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Knowledge and Income Determining Treatment Options For Cancer Patients Raden Nabilah Putri Fauziyyah; Oktavia Nur Azizah Jain; Laili Rahayuwati; Lilis Mamuroh; Kusman Ibrahim
Jurnal Berita Ilmu Keperawatan Vol. 15, No. 1, 2022
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/bik.v15i1.17124

Abstract

Breast cancer is still the most common case in many countries. Breast cancer can threat a person's quality of life, especially for someone who has difficulty choosing treatment due to lack of understanding of treatment options. In choosing a treatment influenced by knowledge and income which are internal factors that must be present in determining treatment options, because itwill determine the right choice of treatment. This study aims to discover the choice of treatment in breast cancer patients based on knowledge and income.The research design used quantitative descriptive. This study used secondary data from a Leading Tertiary Study grant in 2015. Sampling in this study were 200 breast cancer patients undergoing chemotherapy. Data processing used univariate and crosstabs techniques with the correlation test using Chi-Square.In this study, there was a relationship between knowledge and choice of treatment, but there was no relationship between income and choice of treatment. In conclusion, that the choice of breast cancer treatment is influenced by the respondent's understanding of the disease. It is hoped that this research can be a source of information that can be used by health workers in providing nursing care.
GAMBARAN STATUS FUNGSIONAL PADA PASIEN GAGAL GINJAL KRONIS YANG MENJALANI HEMODIALISIS DI RSUP DR. HASAN SADIKIN BANDUNG Riri Amalina; Kusman Ibrahim; Etika Emaliyawati
Jurnal Keperawatan Sriwijaya Vol 5, No 1 (2018)
Publisher : Universitas Sriwijaya

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Abstract

Tujuan: Penyakit gagal ginjal kronis menyebabkan masalah kesehatan seperti manifestasi klinis, komplikasi dan efek samping terapi yang akan mempengaruhi status fungsional yang berhubungan dengan kinerja, kemandirian, pemeliharaan kesehatan, dan kesejahteraan. Penelitian ini bertujuan untuk mengetahui gambaran status fungsional pada pasien gagal ginjal kronis yang menjalani hemodialisis di rsup dr. hasan sadikin bandung.   Metode: Penelitian ini menggunakan metode deskriptif kuantitatif dengan jumlah subyek penelitian sebanyak 80 orang yang diambil dengan menggunakan teknik purposive sampling. Penelitian menggunakan instrumen (FACIT), data dianalisis menggunakan nilai mean. Semakin tinggi skor semakin baik status fungsional atau kesejahteraan.   Hasil: Nilai mean status fungsional pada pasien gagal ginjal kronis yang menjalani hemodialisis adalah 2,65 (±3,08) dengan nilai kesejahteraan emosional 2,36 (±0,48), kesejahteraan fisik 2,40 (±0,60), kesejahteraan fungsional 2,58 (±0,72), kesejahteraan sosial/keluarga 2,87 (±0,78) dan kesejahteraan spiritual 3,07 (±0,41).   Simpulan: Dari hasil tersebut terjadi penurunan status fungsional pada kesejahteraan emosional, fisik, dan fungsional. Upaya meningkatkan status fungsional tersebut dapat dilakukan dengan terapi aktivitas kelompok agar pasien dapat mengungkapkan perasaan dan pengalaman selama menjalani hemodialisis.
Quality of Life and Characteristics of Colostomy Patients Kusman Ibrahim, SKp., MNS., PhD; Ayu Prawesti Priambodo; Aan Nur’aeni; Sri Hendrawati
Jurnal Ners Vol. 12 No. 2 (2017): October 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (498.73 KB) | DOI: 10.20473/jn.v12i2.6026

