fatigue dan treatment
TRANSCRIPT
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21 April 201521 April 2015
PELATIHAN MENINGKATKAN KEMAMPUAN PERAWAT DALAM
MELAKUKAN PENGKAJIAN DAN MEMBERIKAN TREATMENT
BERDASARKAN PENGKAJIAN ESASDI RS KANKER DHARMAIS JAKARTA
PELATIHAN MENINGKATKAN KEMAMPUAN PERAWAT DALAM
MELAKUKAN PENGKAJIAN DAN MEMBERIKAN TREATMENT
BERDASARKAN PENGKAJIAN ESASDI RS KANKER DHARMAIS JAKARTA
FATIGUE DAN TREATMENTTemplate !"r P"#erP"i$t
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%ati&'e(el')a$ '*+e(ti! , peraaa$ lela) ter(ait !a(t"r m'lti-ime$i *ai(e.ara !ii(, me$tal, -a$ em"i"$al -a$ memili(i e$er&i le*i) e-i(it'$t'( mela('(a$ )al/)al a$& *iaa -ila('(a$ ata' i$&i$ -ila('(a$NN, 20034American cancer society, 2012 E.ala$te 6 Ma$'l",200789
Cancer RelatedFatigue R%8 ata' fatigueter(ait (a$(er &e+ala a$&-ita$-ai -e$&a$ peraaa$ (elela)a$, (elema)a$, -a$ (e('ra$&a$e$er&i, -a$ *er*e-a -ari raa lela) *iaa a$& -ialami "le) i$-i:i-'a$& e)at -ima$a fatiguea$& -i alami ti-a( )ila$& -e$&a$ itira)atata' ti-'r H"!ma$, Ra$, M"ele, Pierre 6 M"rr"#, 200;89
Kel')a$ fatigue juga termasuk didalamnya seperti nyeri, depresi,gangguan tidur -a$ a$emia NN, 201189
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Pengkajian
S.ree$i$& !ati&'e
Pe$&(a+ia$ !".'
Pe$atala(a$aa$ !ati&'e
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Screening and Assessment Fatigue
Pe$&(a+ia$ !"(' melip'ti < (apa$ m'lai meraa(a$ !ati&'e
P apa a$& -ila('(a$ '$t'( me$&'ra$&i !ati&'e =
> mi$ta paie$ '$t'( me$-e(ripi(a$ !ati&'e -e$&a$ (ata/(ata e$-iri
R &e+ala lai$ elai$ !ati&'e
S -'rai !ati&'e, apa(a) ("$ta$ ata' a-a per'*a)a$ -ari #a(t'/#a(t'
T apa(a) a-a pe$&"*ata$ a$& -i+ala$i *er'*a) -a$ *erla#a$
U me$'r't a$-a apa a$& me$e*a*(a$ !ati&'e=
? apa t'+'a$ a$-a '$t'( &e+ala i$i=
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Ka+i !a(t"r ("$tri*'i !ati&'e a$& -apat
-iatai K"mpli(ai pe$&"*ata$ -emam, i$!e(i, a$emia
Per'*a)a$ *erat *a-a$@i$ta(e (al"ri e*erapa pe$'r'$a$ BB8 Keti-a(eim*a$&a$& .aira$ ele(tr"lit $atri'm, (ali'm, (ali'm, -a$
ma&$ei'm8
Pe$&"*ata$ "p"i-, a$ti)itami$, a$ti-eprea$, al.")"l@pe$&&'$aa$
"*at a-i(i
Ge+ala lai$ @e!e( ampi$& $eri, -eprei, .ema, &a$&&'a$ ti-'r Per'*a)a$ ti$&(at a(ti:ita pe$'r'$a$ a(ti:ita, pe$'r'$a$ p"la
lati)a$
K"$-ii a*$"rmal a$& me$ertai !ati&'e
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Kategori fatigue :
%ati&'e ri$&a$ 1/8
Ge+ala !ati&'e mi$imal, mamp' mela('(a$ a(ti:ita e)ari/)ari,pera#at$ -iri, pe(er+aa$ r'ma), *e(er+a, #a(t' l'a$&
%ati&'e e-a$& /C8
Ge+ala m'$.'l -a$ me$im*'l(a$ -itre e-a$& -a$ ti$&&i,pe$'r'$a$ a(ti:ita !ii( )aria$, *e*erapa (er'a(a$ !'$&i !ii(
%ati&'e *erat ;/108
%ati&'e -iraa(a$ aat a(ti:ita -aar )aria$, (e*'t')a$ ti-'r ata'itira)at me$i$&(at, &a$&&'a$ ADL *erat, "$et !ati&'e ti*a/ti*a-a$ ata' $a!a pe$-e( aat itira)at, -eta( +a$t'$& .epat -a$ ata'(e)ila$&a$ -ara)
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Intervensi non farmakologi
A$+'r(a$ paie$ me$&at'r a(ti:ita !ii( e-a$& mi +ala$ .epat,
