenges for society and has a considerable impact. One of the impacts of COVID-19 on patients and society is the emergence of anxiety, so efforts are needed to reduce this anxiety. Spiritual therapy is an alternative that can be used by patients and communities affected by COVID-19. Purpose: Find specifically about spiritual therapy to reduce anxiety in COVID-19 patients and communities affected by the COVID-19 pandemic. Methods: Literature review of international literature using Google Scholar, Proquest, and Taylor & Francis databases. A total of 1,544 articles were identified, of which 995 were duplicates, leaving 549 articles. After screening, 539 articles were excluded due to the lack of full-text availability. The remaining 10 articles were further reviewed, resulting in 5 articles that met the criteria and were included in this study. Results: Five articles meeting the inclusion criteria. One true experiment article, 2 pre-experiment articles, 1 RCT article, and 1 qualitative article. All articles analyzed are articles published in the range of 2019-2021. Spiritual therapies that can be used to reduce anxiety include Spiritual Emotional Freedom Technique (SEFT), Benson therapy, psychoreligious therapy, mindfulness meditation, and spiritual psychotherapy with an Islamic religious education approach. Conclusion: COVID-19 has profoundly impacted daily life and created significant challenges for society. However, spirituality serves as an important coping resource to help individuals manage anxiety. Various spiritual therapies such as the SEFT, benson relaxation, psychoreligious therapy, mindfulness meditation, and spiritual psychotherapy based on Islamic teachings have been shown to effectively reduce anxiety and promote mental well-being during the pandemic.
Psychosocial hazard in medical residents at RSUP Dr. Sardjito Praditia, Irsa Gusninda; Hasanbasri, Mubasysyir; Effendy, Christantie
BKM Public Health and Community Medicine Vol 37 No 06 (2021)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v37i06.21634

Abstract

Purpose: This study aims to identify psychosocial hazards by examining the history of physical and non-physical violence, as well as the concerns experienced by residents enrolled in the specialist medical education program at Dr. Sardjito General Hospital. Methods: This research employs a descriptive-analytical design using a cross-sectional approach, in which data are collected at a single point in time. The sampling technique used is proportional stratified random sampling, where the sample is drawn in proportion to the size of each stratum within the population. Results: The majority of respondents were over 30 years old (56.03%), male (58.87%), and held a bachelor's degree (87.94%). The most commonly reported psychosocial hazard among respondents at Dr. Sardjito General Hospital was verbal non-physical violence. A significant relationship was found between demographic characteristics—specifically age—and the history of physical violence among specialist medical education students. Additionally, a relationship was observed between work shift patterns and the history of non-physical violence. Furthermore, non-physical violence was found to be associated with anxiety among the specialist medical education students at Dr. Sardjito General Hospital. Conclusion: Health organizations must establish and prioritize policies against workplace violence through educational training programs and safety protocols.
Co-Authors A.A. Ketut Agung Cahyawan W Adnan, Nur Fatimah Afridayani, Meri Agustina Sandramustika, Agustina Agustina Sri Oktri Hastuti Ainur Rahma, Ainur AKICHIKA MIKAMI Andina Setyawati, Andina Anggraini Lizdiana Wulandari Ardika, Noviana Ayu Arif Rahman Mansur, Arif Rahman Arifin Triyanto Ashar Prima Atsarina Fauzan Bambang Suryono, Bambang Basuki, Suko Bayu, Yoni Setyo Nugroho Christaputri, Silvia Tri Wahyu Darwito, Darwito Dewi Gayatri Dewiyuliana Dewiyuliana Diah Husna Nugraheni, Diah Husna Dian Mawarni Dimas Utomo Hanggoro Putro Dwi Aris Agung Nugrahaningsih Dwi Asih Kusumaningrum, Dwi Asih Dwi Susanti Elsi Dwi Hapsari Endro Basuki Erlina Erlina Fatwa Sari Tetra Dewi Fitria Fitria Fitriana, Nazula Fitrina Mahardani Kusumaningrum Gracia Rosiharjati Sarihastanti Hardiyani, Tati Haryani Haryani Heny Suseani Pangastuti Heny Suseani Pangastuti Heny Suseani Pangastuti Heny Suseani Pangastuti Heru Suwardianto Hieronimous Amandus Hikmawati, Ulfa Ibeneme, Sam Ike Wuri Winahyu Sari Intansari Nurjannah Ismail Setyopranoto Ispriyatiningsih, Ispriyatiningsih Kaningsih Yuniarti, Kaningsih Karolin Adhisty Khudazi Aulawi Kornelia B Simamora, Kornelia B Kurniawan, Catur Lailya Khusna Latifa Erdiana, Latifa Lorica, J D Made Ririn Sri Wulandari Mae Sri Hartati Wahyuningsih Martina Sinta Kristanti Maryadi Merry Olvia Mubasysyir Hasanbasri Muhammad Deri Ramadhan Mulyainuningsih, Wa Ode Saridewi Narni Tri Sulastri, Narni Tri Ningsih, Dini Cristia Novriyanti, Sukma Nur Chayati Nurdina Wahyu HIDAYATI Nurhasanah, Erna Nurul Aida Fathya Osman Sianipar Perdana, Melyza Praditia, Irsa Gusninda Probosuseno Putri Mentari Endraswari Putri Utami Ayu Maninggar Putu Oka Yuli Nurhesti Raeni N, Raeni Rahayu Widiyanti, Rahayu Ridho Rahmadi Ridho Rahmadi Rizki Surtiyan Surya Rizky, Indah Roni Purnomo Rosaria Andriani, Rosaria Ruby SUSMAWATI Rudi Haryono, Rudi S, WIDIYONO Sardiman, Muhammad Satiti, Sekar Setyopranoto Setyopranoto Shodiq, Abror Siregar, Khairati Siti Na'imah SITI NURJANAH Sitti Rahma Soleman Solihin, Asri Handayani Sri Setiyarini Sri Setiyarini SRI SETIYARINI Sri Setiyarini Sri Setiyarini SRI SETIYARINI, SRI Sri Styowati Sri Wahyuni Sri Wahyuni Sri Warsini Suminarhati, Herlina Supriyati Supriyati Tou, Nurhaeka Tsauroh, Salsabila Fiqrotu Vita Ari Fatmawati Wahyudi, Vijna Putri Sukma Wandansari, Sri Wenny Artanty Nisman, Wenny Artanty WIDIYONO S Widiyono Widiyono Widyawati Widyawati Wirastuti, Fita Wiwin Lismidiati Yati Afiyanti Yayi Suryo Prabandari Yohani Setiya Rafika Nur Yuan Sa&#039;adati Yundari, Yundari Yuyun Christyanni, Yuyun Zulia Putri Perdani, Zulia Putri