Abstract

Introduction: Colostomy imposed multiple impacts on the patient’s life including physical, psychological, social, and spiritual. This study aims to identify the level of quality of life as well as to examine the differences of quality of life among colostomy patients with regards to certain demographic characteristics.Methods: This study used a cross-sectional and descriptive analytical approach. Seventy-one colostomy patients were recruited purposively to participate in the study. The studied variables included quality of life and demographic characteristics. The data was collected by using the WHO Quality of Life – BREF instrument. One-way ANOVA and an independent t-test were employed to analyse the differences in quality of life with regards to certain demographic characteristics.Results: The study found that the majority of subjects perceived that their level of quality of life ranged between very low to moderate (77.4%). Satisfaction with support from friends was rated as the highest item of quality of life, whereas satisfaction with sexual relationships was rated as the lowest item of quality of life. There was no significant difference in the patients’ quality of life with regards to age group, educational background, occupation, length of being ostomate, sex, and other health problems.Conclusions: The study implied that nurses need to realise and pay attention to multiple aspects of stoma patient’s quality of life. Nursing care should not merely focus on stoma care but also holistically consider on meeting sexual needs, as well as the psychological, social, and spiritual needs of the patients.
Self-Efficacy and the Competency of Nursing Students Toward the Implementation of Evidence-Based Practice Yusshy Kurnia Herliani; Hasniatisari Harun; Anita Setyawati; Kusman Ibrahim
Jurnal Ners Vol. 13 No. 1 (2018): April 2018
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v13i1.6359

Abstract

Introduction: Professional nurses should have adequate competency in order to apply Evidence Based Practice (EBP) in their nursing care. However, many nurses provide nursing care based on traditions, habits and personal experience. Less confidence in the feeling of nurses about their competency when employing EBP could inhibit successful EBP implementation in nursing care. Therefore, introducing and applying EBP during clinical placements in the Ners program is essential to form a professional attitude and to provide a basic level of experience when applying EBP in patient care. However, the self-efficacy and competence of the students when applying EBP has not yet been evaluated properly and there is little known about the nursing students’ competences and self-efficacy toward EBP implementation during clinical practice. Thus, the study aims to describe the self-efficacy and competency of nursing students toward the implementation of EBP, while also investigating the relationship between self-efficacy and the competency of nursing students in the implementation of EBP.Methods: This descriptive correlational study involved 120 nursing students who were actively registered on the Ners program 2016/2017. The data was collected by using the self-reporting Evidence-Based Practice Questionnaire (EBPQ), which was then analysed descriptively and inferentially using statistics.Results: The results of this study revealed that more than half (55%) of the participants had a high score of self-efficacy and almost half (49%) were categorised as having a high competence when implementing EBP. The self-efficacy score was significantly correlated to the score of competency (r = 0.607, p < 0.01).Conclusion: This study recommends that the development of the students’ competence in implementing EBP is essential to promote self-efficacy when applying EBP, and vice versa.  
Perbedaan Literasi (Pengetahuan dan Pengambilan Keputusan) tentang Kanker melalui Metode Ceramah dan Konseling pada Masyarakat Laili Rahayuwati; Kusman Ibrahim; Ikeu Nurhidayah; Dyah Setyorini
Ners Jurnal Keperawatan Vol 13, No 1 (2017)
Publisher : Fakultas Keperawatan Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (134.98 KB) | DOI: 10.25077/njk.13.1.1-9.2017

