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"Kejadian berulang atau kekambuhan kanker payudara bukan hanya menyerang kembali fisik, namun juga kondisi psikis pasien kanker payudara. Serangkaian pemeriksaan untukmemprediksi kemungkinan kambuh kanker payudara sangat dibutuhkan untuk mencegah terjadinya kekambuhan kanker payudara. Pemeriksaan darah lengkap merupakan salah satu rangkaian peme iksaan awal pasien kanker payudara yang relatif murah dan mudah. Belum ada penelitian sebelumnya mengenai perhitungan inter rasio pada pemeriksaan darah lengkap untuk mendiagnosis penyakit kanker, khususnya kemungkinan kambuh kanker payudara. Hasil penelitian ini diharapkan dapat membantu tenaga medis dalam memprediksi kemungkinan pasien kambuh berdasarkan klasifikasi dari hasil perhitungan inter rasio pemeriksaan darah lengkap. Data dalam penelitian ini diambil dari rumah sakit XYZ di Jakarta dengan 47 pasien. Algoritma klasifikasi yang digunakan dalam penelitian ini yaitu Classification and Regression Tree (CART) untuk mengetahui variabel yang berpengaruh dalam klasifikasi pasien kambuh dan tidak kambuh. Pada penelitian ini digunakan teknik SMOTE untuk mengatasi permasalahan data tidak seimbang. Variabel inter rasio pemeriksaan darah lengkap antara rasio dari neutrofil terhadap limfosit dan rasio dari platelet terhadap sel darah putih, inter rasio pemeriksaan darahlengkap antara rasio dari limfosit terhadap monosit dan rasio dari limfosit terhadap sel darah putih, inter rasio pemeriksaan darah lengkap antara rasio dari hemoglobin terhadap platelet dan rasio dari platelet terhadap sel darah putih, inter rasio pemeriksaan darah lengkap antara rasio dari platelet terhadap limfosit dan rasio dari hemoglobin terhadap platelet merupakan variabel yang berpengaruh dalam mendiagnosis kekambuhan dengan tingkat akurasi 93.7%, sensitivity 100%, specificity 87.5% pada training data yang sudah seimbang dengan teknik SMOTE. Selanjutnya hasil klasifikasi tersebut dikuantifikasi menggunakan metode regresi logistik untuk mengetahui seberapa besar peran masingmasing variabel dalam memprediksi kekambuhan pasien.

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Repeated events or recurrences of breast cancer not only re-attack the condition of breast cancer patients physically, but also psychologically. Diagnostics checking to predict the relapse possibility of breast cancer patients is needed to prevent the recurrence of breast

cancer. Complete blood count are one of the diagnostic checking of early breast cancer patients that relatively cheap and easy. There has been no previous research on the calculation of inter-ratios for complete blood count to diagnose cancer, especially possibility relapse of breast cancer. The results of this study are expected to help medical personnel in predicting the relapse possibility of breast cancer patients based on the classification of

the results of the inter ratio calculation of complete blood count. The data in this study were taken from XYZ hospital in Jakarta with 47 patients. The classification algorithm used in this study is Classification and Regression Tree (CART) to determine the effect of the variables in the classification of relapse and non-relapse patients. In this study, the SMOTE technique was used in handling imbalanced data problems. Inter ratio of complete

blood tests between the ratio of neutrophils to lymphocytes and the ratio of platelets to white blood cells, inter ratio of complete blood tests between the ratio of lymphocytes to monocyte and the ratio of lymphocytes to white blood cells, inter ratio of complete

blood tests between the ratio of hemoglobin to platelet and the ratio of platelet to white blood cells, and inter ratio of complete blood tests between the ratio of platelet to lymphocytes and the ratio of hemoglobin to platelet are the variables that influence in diagnosing

recurrence with 93.7% accuracy rate, 100% sensitivity, and 87.5% specificity on training data that balanced using SMOTE technique. Furthermore, the results of the classification are quantified using the logistic regression method to determine how substantial the role

of each variable in predicting patients relapse."

