Penanganan Umum

Asuhan Medis :
Berfokus pada mengurangi intensitas gejala penyakit

Asuhan Paliatif :
Berfokus pengurangan keparahan gejala
 APA TUJUAN PERAWATAN PASIEN CANCER

Meningkatkan kualitas hidup

The goal is to improve the quality of life for individuals
who are suffering from severe diseases.

Menyediakan bantuan untuk merawat

pasien
Palliative care offers a diverse array of assistance and
care to the patient.
Julianna Tambellini, Meredith Hennon
 Estimasi 7.2-7.5 juta meninggal per tahun di dunia
(It is generally estimated that roughly 7.2 to 7.5 million people worldwide die from
cancer each year)

 Lebih dari 70% pasien kanker meninggal di negara berkembang karena

tidak tersedia pelayanan pencegahan, diagnostic dan trimen
(More than 70% of all cancer deaths occur in developing countries, where resources
available for prevention, diagnosis and treatment of cancer are limited or nonexistent)

 Lebih dari 40% semua jenis kanker dapat dicegah

(More than 40% of all cancers can be prevented. Others can be detected early, treated
and cured. Even with late-stage cancer, the suffering of patients can be relieved with
good palliative care)
 PERAWATAN PASIEN KANKER

 Setiap orang mempunyai hak dirawat dan mati secara bermartabat

(Everyone has a right to be treated, and die, with dignity)
 Menghilangkan nyeri - fisik, emosional, spiritual dan sosial - adalah hak
asasi manusia
(The relief of pain - physical, emotional, spiritual and social - is a human right)
 Perawatan paliatif merupakan kebutuhan mendesak di seluruh dunia untuk
orang yang hidup dengan kanker stadium lanjut
(Palliative care is an urgent need worldwide for people living with advanced stages of cancer)
 Di negara-negara berkembang, di mana proporsi yang tinggi dari orang
dengan kanker didiagnosis ketika pengobatan tidak lagi efektif
(In developing countries, where a high proportion of people with cancer are diagnosed when treatment
is no longer effective)
Julianna Diseases
(Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Tambellini, Meredith
and Mental Hennon
Health)
 SIAPA YANG MEMBERI PERAWATAN

Team
Team
 Nurse
Doctors
 Nursing Assistant
Nurses
 Physician
social workers  Social Worker
massage therapists
 Dietitian
Pharmacists
 Chaplain
Nutritionists
 Physical/Occupational Therapist
(Tambellini, Hennon)
 Recreation Therapist
(Parrish, Stillman, Strumpf, 2012)
 Volunteers
Physicians
Nurses

Patient
Spiritual
Therapists and Counselors
Family

Home Health Social

Aides Workers
Pharmacists
 PENDEKATAN PERAWATAN

 Tidak ada satu pendekatan yang cocok untuk semua

("Not a “one size fits all approach” )
 Perawatan disesuaikan dengan kebutuhan khusus pasien
(Care is tailored to help the specific needs of the patient)
 Perawatan paliatif diberikan sesuai dengan gejala.
(Since palliative care is utilized to help with various diseases, the care provided must fit the
symptoms)

Image courtesy of uwhealth.org

 Dukungan Pelayanan Perawatan

1. Pain management
 Kenyamanan dan mengurangi stres pasien sangat penting
(Is vital for comfort and to reduce patients’ distress)

 Tenaga kesehatan yang professional dan keluarga dapat

berkolaborasi untuk mengidentifikasi sumber nyeri dan
menghilangkannya dengan menggunakan obat atau terapi
lain
(Health care professionals and families can collaborate to identify the sources of pain and
relieve them with drugs and other forms of therapy)
 Dukungan Pelayanan Perawatan

2. Symptom management
 Merawat gejala lain selain nyeri seperti mual,
kelemahan, masalah usus dan kandung kemih, masalah
kesehatan jiwa, kelelahan, dan kesulitan bernapas
(involves treating symptoms other than pain such as nausea, weakness, bowel and bladder
problems, mental confusion, fatigue, and difficulty breathing)
 Dukungan Pelayanan Perawatan

