TUGAS RANGKUMAN INHS 4

(International Nursing and Health Sciences Conference 4)

NAMA : SEHAT DWI PRASAJA

NIM : 2311020358

ALIH JENJANG PROGRAM STUDI ILMU KEPERAWATAN S1

FAKULTAS ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH PURWOKERTO

2023
 SESSION I
The Role of Community Nurse in Palliative Care
By : Agus Setiawan
Faculity of Nursing Universitas Indonesia

1. INDONESIA
- Located in south-east Asia
- + 17.504 islands
- Total population : + 272 milion
- Population density : + 142 people/km2
- 300 etnic groups – 1.340 sub-ethnic
- 742 languages and dialect
2. Impact of Ageing population
- Increase in the dependency ratio
- Increased goverment spending on health care and pensions
- Those in work may have to pay higher taxes
- Shortage of workers
- Changing sectors within the economu, including in health industry
- Increased the need for long-term care services
The growing numbers ofolder people + increasing prevalence of chronic illness  increased
needs for palliative care
3. Palliative care :
a. It is care for patients with life-threatening illneses and their families
b. It can be given in homes, health centres, hospitals and hospices
c. It improve quality of life
d. It benefit health systems by reducin unnecessary hospital admissions
e. It relieves physical, psychosocial & spriritual suffering
f. It can be done by many types of health professionals & volunteers

Community-based palliative care (Olvera, et al. , 2023) :

a. Palliative care delivered outside of the hospital and outpatient clinics

b. These settings include the home, nursing homes, day programs, volunteer organizations,
and support groups
c. There is strong evidence that community-based palliative care can reduce hospital cost
and admissions at the end of life

Indonesia’s unique social as key to successful implementation of community and home based
palliative care (Eng, et al., 2023)

- Inceraseing burden of cancer (1.8 every 1.000 people), with the majority of cases (70%
from 240.000 incidence per year) found in the advanced stage.
 - It was estimated in 2018 that 662.262 Indonesian people are in need of palliative care
support.
- According where the need for palliative care is not met, patients with terminal and
incurable illnesses suffer total pain and burdensome costs.
- Also, in the terminal stage, patients would opt for home care for end of life management in
consideration of cos and family ties and thus the need for good home-based palliative care
in the community.

Community and palliative care in the context of cancer and palliative care, the tiered
neighborhood system and gotong royong mutual assistance serve as valuable tools for early
detection and ensuring continous care throughout the cancer journey.

4. Community Health Nursing

The syntesys of nursing and public health practice applied to promote and protect the health of
population. It combines all the basic elements of professional, clinical nursing with public
health and communiy practice.
Role of community nurses in the community (as care providers ) : health promotion, health
protection, early diagnosis and prompt treatment, tertiary prevention.

SESSION II
Learning Needs and Models on Palliative Care and End-of-Life Care of Nursing Students
By : Prof. Melvin D. Miranda, MAN, RN
National President, Philipine NursesAssosiated, Inc.
Dean, Manila Central University College of Nursing, Philippines

Benefits of Palliative care :

1. Physical : relieve pain, manage symptoms, mitigate discomfort
2. Psychosicial : provide emotional and mental support, fulfil goals and desires
3. Spiritual : emprovement, finding purpose and closure

ELDAC (End of Life Directions for Aged Care) Care Model Nursing from Australia :

Bereavement, advace care planning, recognise end of life, assess palliative care needs, provide
palliative care, workt together, respond to deterioration, manage dying.

End of care in General Practice :

1. Continuity of care
2. Patient and family factors
3. Medical management
4. Expertise and training

SESSION III

Getting Involved with Palliative Care Research

By : Emile M. Lopez, Ed.D., MAN, RN

Assistant Professor, Departement of Nursing Colage of Health and Welfare Woosong University,
Daejoen City

Roles in Palliative Care Research (PCR) Participation/Involvement

In what capacity can we contribute to thi merging and growing field :

1. As a palliative care provider (PCP)

2. Primary researcher (co-researcher or RA)
3. As amember of the intitutional review board (IRB)
4. Presenter of PCR
5. Producer og PCR (Journal Publication of PCR)
6. Educators/ Health promton/Illness Prevention Advocate (address NCDs)

Palliative care related studies use of “OPQRSTU” in PCR

Opinions, perceptions, quality of life care, related lerarning experiences, strories to tell adn share,
topics, undertanding of life’s challenges.

SESSION IV

Mental Health, Wellbeing and Support Needs in Palliative and End of Life Care

By : Assoc.Prof. Dr. Samsiah Mat

Dean Faculty of Nursing, UCMI

Mental health and palliative care : depression and anxiety are common in all patiens with serious
illness, lack of attention may lead to ongoing dysphoria ( a disordr of affect characterized by
depression and anguish), depression affects around 20% of patients who have a chronic physical
health problem.

Symptoms indicating depressive disorder the medically ill : depresed or sad mood, lack of
pleasure, hopeless, fatigue, diminished ability to think and make decisions.
End of life care is the care and service given to people and their families who are facing the end
of their life. Is an important part of palliative care to help patient, if he has a life limiting or life
theatening illness.

The 4 key components of palliative care :

1. Recognising symptoms
2. Identifying patient goals
3. Understanding the many patient
4. Assisting with advanced care directives to help people formulate

Palliative care vs end of life vs hospice care :

Improving life quality through treatment and symptom management of a life-limiting illness –
illness is no longer responding to the treatment, < 6 months to live, comprehensive comfort care
will be provided – one of the models for end-of-life care, days to hours to live, emotional and
spiritual support will be prioritised.

SESSION V

Insomnia Mnagement Following Breast Cancer Survivors

By : Fairul Hasan, RN, MSN, Ph.D

Faculty of Nursing Chulalongkorn University Thailand

Definition of insomnia : the presence of an individual’s report of dificulty with sleep, trouble
falling asleep, trouble remaining asleep through the night, waking up too early, unrefreshing
sleep.

Cause of insomnia breast cancer : physical discomfort and pain, emotional distress and anxiety,
medications distress.

Treatment of insomnia : pharmacological treatment (drug toxicity with cancer therapeutics), non-
pharmacological treatment (Cognitive Behavioral therapy for insomnia (CBTI) and BBTI (Brief),
physical activity susch as exercise.

Component of CBTI : stimulus control, sleep restriction, cognitive therapy, sleep hygine.

Component of BBTI : stimulus control, sleep restriction, sleep hygine.

Endurance training combined with resistance training is effective in improving sleep sleep quality
in adult breast cancer survivors.
 SESSION VI

Improving Care and Support Needs of End-of-Life Care and Palliative Care

By : Ns. Susana Widyaningsih, S.Kep., MNS

Faculty of Nursing Universitas Muhammadiyah Purwokerto

What makes talk to patients and their family about death and dying difficult :

1. sometime it’s difficult to determine if it’s the right time and place to discuss.
2. Lack of communication skills
3. Fear of causing distress to the patient/ the family
4. Fear of being blamed

Physical manifestation at the End-of-Life : metabolism decreases, body gradually slows down
until all funtions stop, when someone is dying, their heartbeat and blood circulation slow down,
the brain and organs receive less oxigen than they need and so work less well, in the days before
death, people often begin to lose control of their breathing, its common for people to be very
calm in the hours before they die.

Treatments : pain relief, managing breathelessness, managing nausea vomiting, managing

anxiety, treating noisy breathing, keep patiens hydrated, taking the right medicine.

Other aspects of Well-being : psychological, emotional, spiritul, social

Challenges in Palliative care in Indonesia : goverment policy, lack of palliative care education,
healthcare professionals sklills.