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Kambuhnya kanker payudara bergantung pada stadium tumor awal, terapi yang dilakukan sebelumnya, dan tumor biologi. Pengukuran darah lengkap merupakan salah satu pemeriksaan laboratorium yang relatif murah, mudah dan efektif dalam mendiagnosis kanker. Analisis regresi kesulitan dalam membuat kesimpulan dari data yang mengandung sejumlah besar variabel penjelas yang saling berkorelasi. Profile regression mengadopsi sudut pandang yang lebih global, dimana kesimpulan didasarkan pada kelompok yang mewakili pola variabel penjelasnya. Pengelompokan dilakukan untuk menganalisis suatu data dengan melihat karakteristik tiap pengamatan pada data. Suatu data jika dibagi menjadi beberapa kelompok mengartikan data tersebut memiliki karakteristik pengamatan yang berbeda-beda. Analisis pada data yang heterogen bertujuan untuk mengidentifikasi subpopulasi yang homogen dan menentukan hubungan antar variabel dalam setiap subpopulasi. Finite Mixture Model (FMM) dengan pendekatan Bayesian digunakan untuk mengidentifikasi subpopulasi dari pasien kanker payudara berdasarkan pengukuran darah. Berdasarkan nilai Deviance Information Criterion (DIC) didapatkan bahwa subpopulasi yang terbentuk untuk data rasio pengukuran darah pasien kanker payudara adalah dua subpopulasi. Peluang pasien mengalami kekambuhan pada subpopulasi 1 sebesar 35% dan 72% pada subpopulasi 2. Sedangkan subpopulasi yang terbentuk untuk data inter-rasio pengukuran darah pasien kanker payudara yang terbentuk adalah dua subpopulasi. Peluang pasien mengalami kekambuhan pada subpopulasi 1 sebesar 9% dan 3% pada subpopulasi 2.

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Recurrence of breast cancer depends on the initial tumor stage, previous therapies, and biological tumors. A complete blood test is one of the relatively inexpensive, easy and effective laboratory tests in diagnosing cancer. Simple regression analysis has difficulties in drawing conclusions from data that contain large numbers of explanatory variables that are correlated.  Profile regression adopts a more global perspective, where conclusions are based on groups representing covariate patterns. Clustering method aims to analyze data by looking at the characteristics of each observation in the data. If the data is divided into groups, that means that the data has different observational characteristics. Analysis of heterogeneous data purposes to identify homogeneous subpopulations and determine the relationships between variables in each subpopulation. Finite Mixture Model (FMM) with Bayesian approach is used to identify subpopulations of breast cancer patients based on blood measurements. Based on the value of the Deviance Information Criterion (DIC), it was found that the number of subpopulations formed for the data of the ratio of blood measurements for breast cancer patients are two subpopulations.  The probability of patients experiencing recurrence in subpopulation 1 was 35% and 72% in subpopulation 2. Whereas the number of subpopulations formed for the data of the inter-ratio data of breast cancer patients formed are also two subpopulations.  The probability of patients experiencing recurrence in subpopulation 1 is 9% and 3% in subpopulation 2.

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"Angka kejadian kanker payudara di Indonesia dan di dunia masih tinggi begitu pula dengan angka kekambuhan kanker payudara pada pasien yang telah menjalani pengobatan, saat ini diperlukan prediktor yang dapat dijadikan dasar untuk memperkirakan apakah kanker payudara dapat kambuh kembali setelah ditata laksana. Oleh karena itu penelitian dilakukan untuk mengetahui hubungan inter-rasio NLR/PWBR terhadap rekurensi kanker payudara apakah dapat dijadikan prediktor rekurensi kanker payudara. Penelitian dilakukan menggunakan metode cohort retrospektif minimal 3 bulan sampai 7 tahun dengan melihat rekam medis pasien kanker payudara yang telah mendapatkan terapi untuk mengambil data hasil pemeriksaan darah tepi. Selanjutnya data dianalisis menggunakan uji Chi-Square dengan program SPSS. Dari 106 sampel yang memenuhi kriteria seleksi, ditemukan 53 pasien dengan NLR/PWBR rendah dengan 23 kejadian rekurensi dan dari 53 pasien dengan NLR/PWBR tinggi dengan 13 kejadian rekurensi (RR=1,77, CI 95% 1,0070 – 3,1083, p=0,065). Dari pasien dengan hormonal positif, ditemukan 21 kejadian rekurensi pada kelompok NLR/PWBR rendah, dan 9 kejadian rekurensi pada kelompok NLR/PWBR tinggi (RR=2,05, CI 95%=1,088 – 3,857, p=0,035).