*erepe-a, *ere$a$&, lati)a$ ta)a$a$, elama -a$ etela) pera#ata$
(a$(er (e.'ali ("$trai$-i(ai ata' me$etap -e$&a$ lati)a$ elama 0 me$it
per)ari, -alam 5 )ari emi$&&&' e'ai t"lera$-i8
I$ter:e$i pi("l"&i A$tiipai p"la !ati&'e, Lati)a$ ("pi$&, Melati)
ma$a+eme$ -iri -a$ me$&atai !ati&'e R'+'( (e terapi BT
S'pp"rti:e eprei:e terapi me$-e$&ar(a$, me$+a#a* perta$aa$
paie$, mea(i$(a$ aat -i*'t')(a$
K"$'ltai $'trii
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Intervensi en!ega"an #an en#ukung
E-'(ai
K"$eli$&
D"r"$& paie$ '$t'( me$&&'$a(a$ *'('.atata$ ata' -iari
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Relaksasi untuk mengurangi
fatigue
S'at' *e$t'( te($i( a$& -i&'$a(a$ '$t'(
me$&'ra$&i (ete&a$&a$ pa-a "t"t9
Rela(ai mer'pa(a$ ala) at' *e$t'(
mind-body therapy
Relaxation breathing exercise
Me$i$&(at(a$ "(i&e$ai (e el'r')
t'*')
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Pe$elitia$ te$ta$& rela(ai per$a!aa$ Kim 6 Kim
ta)'$ 2005RBE pa-a paie$ le'(emia a$&
me$-apat(a$ tra$pla$tai )em"p"iti( '$t'( me$&'ra$&i
!ati&'e
Haama 6 I$"'e 20128 me$ata(a$ *a)#a rela(ai
deep breathing -apat me$'r'$(a$ tension-anxiety -a$
fatigue pa-a paie$ &i$e("l"&i a$& me$+ala$i
(em"terapi
M'l)aeria) ta)'$ 2018, te$ta$& e!e(ti!ita RBE pa-a
fatigue paie$ (a$(er &i$e("l"&i a$& me$+ala$i
(em"terapi
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Rela$ation %reat"ing e$er!ise
Lati)a$ a#al
pre limi$areer.ie8Ber*ari$&la) -itempat ti-'r-alam p"ii tele$ta$&,("$e$trai(a$ per)atia$ pa-aper't *a&ia$ *a#a) -'raielama me$it9Tar') per&ela$&a$ (a(i (iripa-a l't't (a$a$ elama me$itTar') per&ela$&a$ (a(i (a$a$
pa-a l't't pa-a l't't (iri elama me$itTe('( (e-'a (a(i elama 2me$it
Rela(aiper$a!aa$
L'r'(a$ (a(i, (em'-ia$rela(ai -e$&a$ me$ari( $a!a-alam/-alam (em'-ia$me$&e)em*'(a$ e.araperla)a$/la)a$ melal'i m'l'telama 10 me$it9
Tera()ir !i$i)
eer.ie8Tetap *er*ari$& -alam (ea-aa$rile( -e$&a$ (a(i -il'r'(a$-e$&a$ pi(ira$ -a$ t'*') te$a$&elama 2 me$itUap #a+a) -a$ ram*'t e.araperla)a$/la)a$ -e$&a$ (e-'ata$&a$ la('(a$ elama 2 me$itGera((a$ per&ela$&a$ (a(i (iri-a$ (a(i (a$a$ -e$&a$ -'a ara)e.ara *er&a$tia$ elama 2 me$itRe&a$&(a$ (a(i -a$ -a$ ta$&a$(eata (em'-ia$&era((a$@&etar(a$ elama 2 me$itRe&a$&(a$ *a-a$ -i ata tempatti-'r elama -'a me$it9
Kim 6 Kim 20058, pr"e-'r RBE ait' ter-iri -ari ta)apa$ -alam -'rai
le*i) ('ra$& 0 me$it
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Gangguan Ti#ur
Ga$&&'a$ ti-'r a$& -ialami mer'pa(a$
per'*a)a$ a.t'al -alam itira)at ata'
ti-'r -a$ pa-a pa-a aat *a$&'$ ata'
-alam (e&iata$ ia$& )ari meraater&a$&&' -e$&a$ ti-a( terpe$')i$a +am
ti-'r
Ga$&&'a$ a$& pali$& 'm'm a-ala)i$"m$ia, &a$&&'a$ per$a!aa$ pa-a
aat ti-'r, &a$&&'a$ pa-a aat ti-'r
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Dalam maala) ti-'r ter-apat -'a
perta$aa$ '$t'( i-e$ti!i(ai &a$&&'a$ Apa(a) memp'$ai maala) -e$&a$ ti-'rm'
elama ti&a malam ata' le*i) etiapmi$&&'$a=
Ji(a a, apa(a) &a$&&'a$ ti-'r i$i
me$&a$&&' a(ti!ita e)ari/)ari= Ji(a+a#a*a$ a at' ata' (e-'a $a ma(a !".'