Abstract

Sistem kesehatan di Indonesia membutuhkan suatu wadah yang bisa membangun dan meningkatkan sistem pendidikan dan pelayanan kesehatan tidak hanya di kota tetapi hingga pelosok daerah. Didukung oleh salah satu perguruan tinggu negeri di Indonesia yaitu Universitas Padjadjaran yang menjadi salah satu perguruan tinggi yang mempunyai kelayakan SDM dan dukungan lain untuk pelaksanaan kegiatan PKM. Tujuan dari kegiatan Pengabdian Kepada Masyarakat tersebut Universitas Padjadjaran ingin mengembangkan salah satu desa binaan Universitas Padjadjaran yaitu Desa Arjasari agar masyarakatnya lebih concern dalam menanggulangi masalah kesehatan khususnya kanker karena penyebarannya sudah menggerogoti masyarakat desa sekalipun. Metode yang digunakan adalah pendidikan kesehatan dan pemeriksaan deteksi dini Ca Serviks yang diadakan secara gratis kepada ibu-ibu di Desa Arjasari. Hasil dari PKM ini didapatkan bahwa karakteristik usia wanita yang menghadiri acara penyuluhan dan pemeriksaan dini Ca Serviks adalah usia 46 – 55 tahun sebanyak 23 orang (38,33%). Hal ini menunjukkan bahwa wanita dewasa lebih tertarik dibandingkan lainnya. Untuk pendidikan terakhir yang terbanyak adalah lulusan SMA sebanyak 26 orang (43,3%). Untuk hasil pretest didapatkan ada sebanyak 29 orang memiliki score tinggi (48,33%). Sedangkan pada hasil posttest didapatkan ada 23 orang yang memiliki score dengan kategori sedang (38,33%). Hal ini menunjukkan adanya penurunan nilai dari pretest dan posttest, dikarenakan dengan berbagai faktor dilapangan. Dari hasil kegiatan setelah dilakukan penyuluhan dan pembelajaran secara intensif kepada masyarakat, masyarakat menjadi lebih banyak tahu mengenai informasi kanker serviks dimasyarakat. Hasil pengabdian kepada masyarakat ini diharapkan dapat menghasilkan masyarakat yang memiliki pengetahuan tentang tindakan preventif penyakit kanker dan peningkatan kualitas hidup pada pasien penderita kanker.
Eksplorasi Perubahan Fisik dan Gejolak Emosional pada Pasien Gagal Ginjal Kronis yang Menjalani Hemodialisis: Pendekatan Kualitatif Lilin Rosyanti; Indriono Hadi; Kusman Ibrahim
Health Information : Jurnal Penelitian Vol 10 No 2 (2018): Juli-Desember
Publisher : Poltekkes Kemenkes Kendari

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (318.883 KB) | DOI: 10.36990/hijp.v10i2.83

Abstract

Patients with terminal kidney failure report limitations and physical changes, psychological functions, and weaknesses that have a negative effect on health status and a decrease in survival. Progress in dialysis technology and disease management still raises many complaints both physically and psychologically by increasing the mortality rate of patients undergoing hemodialysis. In 2008, there were about 1.75 million patients worldwide who regularly received kidney replacement therapy in the form of dialysis, about 1.55 (89%) million underwent hemodialysis (HD) and around 197.000 (11%) used peritoneal dialysis (PD). This research explored the experience of hemodialysis patients with physical changes and emotional turmoil. This was a descriptive qualitative research that aimed to reveal broadly and deeply the causes and things that influenced the pattern of life behavior of patients from aspects of sexuality. The study found two categories of themes (1) physical changes and physical complaints: black facial skin, damaged teeth,body thin, body weak, and fatigue. (2) feeling and emotional turmoil: not accepting and fearing death, feeling helpless and useless, apologizing and suggesting that the couple remarry. The exploration experience of physical changes and emotional turmoil of hemodialysis patients were influenced by physical, physiological, psychological, social and spiritual aspects as well as values, cultures that exist in the lives of participants.
Evidence-Based Practice: Community-Based Palliative Cancer Care Jajang Ganjar Waluya; Nur Maziyya; Eva Nurlaela; Ita Vusfita; Ihda Al Adawiyah Mz; Kusman Ibrahim; Ikeu Nurhidayah; Laili Rahayuwati
Journal of Nursing Care Vol 2, No 2 (2019): Journal of Nursing Care
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1253.468 KB) | DOI: 10.24198/jnc.v2i2.18726