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Incidence rates of breast cancer are still high in Indonesia and in the World. So as the rate of recurrence breast cancer in patients who have undergone treatment. Now needed predictor that can be used as a standard for estimating whether breast cancer can recur after treatment. This research was done to investigate the association between NLR/PWBR inter-ratio to breast cancer recurrence.This research was conducted using a retrospective cohort method by looking at the peripheral blood tests in medical records with minimal 3 months until maximal 7 years observation. The data were analyzed using the Chi Square test with the SPSS software. From 106 patients there were 53 patients with lower NLR/PWBR with 23 breast cancer reccurrence, and from 53 patient with higher NLR/PWBR with 13 breast cancer recurrence (RR=1,77, CI 95%=1,0070 – 3,1083, p=0,065). From patients with hormonal potive, there were 21 breast recurrence from lower NLR/PWBR, and 9 from higher NLR/PWBR (RR=2,05, CI 95%=1,088 – 3,857, p=0,035)."

"Latar Belakang: Sekitar 40% pasien kanker payudara pasca terapi mengalami rekurensi kanker payudara. Sementara itu, masih belum banyak penelitian mengenai faktor prognosis untuk memprediksi kemungkinan rekurensi pada kanker payudara.Tujuan: Mengetahui inter-rasio rasio limfosit-monosit (LMR) dan rasio limfosit-sel darah putih (LWR) sebagai prediktor rekurensi pada kanker payudara.Metode: Penelitian ini dilakukan secara cohort retrospektif dengan melihat rekam medis pasien dari RSCM dan RS MRCC Siloam Jakarta. Peneliti melihat riwayat pasien sejak selesai mendapat terapi dengan rekurensi yang diikuti minimal 3 bulan dan maksimal 7 tahun. Kemudian dilakukan analisis dengan menggunakan uji Chi-square dengan program SPSS for Mac.Hasil: Peneliti mengelompokkan pasien menjadi kelompok inter-rasio LMR/LWR rendah dan tinggi dengan cut-off berupa median senilai 19,67 103/L. Dari 106 sampel yang memenuhi kriteria, didapatkan 52 pasien kelompok rendah dan 54 pasien kelompok tinggi. Hasil yang didapatkan dari analisis kedua kelompok dengan status rekurensi adalah nilai p 0.001 dengan 26 pasien pada kelompok rendah dan 10 pasien pada kelompok tinggi mengalami rekurensi. RR yang didapat adalah 2,7 (95%CI: 3,45 – 5,029) pada inter-rasio LMR/LWR rendah.Kesimpulan: Terdapat hubungan antara inter-rasio LMR/LWR dengan kemungkinan rekurensi pada pasien kanker payudara pasca terapi dan dapat dijadikan salah satu prediktor, dengan kelompok inter-rasio LMR/LWR dibawah cut-off penelitian memiliki resiko lebih tinggi mengalami rekurensi kanker payudara.

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Background: About 40% cancer patients after they finished their first therapy having a recurrence. However, there isn’t many researches on prognostic factors to predict the possibility of recurrence in breast cancer.

Objective: This research was done to know inter-ratio of lymphocyte-monocyte ratio (LMR) and lymphocyte-white blood cells ratio (LWR) as the predictor for recurrence in breast cancer.

Methods: This study was conducted with cohort retrospective by looking at patient’s medical records at RSCM and MRCC Siloam Hospital Jakarta. Researcher followed patients record after their first therapy finished, and recurrence from 3 months until 7 years later. An analysis was conducted using the Chi-Square test with the SPSS for Mac program.