pa-a (e*'t')a$ pe$&(a+ia$9
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La$&(a) 1I-e$ti!i(ai (e*'t')a$ perl'$a e&era mer'+'( (e a)li ti-'r
(a+i ta$-a leep ap$ea (r"$i( $"ri$&, (era, tere-a( -a$ $a!a
tere$&a)/e$&a) elama ti-'r, peri"-e ap$ea leep elama ti-'r,
ti-'r a$& *erle*i)a$ etiap )ari, $eri (epala pa&i )ari, ti-a( *ia*er("$e$trai -a$ me$&alami maala) i$&ata$
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La$&(a) 2 !"(' (e*era-aa$&a$&&'a$ti-'r -a$*a$&'$
< (apa$ &a$&'a$ i$i m'lai -iraa(a$=
P a(ti:ita e*el'm ti-'r
> pe$&(a+ia$ F'alita ti-'r
R )al apa a$& mempe$&ar')i -ari )ari (e )ari
S *a&aima$a maala) ti-'r it' me$&a$&&' a$-a=
T apa(a) a$& (am' la('(a$ '$t'( me$&el"la maala) ti-'rm'=
U me$'r't a$-a apa a$& me$+a-i pe$e*a* maala) ti-'r =
I apa -amapa( pa-a r'ti$ita )aria$ -a$ ape( lai$ =
? apa a$& me$+a-i t'+'a$ '$t'( &e+ala eperti i$i=
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Ge+ala i$"m$ia ti-a( e&ar, 'lit ti-'r
0 me$it8, *a$&'$ le*i) a#al, *a$&'$
malam 0 me$it8 ata' le*i) -ari malam
per mi$&&'4 -itre ata' ti-a( m"- '$t'(ti-'r, me$'r'$$a ("$e$trai ata'
per)atia$ rep"$ a$& -i*eri(a$9
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Faktor resiko sesifik untuk
gangguan ti#ur #an %angun Ri#aat a$& *er)'*'$&a$ -e$&a$ maala) ti-'r, -eprei, a-a$a
maala) me$tal a$& lai$9
Stre ."$t") pe$&alama$ )i-'p, tat' pe$a(it, -ia&$"i,
(am*'), (ela$+'ta$ -ari pe$a(it a$& me$ertai m'-a) -iera$&88
A-a$a per'*a)a$ pe$&"*ata$ a$& *er)'*'$&a$ -e$&a$ -epreia$& me$e*a*(a$ i$"m$ia8 ata' "*at e-ati:e
Terapi m"-alita (a$(er ."$t") pe$&"*ata$ -e$&a$ (em"terapi,
a&e$ lai$ eperti ter"i- -apat me$&&a$&&' ti-'r8
Nilai !a(t"r/!a(t"r a$& *er("$tri*'i e'ai &'i-eli$e eperti $eri,
(elema))a$, -eprei8 Maala) ti-'r eri$& ter+a-i eperti *a&ia$ -ari (el"mp"( &e+ala
ti-'r, $eri -a$ (elema)a$9
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Klasifikasi gangguan ti#ur
Ga$&&'a$ ti-'r ri$&a$
Ga$&&'a$ ti-'r a$& ti-a( me$&&a$&&'
a(ti!ita )aria$, mamp' mela('(a$
ADLmela('(a$ a(ti!ita e'ai (ei$&i$a$
eperti t'&a )aria$, (er+a, (e)i-'pa$
".ial -a$ lai$a89
Pe$.e&a)a$ -a$ e-'(ai 'p"rti!