Abstract

Prevalence of  cancer is estimated will increase in the next two decades. Therefore, there is a challenge for health provider to encounter treatment and caring for the patients. Especially, the cancer patients face several problems not only physical but also psychological, emotional, spiritual and social cultural aspects.This study explored the evidence-based practice on community-based palliative cancer care. Literature study is done by making a summary of published articles related to the question. The searching method used several electronic databases such as Google Scholar, Proquest, and PubMed. Articles under the keywords of “Palliative Cancer Care”, “Community”, and “Nursing” reach as much as 1.804. The inclusion criteria for this literature review were articles that have been peer-reviewed, are in full-text, in either English or Indonesian, and publication year from 2008 to 2018. Meanwhile, the exclusion criteria include those that do not follow a standardized structure of an article (consisting of Abstract, Introduction, Method, Result, Discussion, Implication, and Reference), are in the form of a review, and whose content does not answer research questions.Results: The United States of America is on the highest place regarding palliative care service, following by community-based palliative cancer implementation in Europe. Asian countries had been applying palliative care service, integrated with national health care system. In the Middle East countries, palliative care program ranks the lowest, but in implementation, they have discreetly performed community-based palliative care. In Africa, it is not the main focus in the field of health. Palliative care for cancer patients that is potential for development in Indonesia is that of family-based.Conclusion: Community-based palliative care is a variant of palliative treatment long applied and being developed in many countries in the world. In continents such as America and Europe, the implementation of palliative care ranks the highest place. In Indonesia, it is done partially and only available in hospitals or non-governmental organization. In the level of community, family-based palliative care can be developed by involving trained family members.
PENGALAMAN KEKERASAN PADA PEREMPUAN DENGAN HIV DI BANDUNG: Experiences of Violence on Women with HIV in Bandung Gina Nurdina; Kusman Ibrahim; Desy Indra Yani
Jurnal Ilmiah Keperawatan (Scientific Journal of Nursing) Vol. 8 No. 1 (2022): JIKep | Februari 2022
Publisher : LPPM STIKES Pemkab Jombang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.978 KB) | DOI: 10.33023/jikep.v8i1.977

Abstract

Pendahuluan: Kekerasan terhadap perempuan merupakan salah satu bentuk ketimpangan gender terluas yang meningkat menjadi rentan terhadap HIV dan akibatnya dapat didiagnosis dengan HIV. Perempuan HIV-positif lebih rentan terhadap kekerasan sebelum atau setelah didiagnosis daripada perempuan HIV-negatif. Kekerasan terhadap perempuan berdampak pada status kesehatan fisik dan mental yang mempengaruhi kualitas hidup mereka dan semakin kompleks dengan HIV yang dideritanya. Oleh karena itu, mengungkapkan pengalaman mereka dengan kekerasan menjadi sangat penting. Penelitian ini bertujuan untuk mengungkap makna pengalaman hidup perempuan dengan HIV yang mengalami kekerasan di Kota Bandung. Metode: Penelitian ini menggunakan metode fenomenologi deskriptif. Enam partisipan dalam penelitian ini yang memiliki pengalaman kekerasan dipilih dengan metode purposive sampling. Pengalaman kekerasan diperoleh dengan wawancara mendalam dan dianalisis dengan metode Colaizzi. Studi tersebut mengidentifikasi lima tema: rasa sakit menyebabkan kekerasan; ketidakberdayaan untuk menghadapi kekerasan; takut untuk terbuka tentang status HIV; membutuhkan dukungan dan penguatan untuk menghadapi kekerasan; dan dilema untuk menikah lagi. Hasil penelitian ini diharapkan dapat meningkatkan pengetahuan perawat agar lebih peka terhadap perempuan korban kekerasan untuk meningkatkan kualitas pelayanan terhadap perempuan yang terinfeksi HIV.
PEMENUHAN KEBUTUHAN SPIRITUAL OLEH PERAWAT DI RUANG GENERAL INTENSIVE CARE UNIT RSUP Dr. HASAN SADIKIN BANDUNG Siti Romadoni; Kusman Ibrahim; Titis Kurniawan
Masker Medika Vol 1 No 1 (2013): Masker Medika
Publisher : IKesT Muhammadiyah Palembang