Results: The patients were grouped into patients with low and high LMR/LWR inter-ratio with median (19,67 103/L) as the cut-off. From 106 samples that met the criteria, there were 52 patients in low group and 54 patients in high group. The results obtained from the analysis between low and high LMR/LWR and patient’s recurrence status is p-value 0.001 which means significant, with 26 patients in low group and 10 patients in high group had recurrence. RR for low LMR/LWR inter-ratio is 2,7 (95% CI : 3,45-5,029) in association with breast cancer’s recurrence.

Conclusion: There is an association between LMR/LWR inter-ratio and the possibility of recurrence in post-treatment breast cancer patients and can be used as predictor. Patients with LMR/LWR inter-ratio under the study cut-off are at higher risk of getting recurrence."

"Doksorubisin merupakan salah satu terapi antikanker yang termasuk golongan antrasiklin, memiliki aktivitas klinis pada penyakit kanker payudara. Doksorubisin dapat menimbulkan efek kardiotoksik akibat pembentukan doksorubisinol selaku metabolit utamanya. Salah satu metode biosampling terbaru yaitu volumetric absorptive microsampling memiliki berbagai kelebihan yaitu pengambilan darah secara finger prick, tidak dipengaruhi oleh hematokrit, dan dapat disimpan dalam suhu ruang. Penelitian ini bertujuan untuk menganalisis doksorubisin dan mengetahui reaksi obat merugikan kemoterapi berbasis doksorubisin. Nilai multiple reaction monitoring (MRM) diatur pada m/z 544,22>396,9 untuk doksorubisin; m/z 546,22>398,9 untuk doksorubisinol; dan m/z 528,5>362,95 untuk daunorubisin. Nilai LLOQ yang diperoleh adalah 8 ng/mL untuk doksorubisin dan 3 ng/mL untuk doksorubisinol dengan linearitas 0,9904 untuk doksorubisin dan 0,9902 untuk doksorubisinol. Hasil analisis mendapatkan rentang kadar terukur untuk doksorubisin sebesar 9,47 – 87,84 ng/mL serta rentang kadar terukur untuk doksorubisinol sebesar 4,24 – 54,02 ng/mL. Dosis kumulatif doksorubisin pada pasien sebesar 47,93 – 346,09 mg/m2, hal ini menunjukkan bahwa risiko seluruh pasien terkena kardiomiopati di bawah angka kejadian 4%. Pasien yang mengalami penurunan fraksi ejeksi ventrikel kiri setelah kemoterapi doksorubisin terdiri dari penurunan fraksi ejeksi <10% dan ada 3 pasien yang mengalami penurunan fraksi ejeksi ventrikel kiri >10%. Alopesia merupakan reaksi obat merugikan subjektif yang paling banyak dirasakan pasien diikuti dengan mual dan muntah. Hasil uji hubungan menunjukkan adanya tidak signifikan antara kadar doksorubisin dan doksorubisinol terhadap reaksi obat merugikan pada pasien kanker payudara. Terdapat hubungan signifikan pada kadar doksorubisin terhadap dosis kumulatif dan waktu pengambilan sampel pasien.

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Doxorubicin is an anticancer therapy belonging to the anthracycline class, which has clinical activity in breast cancer. Doxorubicin can cause cardiotoxic effects due to the formation of doxorubicinol as its main metabolite. One of the newest biosampling methods, namely Volumetric Absorptive microsampling, has many advantages, namely blood collection by finger prick, not affected by hematocrit, and can be stored at room temperature. This study aims to analyze doxorubicin and determine the adverse drug reactions of doxorubicin-based chemotherapy. The multiple reaction monitoring (MRM) value is set at m/z 544.22> 396.9 for doxorubicin; m/z 546.22>398.9 for doxorubicinol; and m/z 528.5>362.95 for daunorubicin. The LLOQ values ​​obtained were 8 ng/mL for doxorubicin and 3 ng/mL for doxorubicinol with a linearity of 0.9904 for doxorubicin and 0.9902 for doxorubicinol. The results of the analysis showed that the measured concentration range for doxorubicin was 9.47 – 87.84 ng/mL and the measured concentration range for doxorubicin was 4.24 – 54.02 ng/mL. The cumulative dose of doxorubicin in patients was 47.93 – 346.09 mg/m2, this shows that the risk of all patient developing cardiomyopathy is below the incidence rate of 4%. Patients who experienced a decrease in left ventricular ejection fraction after doxorubicin chemotherapy consisted of a decrease in ejection fraction <10% and there were 3 patients who experienced a decrease in left ventricular ejection fraction >10%. Alopecia is the most common subjective adverse drug reaction experienced by patients, followed by nausea and vomiting. The results of the relationship test showed that there was no significant relationship between doxorubicin and doxorubicinol levels on adverse drug reactions in breast cancer patients. There is a significant relationship between doxorubicin levels and cumulative dose and patient sampling time.xv,"

