Article Per Year (5 Year)
p-Index From 2020 - 2025
0.408
P-Index
This Author published in this journals
All Journal Indonesian Journal of Cancer Academic Hospital Journal
Darwito, Darwito
Unknown Affiliation
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

Published : 2 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 2 Documents
Search

 1 
Evaluating the Implementation of an Early Palliative Care Screening Tool for Inpatients at Persahabatan Hospital: Impact on Quality of Care, Length of Stay, and Clinical Outcomes Khonsa, Oni; Meliala, Andreasta; Darwito, Darwito
Indonesian Journal of Cancer Vol 19, No 3 (2025): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v19i3.1263

Abstract

Background: Palliative care is integrated medical care that is active and comprehensive, with a multidisciplinary approach to reduce the pain of terminally ill patients at the end of their lives. Persahabatan Hospital, as a national referral Type A hospital, receives many patients in severe and complex conditions, some of whom require palliative care. Early identification of Palliative Care Screening Tool (PCST) screening can result in more effective interventions and more optimal care in improving quality of life, reducing length of stay, and intensive care unit (ICU) admission rates. This study aims to assess the early implementation outcomes of the PCST in inpatients at Persahabatan Hospital. Method: This research is a sequential explanatory mixed methods design that examines how the implementation evaluation of PCST in palliative care at Persahabatan General Hospital is conducted, utilizing both retrospective quantitative and qualitative approaches. The quantitative approach involves utilizing secondary data from medical records and the PCST at Persahabatan General Hospital in Jakarta from January to December 2023. A random sampling technique was applied to select patients diagnosed with palliative care conditions, including severe liver disease,end-stage kidney disease, chronic obstructive pulmonary disease (COPD), advanced heart failure,and other chronic illnesses. At the same time, the qualitative approach employs the focus group discussion analysis method.Results: Out of 82 patients who underwent PCST screening, 56 patients underwent early screening, and 26 patients underwent late screening. The median length of stay for patients with early screening was 4 days, whereas for those with late screening, it was 18 days (p 0.001). Early screening had a relative risk of 4.34 (1.72–26.2) for successful palliative screening compared to late screening. Based on the analysis of the focus group discussion results, the main issues in implementing early screening were a lack of understanding of the screening process and difficulties in its implementation
Tunneled Epidural Analgesia for Refractory Scrotal Cancer Pain: A Case-Based Evaluation of Therapeutic Efficacy Nur Azza, Kamala Kan; Tomo, Wahyu Kartiko; Darwito, Darwito; Puspitasari, Ika; Mahmud, Mahmud; Widyastuti, Yunita
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.v7i2.109434

Abstract

Background: Scrotal Squamous Cell Carcinoma (SCC) is a rare malignancy. Although SCC typically demonstrates slow progression, in advanced stages with significant size, it can cause considerable pain due to mass effect and local tissue invasion. The management of cancer-related pain encompasses a wide spectrum of approaches, ranging from pharmacologic to surgical interventions. In cases where patients become intolerant to the side effects of pharmacologic therapies and adequate pain relief cannot be achieved, while surgical options are either not feasible, interventional pain management may offer an effective alternative. Tunneled Epidural Analgesia represents one such interventional technique that can be considered for refractory pain. This case report aims to evaluate the efficacy of tunneled epidural analgesia administration in managing intractable pain associated with advanced scrotal SCC.Materials and methods: This case report is structured according to the CARE (Case Report) guideline. The study was conducted at UGM Academic Hospital, where the patient received evaluation and treatment.Case: A 65-year-old male diagnosed with SCC presented experiencing refractory cancer pain. Despite receiving conventional analgesic therapy, he experienced no significant pain relief and developed adverse effects. Pain management was subsequently escalated to an interventional approach using a bupivacaine 0.125% and fentanyl 25 mcg administered via a tunneled epidural drug delivery system. This intervention resulted in effective pain control, enabling him to do daily activities. With this modality, the pain remained well managed, although occasional breakthrough pain occurred, which was successfully managed with 1% lidocaine as a rescue analgesic.Conclusion: Tunneled epidural analgesia using a combination of opioid and bupivacaine has demonstrated effectiveness in the management of refractory scrotal cancer pain.
Co-Authors Andreasta Meliala Ika Puspitasari Khonsa, Oni Mahmud Mahmud Nur Azza, Kamala Kan Tomo, Wahyu Kartiko Yunita Widyastuti