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Abstract

Kebutuhan spiritual merupakan salah satu kebutuhan dasar yang dibutuhkan oleh setiap manusia, salah satunya adalah pasien dalam kondisi kritis maupun terminal yang di rawat di ruang intensif. Tujuan penelitian ini adalah untuk menggali lebih dalam tentang pemenuhan kebutuhan spiritual oleh perawat di Ruang General Intensive Care Unit (GICU) RSUP Dr. Hasan Sadikin Bandung Tahun 2012. Sebanyak sepuluh partisipan dilibatkan dalam penelitian deskriptif kualitatif eksploratif ini. Partisipan tersebut adalahperawat pelaksana yang bekerja di Ruang GICU RSHS Bandung, rentang usia antara 28- 47 tahun, dan bekerja selama 7-17 tahun. Pengumpulan data dengan melakukan wawancara mendalam, dan analisis yang digunakan adalah content analysis. Hasil penelitian mendapatkan 18 tema yang dikelompokkan menjadi 5 kategori yaitu: 1) Makna spiritual yaitu: agama, keyakinan terhadap Tuhan, hubungan manusia dengan Tuhan dan sesama Manusia. 2) Persepsi Kebutuhan Spiritual yaitu: Kebutuhan ibadah, semangat,nyaman, kasih sayang. 3) Bentuk-bentuk pemenuhan kebutuhan spiritual yaitu: membantu kegiatan ibadah pasien, melibatkan keluarga dan tokoh agama, memberikan semangat. 4) Hambatan-hambatan dalam pemenuhan kebutuhan spiritual yaitu: anggapan kurang penting bukan prioritas, kesibukan, perbedaan agama, agama hal privasi, dan kurang paham konsep spiritual. 5) Langkah-langkah untuk meningkatkan pemenuhan kebutuhan spiritual yaitu: ada petugas khusus (ustadz, pendeta, warois), dibuat Protap/SOP, penambahan fasilitas, dan peningkatan kualitas perawat melalui pelatihan dan pendidikan. Dapat disimpulkan bahwa pemenuhan kebutuhan spiritual dalam penelitian ini berbentuk upaya-upaya dalam membantu kegiatan ibadah pasien, melibatkan keluarga dan tokoh agama, serta memberikan semangat. Dengan demikian penting bagi pihak rumah sakit mengadakan kegiatan untuk meningkatkan pengetahuan, pemahaman atau pun kemampuan perawat dalam pemenuhan kebutuhan spiritual. Dan bagi pendidikan untuk menambahkan muatan aspek spiritual dalam materi-materi yang disampaikan dalam perkuliahan. Serta dapat dijadikan data dasar untuk penelitian selanjutnya terkait pemenuhan kebutuhan spiritual
Respon Berduka pada Pasien Kanker Payudara Nia Kurniasih; Laili Rahayuwati; Lilis Mamuroh; Kusman Ibrahim; Raden Nabilah Putri Fauziyyah
Journal of Health Science and Prevention Vol. 6 No. 1 (2022): JHSP Vol 6 No 1 - 2022
Publisher : State Islamic University of Sunan Ampel