"Karya Ilmiah akhir KIA merupakan laporan praktik residensi keperawatan medikal bedah yang terdiri dari pengelolaan kasus kanker dengan pendekatan teori peaceful end of life, penerapan evidence based nursing self-management untuk mengurangi konstipasi pada pasien kanker payudara akibat kemoterapi yang mendapatkan antiemetik 5-hydroxytryptamine serotonin; 5HT3 yaitu ondansentron dan melakukan proyek inovasi kelompok tentang manajemen edukasi multimedia pada pasien kanker tiroid yang akan menjalani terapi radioaktive iodine RAI 131. Konsep peaceful end of life memberikan gambaran pada perawat untuk memberikan asuhan keperawatan paliatif pada pasien kanker. Self-management dapat digunakan sebagai salah satu terapi non farmakologi untuk mengurangi konstipasi, bersifat mudah dilakukan, aman dan secara teknis praktis untuk mengurangi konstipasi pada pasien kanker payudara karena tidak dibutuhkan keterampilan atau pelatihan khusus untuk melakukannya. Manajemen edukasi multimedia dapat memfasilitasi media edukasi pada pasien yang menjalani perawatan isolasi RAI 131, meningkatkan pengetahuan dan keterampilan perawat dalam manajemen edukasi pada pasien yang menjalani perawatan isolasi RAI 131.

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The final paper is a report of residency medical surgical nursing practice consisting of the management of the cancer cases with the approach of the peaceful end of life theory, application of evidence based nursing self management to reduce constipation in breast cancer patients due to chemotherapy who received antiemetic 5 hydroxytryptamine Serotonin 5HT3 in this case ondansentron and undertaking a group innovation project on multimedia education management in patients with thyroid cancer undergoing radioodine iodine RAI therapy 131. The concept of peaceful end of life provide an overview for nurses to provide palliative nursing care in cancer patients. Self management can be used as one of the non pharmacological therapies to reduce constipation, it is easy to do, safe and technically practical to reduce constipation in breast cancer patients since it does not require special skills or training to do so. Multimedia education management is able facilitate educational media in patients undergoing RAI 131 isolation treatments, improving nurse knowledge and skills in educational management in patients undergoing RAI 131 isolation treatments."

"Kanker payudara merupakan salah satu tumor ganas pada jaringan payudara yang paling sering menyerang wanita dan menjadi salah satu penyakit serius di dunia yang mengancam jiwa. Insiden kanker payudara dilaporkan meningkat dari tahun ke tahun. Karya Ilmiah Akhir (KIA) ini adalah sebagai laporan praktik residensi keperawatan medikal bedah peminatan onkologi di RS Kanker Dharmais Jakarta yang berisi tentang: (1) penerapan teori Peaceful End of Life (PEOL) pada pasien kanker payudara, (2) intervensi menghirup aromaterapi jahe sebagai evidence based nursing untuk mengurangi mual muntah akibat kemoterapi pasien kanker payudara (3) proyek inovasi penggunaan Modified Early Warning Score (MEWS) sebagai alat deteksi awal terhadap perburukan kondisi pasien. Kesimpulan: bahwa teori Peaceful End Of Life tepat digunakan dalam perawatan paliatif pasien kanker. Intervensi menghirup aromaterapi jahe dapat digunakan sebagai salah satu alternatif pilihan manajemen mual muntah nonfarmakologi. Instrumen MEWS dapat diterapkan pada unit emergensi dan dapat membantu mengidentifikasi pasien dengan risiko perburukan kondisi yang membutuhkan peningkatan level perawatan seperti rawat inap atau masuk ICU.