3. Emotional and spiritual support

 Penting bagi pasien dan keluarga dalam menghadapi
masalah emosional terhadap penyakit kritis.
(is important for both the patient and family in dealing with the emotional demands of
critical illness)
PERAWATAN YANG DISEDIAKAN UNTUK PASIEN

 Membantupasien mendapat kekuatan dan rasa damai

dalam menjalani kehidupan setiap hari
(Helps patients gain the strength and peace of mind to carry on with daily life)
 Membantu kemampuan pasien untuk mentolerir
tritmen medis
(Aid the ability to tolerate medical treatments)
 Membantu pasien untuk lebih memahami perawatan
yang mereka pilih
(Helps patients to better understand their choices for care)
 PERAWATAN YANG DISEDIAKAN UNTUK
KELUARGA

Membantu keluarga memahami pilihan

perawatan yang tersedia
(Helps families understand the choices available for care)
Meningkatkan kehidupan sehari-hari
pasien; mengurangi kekhawatiran dari
orang yang dicintai (ASKEP KELUARGA)
(Improves everyday life of patient; reducing the concern of
loved ones)
Memberi kesempatan system pendukung
yang berharga
(Allows for valuable support system)
Image courtesy of
 PENDEKATAN PERAWATAN

Tim perawatan paliatif memberikan berbagai bentuk asuhan

untuk menolong pasien menghadapi keparahan dari penyakitnya
(A palliative care team delivers many forms of help to a patient suffering from a severe illness)

Komunikasi yang intensif dengan tim

(Close communication with doctors/team)
Manajemen nyeri dan gejala yang lain
(Expert management of pain and other symptoms)
Membantu mengarahkan sistem kesehatan
(Help navigating the healthcare system)
Bimbingan dalam memilih tritmen yang sulit dan kompleks
(Guidance with difficult and complex treatment choices)
Dukungan emosional dan spiritual bagi pasien dan keluarga mereka
(Emotional and spiritual support for the patient and their family)
 GEJALA PADA AKHIR KEHIDUPAN
(Symptoms at End-of-Life)

 Pain
 Umum dan kompleks (Common, complex)
 Respiratory Symptoms
 Sesak, Batuk dan Bersin (Shortness of breath, coughing, wheezing)
 Gastrointestinal Symptoms
 Mual dan Konstipasi (Nausea, constipation)
 Psychological Symptoms
 Depresi, Delirium dan Ansietas (Depression, delirium, anxiety)
(Parrish, Stillman, Strumpf, 2012)
 PEMENUHAN KEBUTUHAN SPIRITUAL
(Addressing Spiritual Needs)

 Jangan tunggu sampai menit terakhir

(Don’t wait until the last minute!)
 Sediakan/berikan music atau cerita religi
(Offer religious music and/or icons)
 Rencanakan kunjungan pemuka agama
(Arrange visit from religious leader)

 Fasilitasi ibadah religi

 PERTIMBANGAN BUDAYA
(Cultural Considerations)

 Setiap orang mempunyai berbagai latar budaya

(Everyone has one or more cultures)
 Ras,Suku Bangsa, Religi, Kebiasaan Hidup berkontribusi
pada budaya (Race, ethnicity, religion, lifestyle contribute to culture)
 Budaya (Culture)

Dimanifestasikan melalui nilai-nilai, kebiasaan, perilaku dan
kepercayaan (Is manifested through values, customs, behaviors & beliefs)
 Mempengaruhi pengambilan keputusan dan pandangan
tentang mati dan proses kematian serta perawatan paliatif
(Affects decision-making and views re: death and dying and palliative care)
 PRESERVING PERSONHOOD AND DIGNITY

 Kebersihan dan kontrol bau (Cleanliness and odor control)

 Mandi dan Dandan (Bathing and grooming)

 Muka, Tangan dan Kaki (Face, hands, and feet)
 Kebersihan mulut dan perawatan kuku (Mouth
care, nail care)

 Clothing and bedding

 Promosikan suasana seperti di rumah (Promote
home-like environment)
 Pictures, bedding, personal items
 DIGNITY
FOR
CANCER PATIENT