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Gambaran derajat stres pada pasien tumor payudara Musani, Melda Ayu Amanda; Jaya, Muhammad Alim; Swarga, Tirta; Gani, Aziz Beru; Karsa, Nevi Sulvita
Holistik Jurnal Kesehatan Vol. 19 No. 10 (2025): Volume 19 Nomor 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i10.1834

Abstract

 Background: The diagnosis and treatment of breast cancer pose significant psychological challenges, often leading to stress that can negatively impact patients' quality of life and recovery. Purpose: To determine the level of stress in breast cancer patients. Method: This study used a descriptive design with a cross-sectional approach and a sample of 70 respondents. Data collection used the Depression Anxiety Stress Scale-42 (DASS-42) stress measurement instrument. The collected data were processed and analyzed univariately using Microsoft Excel to display the frequency distribution and percentage of each stress category. Results: The majority of respondents (89%) experienced stress, with severe stress being the highest (36%), followed by moderate stress (24%). The largest proportion of respondents were in the 41–50 age group (23%), and the most common type of tumor was right breast cancer (31%). High levels of stress are related to the psychological impact of the diagnosis, changes in body image, and anxiety about treatment, which are often exacerbated by the multidimensional life burdens of middle adulthood. Conclusion: Breast tumor patients experience a high prevalence of stress, with severe stress being the most prevalent. Suggestion: Holistic patient management is needed, integrating psychosocial interventions and medical therapy to improve overall patient well-being.   Keywords: Breast Tumor;Right Breast Tumor; Stress Level.   Pendahuluan: Diagnosis dan pengobatan tumor payudara menimbulkan tantangan psikologis yang signifikan, seringkali menyebabkan stres yang dapat berdampak negatif terhadap kualitas hidup dan proses pemulihan pasien. Tujuan: Untuk mengetahui gambaran derajat stres pada pasien tumor payudara. Metode: Penelitian ini menggunakan desain deskriptif dengan pendekatan cross-sectional dan sampel yang digunakan sejumlah 70 responden. Pengumpulan data menggunakan instrumen pengukuran stres Depression Anxiety Stress Scale-42 (DASS-42). Data yang terkumpul diolah dan dianalisis secara univariat menggunakan microsoft excel untuk menampilkan distribusi frekuensi dan persentase setiap kategori stres. Hasil: Menunjukkan bahwa sebagian besar responden (89%) mengalami stres, dengan kategori stres berat sebagai yang tertinggi (36%), diikuti stres sedang (24%). Proporsi terbesar responden berada pada kelompok usia 41–50 tahun (23%), dan jenis tumor yang paling sering ditemukan adalah Tumor Mamma Dextra (31%). Tingginya tingkat stres berkaitan dengan dampak psikologis dari diagnosis, perubahan citra tubuh, serta kecemasan terhadap pengobatan yang sering diperburuk oleh beban kehidupan multidimensi pada masa dewasa madya. Simpulan: Pasien tumor payudara mengalami prevalensi stres yang tinggi dengan kategori stres berat sebagai yang paling dominan. Saran: Diperlukan manajemen pasien secara holistik dengan mengintegrasikan intervensi psikososial dan terapi medis untuk meningkatkan kesejahteraan pasien secara menyeluruh.   Kata Kunci: Derajat Stres; Tumor Mamma Dextra; Tumor Payudara.
EFFECT OF EPIDURAL AND GENERAL ANESTHESIA ON PERIOPERATIVE NEUTROPHIL LYMPHOCYTE RATIO CHANGES IN MASTECTOMY PATIENTS Damayanti, Fina; Harahap, Muhammad Wirawan; Karim, Abdul Mubdi Ardiansar Arifuddin; Sommeng, Faisal; Swarga, Tirta
International Journal of Health Science & Medical Research Vol 5, No 1 (2026): February 2026
Publisher : UNG

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37905/ijhsmr.v5i1.36603

Abstract

Mastectomy induces a systemic inflammatory response that may be influenced by the anesthetic technique, as reflected by changes in the neutrophil–lymphocyte ratio (NLR). Unlike previous studies that assessed mixed breast surgeries, broadly evaluated regional anesthesia, or focused on combined general–epidural techniques and cytokine markers, this study uniquely compares perioperative pre–post changes in NLR (ΔNLR) between epidural anesthesia alone and general anesthesia alone in mastectomy patients using a routinely available biomarker. This quantitative experimental study was conducted at Ibnu Sina YW-UMI Hospital, Makassar, from August 2025, involving 30 mastectomy patients recruited consecutively and allocated into two independent groups (15 epidural, 15 general anesthesia). Venous blood samples were collected preoperatively and 24 hours postoperatively to calculate NLR, with ΔNLR as the primary outcome. Within-group analysis using the Wilcoxon test showed significant postoperative increases in NLR in both the epidural group (5.13 ± 5.42 to 7.65 ± 5.99; p0.001) and the general anesthesia group (4.12 ± 4.59 to 14.72 ± 8.43; p0.001). Between-group comparison using the Mann–Whitney test demonstrated that ΔNLR was significantly higher in the general anesthesia group (10.60 ± 7.23) than in the epidural group (2.52 ± 2.36; p0.001). These findings indicate that epidural anesthesia is associated with a smaller postoperative increase in NLR, suggesting better attenuation of the systemic inflammatory response after mastectomy. Further randomized studies with larger samples, additional inflammatory biomarkers, and clinical outcomes are recommended to enhance evidence strength and generalisability.