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Breast cancer is a malignant tumor of the breast tissue that most often affects women and become one of serious diseases in the world and life-threatening. The incidence of breast cancer was reported increase year to year. This final paper clinical practice is a clinical report Medical Surgical nursing specialization in oncology at the Cancer Hospital Dharmais Jakarta which consist of : (1) the application of the theory of Peaceful End of Life (PEOL) in breast cancer patients, (2) intervention inhaling aromatherapy ginger as evidence based nursing to reduce nausea and vomiting due to chemotherapy in breast cancer patients (3) innovation projects implement the Modified Early Warning Score (MEWS) as a tools for early detection of the deterioration of the patient's condition. Conclusion: The theory of Peaceful End of Life is appropriate to use in the palliative care of cancer patients. Ginger aromatherapy can be used as an alternative nonpharmacological management of nausea and vomiting. MEWS instruments can be applied to the emergency unit and may help identify patients at risk to worsening condition require increased levels of care such as hospitalization or ICU. "

"[ABSTRAKKanker merupakan faktor penting dalam beban penyakit global saat ini.Kasus baru setiap tahun terus meningkat. Angka kasus kanker payudara di RumahSakit Kanker Dharmais masih menempati urutan pertama dari jenis kanker lain.Informasi mengenai kualitas hidup perempuan dengan kanker payudara menjadisangat penting mengingat masih tingginya angka kasus kanker payudara sertauntuk memberikan dukungan kepada pasien kanker payudara dalamkeberlangsungan hidup jangka panjang. Kualitas hidup pasien kanker payudaratak luput dari faktor karakteristik individu, faktor karakteristik klinis dan faktorlingkungan sosial. Penelitian ini menggunakan desain case series dengan 90sampel diambil secara consecutive sampling. Hasil penelitian menunjukkanbahwa usia, terapi yang sedang dijalani, paparan informasi serta dukungankeluarga berhubungan dengan kualitas hidup pasien kanker payudara. Saran untukRumah Sakit Kanker Dharmais agar lebih meningkatkan penyebaran informasitentang kanker payudara, bagi masyarakat meningkatkan dukungan keluargaterhadap pasien kanker payudara.