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29080/jhsp.v6i1.668

Abstract

Cancer is one of the various non communicable diseases. Breast cancer often occurs at an advanced stage caused by a person's delay in early detection. Everyone has a different response in dealing with a disease. Grieving is an emotional reaction that a person feels towards loss. Several factors influencing the grieving response include age, stage, and duration of illness. This study aimed to identify the grieving response by age, stage of cancer, duration of illness, and determine the relationship between age, stage of cancer, duration of illness, and grieving response. The research method used descriptive correlational. The population in this study was 200 people with sampling technique using a total sampling of 200 respondents. Data analysis was univariate and bivariate using the Chi-Square correlation test. This research showed that almost all respondents were at the acceptance stage; nearly half were aged 45-54 years were in stage 3, and half had <1 year of illness. Correlation results showed a significant relationship between age and grieving response p-value 0.000 <0.050, but there was no significant relationship between stage, duration of illness, and grieving response p-value> 0.050. There is a relationship between age and grieving response. There is no relationship between cancer stage, duration of illness, and grieving response. This research can be used to develop information that age influences the grieving response in breast cancer patients.
Co-Authors Aan Nur&#039;aini Aan Nuraeni Aan Nur’aini Aat Sriati Abdul Rahman Aditya Salya Adnyana , I Made Dwi Mertha Ai Nuraeni Alfian Alfian Amelia, Iftikar Salma Amelia, Vira Amirah, Shakira ANA IKHSAN HIDAYATULLOH Andri Nugraha Anita Setyawati Aprilia Aulia Ardianti Aria Nurahman Hendra Kusuma Arlette Suzy Puspa Pertiwi Asadul Islam Asep Supriatna Astilia, Astilia Baiq Emi Nurmalisa Cabanes, Ria C Cahyo Nugroho, Cahyo Cecep Eli Kosasih Christina Listha Citra Windani Mambang Sari Cruz, Zito Viegas da Dadang Purnama Derison Marsinova Bakara Desy Indra Yani Dian Adiningsih Didi Kurniawan Dwi Pudjonarko Dwinka Syafira Eljatin Dyah Setyorini Dyah Setyorini Earlyana Octavia limbong ENDAH NESTITI URIP RAHAYU Erin M. Kahle Ermiati Ermiati Etika Emaliyawati Etika Emaliyawati Etika Emliyawati Eva Nurlaela Faizal Idrus Fauziyyah, Raden Nabilah Putri Fera Imelia Agustin Gina Nurdina Habsyah Saparidah Agustina Hadi Nasbey Hana Rizmadewi Agustina Hardhono Susanto Harmita, Devi Hartiah Haroen Harun, Hasniatisari Harun, Hasniatisari Harun, Hasniatisari Harwadi, Hendra Hasanah, Ulung Hayaty, Helmi Helmi Hayaty Hendra Harwadi Heri Budiawan Herliani, Yusshy Kurnia HIDAYATULLOH, ANA IKHSAN Ida Maryati Ida Rosidawati Ihda Al Adawiyah Mz Ikeu Nurhidayah Imas Rafiyah Indriono Hadi Inriyana, Ria Iqbal Pramukti Irman Somantri Ita Vusfita Iyus Yosep Jabareen, Raifa Jain, Oktavia Nur Azizah Jayalangkara Tanra Kesumawati, Rianti Kintan Komala Kombong, Rita Kurniawan Yudianto La Rangki La Rangki La Rangki Laili Rahayuwati Lia Meilianingsih Lilin Rosyanti Lilis Lismayanti Lilis Lismayanti Lilis Mamuroh limbong, Earlyana Octavia Lin, Chung-Ying Luh Nik Armini Luthfi, Wazirul Made Yos Kresnayana Mamat Lukman Manumara, Theophylia Melisa Maria komariah Maria Komariah Maulana, Sidik Maziyya, Nur Mediawati, Ati Surya Meidiana Dwidiyanti Meilita Enggune Meita Dhamayanti Mia Listia Mochammad Hatta Mustari Aji, Nandang Nasrulloh, Iqbal Nia Kurniasih Nita Arisanti Nita Fitria Novi Malisa Novi Malisa, Novi Nur Chayati Nursiswati Nur’aeni, Aan Oktavia Nur Azizah Jain Olivia, Claudia Priambodo, Ayu Prawesti Purwo Suwignyo Putri Karisa Raden Nabilah Putri Fauziyyah Raden Nabilah Putri Fauziyyah Raden Nabilah Putri Fauziyyah Rahmah, Tira Nur Rahmi Muthia Raini Diah Susanti Ramadani, Regina Cahya Ramoo, Vimala Restuning Widiasih Ria Bandiara Ria Inriyana Riri Amalina Riri Amalina Ristina Mirwanti, Ristina Rudi Kurniawan Rudi Wisaksana Rudi Wisaksana Sandra Pebrianti Saritessa, Nining Septian Andriyani, Septian Setiawan Setiawan Setiyawan Setiyawan siti romadoni Siti Ulfah Rifa’atul Fitri Slamet Riyanto Sri Elis Rohaeti Sri Hartati Pratiwi Sri Hendrawati Sri Hendrawati Sri Hendrawati SRI WULANDARI Sridiawati, Esy Stevani Basry Suryani Suryani Tati Sumarni Tertianto Prabowo Titin Mulyati Titin Sutini Titis Kurniawan Titis Kurniawan Titis Kurniawan Tuti Anggriani Utama Tuti Pahria Udin Rosidin Umar, Tungki Pratama Untung Sujianto Upit Pitriani Urip Rahayu Veny Hadju Waluya, Ady Waluya, Jajang Ganjar Widaningsih, Ida Windiramadhan, Alvian Pristy Witdiawati Witdiawati Witdiawati, Witdiawati Witdiawati, Witidiawati Yanny Trisyani Yanny Trisyani Yeni Yulianti Yovita Hartantri Yusshy Kurnia H Yusshy Kurnia Herliani Yusshy Kurnia Herliani Zahara Farhan