Hasil Pencarian  ::  Simpan CSV :: Kembali

"Kanker vulva merupakan kanker ginekologi yang kejadiannya relative sedikit. Pasien umumnya datang pada stadium lanjut, terapi radiasi pada stadium lanjut tidak memberi prognosis yang baik. Dua modalitas utama pengobatan kanker vulva yaitu terapi pembedahan dan terapi radiasi. Terapi radiasi dapat dilakukan pula pada stadium awal, tetapi terapi pembedahan dinilai mempunyai beberapa kelebihan, antara lain faktor efek samping pada ovarium/gangguan fungsi reproduksi, faktor higienis pasien dan kemudahan terapi bila terjadi residif. Berbagai variasi teknik pembedahan kanker vulva, antarannya adalah vulvektomi radikal dengan insisi kupu-kupu (VRIK), vulvektomi radikal dengan insisi terpisah (VRIP).Tujuan penelitian adalah melihat keuntungan pembedahan vulvektomi radikal dengan insisi terpisah dibandingkan dengan insisi kupu-kupu dalam hal lamanya pembedahan, penyembuhan luka, kejadian infeksi, lamanya perawatan. Penelitian ini merupakan uji klinik. Selama kurun waktu 1990-2000 terdapat 15 kasus kanker vulva yang dilakukan pembedahan, 14 kasus stadium II dan 14 kasus dengan histologi karsinoma sel skuamosa dan 1 kasus dengan adenokarsinoma. Lama pembedahan pada VRIP rata-rata 168 menit, lebih singkat dibandingkan VRIK yang mencapai rata-rata 275 menit. Kejadian infeksi pada kelompok VRIP 3 dari 11 kasus (27.27%) sedangkan pada kelompok VRIK seluruh kasus mengalami infeksi pada luka pembedahan. Kegagalan aproksimasi luka operasi 1 dari 12 kasus ( 9.99% ) sedangkan pada VRIK seluruh kasus mengalami kegagalan sehingga memerlukan pembedahan kosmetik. Lama perawatan pasca bedah kelompok VRIP 12.3 hari sedangkan VRIK 21.5 hari. Dengan demikian pembedahan VRIP lebih kecil komplikasinya dan lebih pendek lama pembedahan dan lebih pendek masa perawatan pasca bedah. (Med J Indones 2003; 12: 103-8)

---

Vulvar cancer is a gynecological cancer whose incidence rate is relatively low. Patients generally were admitted at advanced stage, and radiation therapy at advanced stage does not provide favorable prognosis. Two main modalities in the treatment of vulvar cancer are surgery and radiation therapy. However, radiation can be performed in early stage vulvar cancer but surgery is thought to have more benefits, such as in side effect on the ovary/ reproductive function disorder, patient's hygiene factor, and the ease in performing therapy if recurrence occurs. There are various techniques of vulvar cancer surgery, such as radical vulvectomy with butterfly incision (RVBI) and radical vulvectomy with separated incision (RVSI).

The objective of this study was to identify the benefits of radical vulvectomy with separated incision in comparison with radical vulvectomy with butterfly incision in terms of the length of surgery, wound recovery, infection incidence, length of hospital stay. This study was a clinical trial performed during the period of 1990-2000. Fifteen cases of vulvar cancer were found and underwent surgery. Fourteen cases were at stage II and 14 cases were histologically defined as squamous-cell carcinoma and 1 case was adenocarcinoma. The average length of surgery in RVSI was 168 minutes, this was shorter than that in VRBI which reached an average of 275 minutes. The incidence of infection in RVSI group was 3 of 11 cases (27.27%), while in RVBI group all cases had infection in surgical wound. Failure of surgical wound approximation was 1 of 12 cases (9.99%), while in RVBI all cases experienced the failure such that cosmetic surgery was required. Length of postoperative care in RVSI group was 12.3 days, while in RVBI 21.5 days. Thus, complications in VRBI were lower, and length of surgery and length of postoperative care were shorter. (Med J Indones 2003; 12: 103-8)"

"Designed for quick, easy reference in the office or clinic, Atlas of Vulvar Disease is a robust pictorial and textual guide to the diagnosis, treatment, and management of vulvar diseases. Written by Edward J. Wilkinson, MD, a professor of pathology and expert in gynecologic pathology, and I. Keith Stone, MD, a professor of obstetrics and gynecology, this atlas is a must-have resource for both clinicians and pathologists focused on women{u2019}s health. Organized by dermatologic findings, Atlas of Vulvar Disease presents a complete overview of diseases within each broader topic area. Each disorder includes a definition, general features, clinical presentation, microscopic features, differential diagnosis, clinical behavior and treatment, and progressive therapeutic options, to guide the diagnosis and treatment of various vulvar diseases."