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ABSTRACTCancer is an important factor in the current global disease burden. New cases eachyear continues to increase. The numbers of breast cancer cases in the DharmaisHospital Cancer still ranks first than other types of cancer. Information on thequality of life of women with breast cancer becomes very important consideringthe high number of cases of breast cancer and to provide support to breast cancerpatients in the long-term survival. The quality of life of breast cancer patientslitely dependent the individual characteristic, clinical characteristics and socialenvironmental factors. This study used a case series design with 90 samplesemployed consecutive sampling. The results showed that age, the therapy beingundertaken, breast cancer exposure information as well as family support relatedto the quality of life of the breast cancer patients. Suggestions one made to theDharmais Cancer Hospital to further improve the dissemination of informationabout breast cancer, in the family to increase family support for breast cancerpatients.;Cancer is an important factor in the current global disease burden. New cases eachyear continues to increase. The numbers of breast cancer cases in the DharmaisHospital Cancer still ranks first than other types of cancer. Information on thequality of life of women with breast cancer becomes very important consideringthe high number of cases of breast cancer and to provide support to breast cancerpatients in the long-term survival. The quality of life of breast cancer patientslitely dependent the individual characteristic, clinical characteristics and socialenvironmental factors. This study used a case series design with 90 samplesemployed consecutive sampling. The results showed that age, the therapy beingundertaken, breast cancer exposure information as well as family support relatedto the quality of life of the breast cancer patients. Suggestions one made to theDharmais Cancer Hospital to further improve the dissemination of informationabout breast cancer, in the family to increase family support for breast cancerpatients.;Cancer is an important factor in the current global disease burden. New cases eachyear continues to increase. The numbers of breast cancer cases in the DharmaisHospital Cancer still ranks first than other types of cancer. Information on thequality of life of women with breast cancer becomes very important consideringthe high number of cases of breast cancer and to provide support to breast cancerpatients in the long-term survival. The quality of life of breast cancer patientslitely dependent the individual characteristic, clinical characteristics and socialenvironmental factors. This study used a case series design with 90 samplesemployed consecutive sampling. The results showed that age, the therapy beingundertaken, breast cancer exposure information as well as family support relatedto the quality of life of the breast cancer patients. Suggestions one made to theDharmais Cancer Hospital to further improve the dissemination of informationabout breast cancer, in the family to increase family support for breast cancerpatients.;Cancer is an important factor in the current global disease burden. New cases eachyear continues to increase. The numbers of breast cancer cases in the DharmaisHospital Cancer still ranks first than other types of cancer. Information on thequality of life of women with breast cancer becomes very important consideringthe high number of cases of breast cancer and to provide support to breast cancerpatients in the long-term survival. The quality of life of breast cancer patientslitely dependent the individual characteristic, clinical characteristics and socialenvironmental factors. This study used a case series design with 90 samplesemployed consecutive sampling. The results showed that age, the therapy beingundertaken, breast cancer exposure information as well as family support relatedto the quality of life of the breast cancer patients. Suggestions one made to theDharmais Cancer Hospital to further improve the dissemination of informationabout breast cancer, in the family to increase family support for breast cancerpatients., Cancer is an important factor in the current global disease burden. New cases eachyear continues to increase. The numbers of breast cancer cases in the DharmaisHospital Cancer still ranks first than other types of cancer. Information on thequality of life of women with breast cancer becomes very important consideringthe high number of cases of breast cancer and to provide support to breast cancerpatients in the long-term survival. The quality of life of breast cancer patientslitely dependent the individual characteristic, clinical characteristics and socialenvironmental factors. This study used a case series design with 90 samplesemployed consecutive sampling. The results showed that age, the therapy beingundertaken, breast cancer exposure information as well as family support relatedto the quality of life of the breast cancer patients. Suggestions one made to theDharmais Cancer Hospital to further improve the dissemination of informationabout breast cancer, in the family to increase family support for breast cancerpatients.]"

"Kejadian infeksi pasca pembedahan dan pasca kemoterapi pada pasien kanker payudara dapat memperpanjang lama rawat inap sehingga meningkatkan biaya kesehatan. Meningkatnya biaya pengeluaran kesehatan mendorong adanya evaluasi ekonomi. Analisis efektivitas-biaya (AEB) sebagai salah metode farmakoekonomi penting dilakukan untuk membandingkan antibiotik yang digunakan. Penelitian ini bertujuan untuk membandingkan total biaya penggunaan, efektivitas seftriakson generik A dan B, dan menentukan seftriakson yang lebih cost-effective untuk pasien kanker payudara di RS Kanker Dharmais tahun 2012. Desain penelitian ini adalah non eksperimental dengan studi perbandingan dan pengambilan data secara retrospektif menggunakan data sekunder dari rekam medis dan Sistem Informasi Rumah Sakit RS Kanker Dharmais. Pengambilan sampel dilakukan secara total sampling. Jumlah sampel sebanyak 16 pasien untuk seftriakson generik A dan 8 pasien untuk generik B.Efektivitas seftriakson pada indikasi pasca pembedahan untuk generik A sebesar 2,5 hari dan untuk generik B sebesar 1,0 hari, sedangkan pada indikasi pasca kemoterapi untuk generik sebesar 4,0 hari dan untuk generik B sebesar 9,5 hari. Total biaya penggunaan seftriakson pada indikasi pasca pembedahan untuk generik A sebesar Rp 4.384.448,00 dan untuk generik B sebesar Rp 3.397.952,00,sedangkan pada indikasi pasca kemoterapi untuk generik A sebesar Rp2.284.655,00 dan untuk generik B sebesar Rp 11.195.270,00. Berdasarkan AEB,pada indikasi pasca pembedahan diperoleh hasil seftriakson generik B lebih costeffective daripada generik A, sedangkan pada indikasi pasca kemoterapi diperoleh hasil seftriakson generik A lebih cost-effective daripada generik B.