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Pe$.e&a)a$ -a$ i$ter:e$i e-'(ai pa-a
em'a paie$
Beri(a$ e-'(ai a$tiipai pa-a paie$ '$t'(memati(a$ per'*a)a$ lap"ra$ -alam
('alita ti-'r ata' maala) ti-'r
Nae)ati paie$ me$&&'$a(a$ *e*erapa
trate&i Ba$&'$ -alam #a(t' *eramaa$, Me$'$+'((a$ (e+elaa$#a(t', Tetap(a$ #a(t' 70 me$it *ata periapa$ ti-'r, Ketempat ti-'r
)a$a '$t'( ti-'r ta$pa )ira'(a$ +am 8 -a$ +a$&a$ )a*i(a$ #a(t'
'$t'( ti-'r, G'$a(a$ tempat ti-'r )a$a '$t'( ti-'r, Ji(a ti-a( ti-'r
-alam #a(t' 20/0 me$it *a$&'$ -a$ (em*ali (etempat ti-'r aat
me$&a$t'(, Pati(a$ )arapa$ ti-'r -e$&a$ (e$ataa$ (e*'t')a$ ti-'r5/10 +am8, Hi$-ari #a(t' a$& ti-a( perl' -itempat ti-'r e)aria$ ata'
)i$-ari ti-'r ia$& a$& eri$&9
Ti-'r ia$&
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%"ll"# 'p -a$ (a+i 'la$& '$t'( e:al'ai
("ri$& ESAS9
Ge+ala i$"m$ia eme$tara
I$"m$ia $-r"me
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Intervensi non farmakologi
Pe$.e&a)a$ -a$ pe$-i-i(a$ eperti .are pat)#a 1 e*a&ai
tam*a)a$ '$t'( i$ter:e$i $"$ !arma("l"&i
BT ()'' '$t'( i$"m$ia BT/I8 mer'pa(a$ i$ter:e$i pali$&
e!e(ti! '$t'( me$&atai maala) ti-'r *er-aar(a$ pe$elitia$
BT/I -apat me$&a#ali i$ter:e$i ma$-iri ata' "le) pelati) ()'',$am'$ $-r"me i$"m$ia pali$& *ai( -i(el"la "le) pi("l"&i ata'
peiali BT/I
I$ter:e$i lai$ eperti lati)a$ +'&a -apat mem*a$t' pa-a i$"m$ia
eme$tara
Pe$&"*ata$ a$& lai$ -i*eri(a$ eperti $eri, (elema)a$ ata'-eprei9
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Intervensi farmakologi
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Intervensi nonfarmakologi
Rela(ai Pr"&rei:e M'.le Relaati"$ -i(e$al(a$ "le) E-m'$-
Ja."*e$ i$ 1727
J'r$al E!!e.t "! relaati"$ trai$i$& "$ leep F'alit a$- !ati&'e i$
patie$t #it) *reat .a$.er '$-er&"i$& a-+':a$t .)em"t)erap9
Progressive muscle relaxationPMR8 a-ala) terapi rela(ai-e$&a$ &era(a$ me$&e$.a$&(a$ -a$ melema(a$ "t"t "t"t pa-a
at' *a&ia$ t'*') pa-a at' #a(t' '$t'( mem*eri(a$ peraaa$
rela(ai e.ara !ii(
Rela(ai -ari 1 (el"mp"( "t"t "t"t ta$&a$, "t"t/"t"t ta$&a$
*a&ia$ *ela(a$&, "t"t/"t"t le$&a$ ata' *iep, "t"t/"t"t *a)', -a)i,"t"t mata , "t"t ra)a$&, "t"t e(itar m'l't, "t"t le)er *ela(a$& , "t"t
le)er *a&ia$ -epa$, "t"t p'$&&'$&, "t"t -a-a, "t"t per't, "t"t (a(i9
U$t'( )ail a$& ma(imal -ia$+'r(a$ '$t'( mela('(a$ PMR pa-a
+am a$& ama 2 (ali e)ari elama 25/0 me$it
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TERIMA KASIH