"This book provides an exhaustive review of the current state of the art in the management of prostate cancer, from screening to treatment. A particular feature is the emphasis placed on the value of a multidisciplinary approach. The opening chapters address basic aspects including epidemiology, biology, and chemoprevention. The role of individual and mass screening is carefully appraised, and diagnosis, clinical work-up, and the role of active surveillance are discussed in detail. Subsequent chapters are devoted to each of the therapies that may be employed, including open and robotic laparoscopic radical prostatectomy, the various forms of radiation therapy, high-intensity focused ultrasound, cryotherapy, hormonal therapy, and targeted therapies and vaccination. Up-to-date data from clinical trials are included."

"Praktek Spesialis Keperawatan merupakan bagian penting dari pendidikan profesi dalam rangka mengaplikasikan peran perawat spesialis untuk meningkatkan kualitas pelayanan. Praktek spesialis keperawatan dilakukan dan dikembangkan berdasarkan ilmu dan teknologi. Kompetensi yang harus dicapai selama praktek residensi keperawatan medikal bedah adalah memberikan asuhan keperawatan dengan menggunakan teori model keperawatan, penerapan tindakan keperawatan berbasis bukti ilmiah (evidence based nursing practice) dan melakukan proyek inovasi. Peran sebagai pemberi asuhan keperawatan, residen melakukan asuhan keperawatan dengan menggunakan pendekatan teori Model Adaptasi Roy pada  30 pasien dengan gangguan sistem respirasi. Target kompetensi dalam hal penerapan tindakan keperawatan berbasis bukti ilmiah adalah penerapan terapi akupresur untuk mengurangi mual muntah pada pasien kanker paru yang menjalani kemoterapi.Hasil penerapan menunjukkan bahwa akupresur efektif mengurangi mual muntah pada pasien kanker paru yang menjalani kemoterapi. Peran selanjutnya sebagai innovator, proyek inovasi yang dilakukan berupa penggunaan mobile phone application untuk pengkajian dan manajemen keperawatan mandiri pada pasien kanker paru. Hasil penerapan menunjukkan bahwa mobile phone application bermanfaat bagi pasien dalam manajemen gejala secara mandiri.

---

Nursing Specialist Practice is an important part of professional education in order to apply the role of specialist nurses to improve service quality. Nursing specialist practice is carried out and developed based on science and technology. Competency that must be achieved during the residency practice of surgical medical nursing is to provide nursing care using the theory of nursing models, application of scientific evidence-based nursing practice, and do innovation projects. Role as a provider of nursing care, resident carries out nursing care using the Roy Adaptation Model theory approach in 30 patients with respiratory system disorders. The competency target in the application of scientific evidence-based nursing actions is the application of acupressure therapy to reduce nausea and vomiting in lung cancer patients undergoing chemotherapy.

The results of the application showed that acupressure effectively reduced nausea and vomiting on patients with lung cancer undergoing chemotherapy. The next role as an innovator, innovation projects carried out in the form of the use of mobile phone applications for the assessment and management of independent nursing on patients with lung cancer. The results of the application show that mobile phone applications are beneficial for patients in symptom management independently."