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The incidence of post-surgery and post-chemotherapy infections in breast cancer patients prolonged the hospitalization days leading to the increase of health costs.The increasing health expenditure demanded the use of economic evaluation.Cost-effectiveness analysis (CEA) as one of pharmacoeconomics methods was important to compare the usage of antibiotics. The purposes of this research were to compare total cost and effectiveness of using generic ceftriaxone A and B, and to decide which ceftriaxone that was more cost-effective in breast cancer patients in Dharmais Cancer Hospital during 2012. Effectiveness was measured as ceftriaxone-using days, meanwhile cost was measured as total direct medical cost.

The research design was non experimental with comparative study and retrospective data were collected from medical records and hospital information systems of Dharmais Cancer Hospital. Samples were taken by using total sampling method. There were 6 patients using generic ceftriaxone A and 8 generic ceftriaxone B. Effectiveness of ceftriaxone for post-surgery indication in generic ceftriaxone A was 2,5 days and in generic B was 1,0 days, meanwhile for postchemotherapy indication in generic A was used 4,0 days and in generic B was 9,5 days.

Total direct medical cost of ceftriaxone for post-surgery indication in generic A and B, respectively Rp 4.384.448,00 and Rp 3.397.952,00, meanwhile for post-chemotherapy indication in generic A and B, respectively Rp 2.284.655,00 and Rp 11.195.270,00. According to CEA result, it could be concluded that generic ceftriaxone B was more cost-effective than A for postsurgery indication, meanwhile generic ceftriaxone A was more cost-effective than B for post-chemotherapy indication."

"Praktik residensi spesialis Keperawatan Medikal Bedah peminatan Onkologi berfokus pengaplikasian perawat dalam pemberi asuhan keperawatan, pendidik, dan peneliti. Peran sebagai pemberian asuhan keperawatan dilaksanakan dengan melakukan pengelolaan 30 pasien keganasan kanker dan satu kasus yang dijadikan kasus kelolaan pasien yang terdiagnosa kanker payudara metastase paru, hati dan tulang menggunakan pendekatan teori Peacefull End Of Life (PEOL). Pelaksanaan penerapan intervensi keparawatan berbasis bukti ilmiah merupakan perawat sebagai peneliti dalam bentuk ponerapan Progresif Muscle Relaxation (PMR) terhadap penurunan kecemasan dan nyeri pasca pembedahan abdomen. peran perawat sebagai pendidik dilaksanakan dalam bentuk implementasi penggunaan aplikasi J-Hati (jalan sehat berenergi) dengan memberikan latihan fisik walking exercise berbasis android kepada pasien kanker dengan masalah fatigue. Seluuruh rangkaian kegiatan praktek residensi ini mempunyai tujuan untuk meningkatkan kualitas dan profesionalitas keperawatan secara komprehensif.

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Medical Surgical Nursing specialist residency practice with a specialization in Oncology focuses on the application of nurses in nursing care providers, educators, and researchers. The role as the provision of nursing care is carried out by managing 30 patients with cancer malignancy and one case which is used as a managed case for a patient diagnosed with metastatic breast cancer of the lung, liver and bone using the theoretical approach by Peaceful End Of Life (PEOL). The implementation of the application of scientific evidence-based nursing interventions is a nurse as a researcher in the form of Progressive Muscle Relaxation (PMR) application to reduce anxiety and pain after abdominal surgery. The role of nurses as educators is carried out in the form of implementing the use of the J-Hati application (healthy energy walking) by providing physical training of Android-based walking exercise to cancer patients with fatigue problems. The entire series of residency practice activities has the goal of comprehensively improving the quality and professionalism of nursing."