Efektivitas Pemberian Pendidikan Kesehatan Terstruktur tentang Penggunaan Teknik Non Farmakologi untuk Mengurangi Nyeri Kanker

Abstract

Background: Pain is the most common symptoms suffered by cancer patients that can affect their daily activity and quality of life. Non pharmacological intervention to decrease pain often ignored.
Objective: To determine the effectivity of structured health education of non pharmacological intervention to decrease cancer pain.
Method: This is a quasi experimental research. The inclusion criteria were cancer patients who were more than 18 years old, suffered cancer pain (from 1-10 scale), and were on stage I-IV of cancer. Sixty eight subjects were recruited (34 for intervention group and 34 for control group). The booklet contains about how to treat non-pharmacology pain and management in the form of warm compress, cold compress, and relaxation techniques. Control group only use diary pain while usual care were provided for control group. Daily pain diary was filled by research subjects for three days. Brief Pain Inventory was given for both of two groups. Paired t test was used to compare pain score and ADL disturbance before and after intervention.
Result: There were a significance decrease on both of pain score and daily activity disturbance before and after intervention in the intervention group (p= 0,000). There were not any significant different of pain score (p=0,762) and daily activity disturbance (p= 0,253) in control group. In addition, warm compress is the most nonpharmacological technique used by the intervention group.
Conclusion: Providing structured health education of non-pharmacological intervention technique such as warm and cold compress, and relaxation is effective in reducing pain and ADL disorders in cancer patient.

ABSTRAK

Latar belakang: Nyeri adalah salah satu keluhan yang sering dirasakan penderita kanker. Nyeri yang timbul terus-menerus dan tidak ditangani secara adekuat dapat mengganggu aktivitas sehari-hari pasien dan menurunkan kualitas hidup pasien. Penanganan nyeri secara non-farmakologi sering diabaikan.
Tujuan: Mengetahui efektivitas pemberian pendidikan kesehatan teknik non-farmakologi penanganan nyeri pada pasien kanker.
Metode: Desain penelitian quasi eksperimen. Kriteria inklusi pasien kanker dengan umur >18 tahun, mengalami nyeri skala 1 – 10, stadium I-IV. Kriteria eksklusi adalah pasien yang mengalami gangguan jiwa. Subjek penelitian 68 orang (34 kelompok kontrol dan 34 kelompok perlakuan). Kelompok perlakuan diberikan booklet cara penanganan nyeri non-farmakologi dan demonstrasi teknik non-farmakologi berupa kompres hangat, kompres dingin, dan teknik relaksasi. Kelompok kontrol mendapatkan perawatan standar. Responden mengisi daily pain diary selama 3 hari dan mengisi kuesioner Brief Pain Inventory (BPI). Analisis data menggunakan distribusi frekuesi dan uji t test berpasangan untuk membandingkan skala nyeri dan tingkat gangguan aktivitas sehari-hari akibat nyeri sebelum dan sesudah pemberian intervensi.
Hasil: Teknik non-farmakologi yang banyak digunakan oleh kelompok perlakuan adalah kompres hangat sebesar 56,67%. Terjadi penurunan rata-rata tingkat nyeri sebelum dan sesudah pemberian intervensi (p= 0,000) dan rata-rata tingkat gangguan ADL karena nyeri sebelum dan sesudah pemberian intervensi (p= 0,000). Tidak ada perbedaan tingkat nyeri (p=0,762) dan tingkat gangguan ADL (p= 0,253) pada kelompok kontrol.
Kesimpulan: Pemberian pendidikan kesehatan terstruktur tentang penggunaan teknik non-farmakologi seperti kompres hangat, dingin dan relaksasi efektif dalam menurunkan nyeri dan gangguan ADL pada pasien kanker.