"Praktik keperawatan residensi peminatan sistem respirasi yang dilakukan di Rumah Sakit Persahabatan diharapkan dapat meningkatkan pelayanan keperawatan pada pasien dengan masalah gangguan pernapasan. Selama menjalani proses residensi, residen berperan sebagai clinical nurse specialist yang bertugas sebagai pemberi asuhan keperawatan langsung kepada pasien, konsultan keperawatan bagi staf keperawatan dan edukator bagi pasien, serta peneliti dalam meningkatkan mutu atau kualitas asuhan keperawatan melalui penerapan Evidence Based Nursing (EBN). Dalam memberikan asuhan keperawatan langsung kepada pasien, residen menerapkan teori keperawatan Calista Roy pada kasus kelolaan utama dengan diagnosa medis kanker paru T4N2M1b dan 30 kasus resume dengan masalah gangguan pernapasan. Pada kasus resume ini didapatkan diagnosa medis terbanyak adalah kanker paru, diagnosa keperawatan terbanyak pola napas tidak efektif dan bersihan jalan napas tidak efektif, dan intervensi keperawatan yang paling banyak adalah manajemen airway. Penerapan model adaptasi Roy menunjukkan peran perawat sebagai pemberi asuhan keperawatan dalam membantu individu, baik dalam kondisi sakit maupun pada proses penyembuhan dan peningkatan pemeliharaan kesehatan di setiap mode fisiologis, konsep diri, fungsi peran dan interdependen. Selama melakukan asuhan keperawatan, masalah keperawatan yang banyak muncul yaitu pada mode fisiologis berupa masalah gangguan oksigenasi. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan menggunakan pendekatan model adaptasi Roy bertujuan untuk membantu individu sedini mungkin beradaptasi terhadap stimulus baik stimulus internal maupun stimulus eksternal. Pada penerapan EBN residen melakukan penerapan progressive relaxation exercise untuk mengurangi gejala efek samping kemoterapi pada pasien kanker paru yang menjalani kemoterapi. Hasil penerapan EBN menunjukkan bahwa progressive relaxation exerciseberkontribusi dalam menurunkan gejala efek samping kemoterapi. Selain itu, residen bersama kelompok melakukan inovasi tentang perawatan pasien yang terpasang WSD yang mencakup pada skrinning awal, perawatan sebelum terpasang WSD, perawatan selama terpasang WSD, perawatan saat dan setelah pencabutan WSD. Tujuan dari inovasi ini untuk meningkatkan kemampuan dan pengetahuan perawat dalam perawatan pasien yang terpasang WSD dan hasil akhirnya berupa booklet perawatan pasien yang terpasang WSD sebagai panduan dalam memberikan perawatan kepada pasien yang terpasang WSD.

---

Residency nursing practice specializing in the respiratory system carried out at Persahabatan Hospital is expected can improve nursing care for patients with respiratory problems. During the residency process, residents act as clinical nurse specialists who provide direct nursing care to patients, nursing consultants for nursing staff and educators for patients, as well as researchers in improving the quality of nursing care through the application of Evidence Based Nursing (EBN). In providing direct nursing care to patients, residents apply Roy's adaptation model nursing theory to primary management cases with a medical diagnosis of T4N2M1b lung cancer and 30 resume cases with respiratory problems. In this resume case, the most common medical diagnosis was lung cancer, the most common nursing diagnosis was ineffective breathing patterns and airway clearance is ineffective, and the most common nursing intervention was airway management. The application of Roy's adaptation model shows the role of nurses as providers of nursing care in helping individuals, both in sick conditions and in the healing process and improving health maintenance in every physiological, self-concept, role and interdependent mode. During nursing care, nursing problems that often arise are in the physiological mode in the form of problems with oxygenation disorders. The results of the analysis of nursing residency practice showed that nursing care using the Roy adaptation model approach aims to help individuals adapt as early as possible to stimuli, both internal and external stimuli. In implementing EBN, residents apply progressive relaxation exercise to reduce the symptoms of side effects of chemotherapy in lung cancer patients undergoing chemotherapy. The results of applying EBN show that progressive relaxation exercise contributes to reducing the symptoms of chemotherapy side effects. Apart from that, the resident and the group innovated regarding the care of patients who had a WSD installed, which included initial screening, care before the WSD was installed, care while the WSD was installed, care during and after the WSD was removed. The aim of this innovation is to increase nurses' abilities and knowledge in caring for patients who have WSD installed and the final result is a patient care booklet with WSD installed as a guide in providing care to patients who inserted WSD."