THE EXPERIENCES OF NURSES IN CARING FOR CANCER PATIENTS WITH MALIGNANT WOUNDS: AN INTERPRETIVE DESCRIPTIVE STUDY

KUNIARTI RACHMAT, Dr Christantie Effendy.; Dr Melanie Greenwood

2020 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Merawat luka ganas, atau dikenal sebagai tumor ganas, menjadi tantangan tidak hanya untuk pasien dan keluarga, tetapi juga untuk perawat. Perspektif keperawatan Indonesia dalam merawat pasien kanker dengan luka ganas masih jarang dan memiliki kesenjangan pengetahuan. