Hubungan Dukungan Sosial dengan kKualitas Hidup Pasien Kanker Serviks

SITTI SUDRANI, Prof.Dr.dr.Heru Pradjatmo,M.Kes.,Sp.OG(K).Onk.; dr.Fatwa Sari Tetra Dewi,MPH,Ph.D

2019 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Kanker serviks merupakan kanker kedua terbanyak pada wanita di negara berkembang. Pasien kanker serviks pada umumnya mengalami penurunan kualitas hidup akibat gangguan fisik dan psikologis terkait kanker dan efek samping pengobatannya. Dukungan sosial diketahui dapat memperkuat kemampuan personal dan sosial pasien kanker serviks untuk mengatasi kesulitan psikologisnya, terutama selama proses adaptasi setelah didiagnosa kanker dan menjalani pengobatan. Tujuan: Menganalisis hubungan dukungan sosial dengan kualitas hidup pasien kanker serviks serta mendeskripsikan bentuk dukungan sosial yang dibutuhkan pasien kanker serviks. Metode: Penelitian ini menggunakan metode kombinasi sequential explanatory. Pada tahap pertama, 87 pasien kanker serviks diwawancara dengan kuesioner EQ-5D-3L dan MOS-SSS-6. Generalized linear model diterapkan untuk mengetahui hubungan dukungan sosial dan kualitas hidup setelah dikontrol dengan faktor sosiodemografi dan klinis. Pada tahap kedua, wawancara mendalam dilakukan pada 4 responden yang dipilih secara purposif dengan variasi stadium I,II,III dan IV. Data wawancara ditranskrip dan dianalisis dengan thematic content analysis. Hasil: Lebih dari separuh responden memiliki dukungan sosial dan kualitas hidup yang tinggi. Analisis bivariat menunjukkan dukungan sosial (PR (prevalensi rate) 1.48), status pekerjaan (PR 1.37), tingkat penghasilan rumah tangga (PR 1.58), memiliki 1 komorbiditas (PR 0.62) dan 2 komorbiditas (PR 0.23) secara signifikan berhubungan dengan kualitas hidup pasien kanker serviks. Analisis multivariat menunjukkan dukungan sosial meningkatkan 1,1 kali kualitas hidup pasien kanker serviks (p<0.01, CI 95% 1.03-1.15). Saran memanfaatkan pengobatan medis, petunjuk mengenai proses pengobatan dan efek samping, perhatian, empati, didengarkan, dihibur, diberi semangat, biaya, memberi pekerjaan, pendampingan, mengurus rumah tangga, dan nutrisi merupakan bentuk dukungan sosial yang dibutuhkan pasien kanker serviks. Kesimpulan: Dukungan sosial tidak berdampak besar pada peningkatan kualitas hidup tetapi dapat membantu pasien kanker serviks memperoleh pengobatan yang tepat, mengatasi kekhawatiran serta kesulitan setelah diagnosa dan pengobatan sehingga pasien mampu mencapai kualitas hidup yang lebih baik.

Background : Cervical cancer is the second most prevalent cancer on women in low middle income country. Cervical cancer survivor commonly has decrease in their quality of life, its result physical and psychological problem related cancer or side effect therapy. Social support can improved personal and social resources of cervical cancer survivor to managed their condition, especially during the process of adapting to a life crisis such as a cancer diagnosis or undergoing therapy, Objectives : Analyzed related social support and quality of life on cervical cancer survivor and explained forms of social support which needed. Methods : This study was mix-method sequential explanatory. First, 87 cervical cancer survivors were surveyed using EQ-5D-3L and MOS-SSS-6 questionnaire. Generalized linear model was performed to examine the relationship between social support and quality of life after controlling for clinical and sociodemographic factor. Second, in-depth interview were conducted to understand social support needed from 4 survivors purposively selected based variation stage I,II,III and IV. Interview data were transcribed and analyzed using thematic content analysis. Result : More than half respondent had high social support (56,3%), high utility (73,6%) and high EQ-5D-VAS (69%). Bivariate analysis showed that social support (prevalence rate (PR) 1.48), employment status (PR 1.37), household income (PR 1.58), had 1 comorbidity (PR 0.62) and had 2 comorbidity (PR 0.23) were related to quality of life on cervical cancer survivors. Multivariate analysis showed that social support increased 1.1 time the quality of life cervical cancer survivors. Advice medical therapy, directives processed therapy and side effect, concern, empathy, listening, entertaining, giving spirit, money, labor, accompanion, task household and nutrition were forms of social support needed on cervical cancer survivors. Conclusion : Social support does not have a major impact on improving the quality of life, but this support can help cervical cancer survivor to obtain proper therapy, to cope their fear and difficulties after diagnosed and undergoing therapy for improved the quality of life.

Kata Kunci : kanker serviks, kualitas hidup, dukungan sosial, cervical cancer, quality of life, social support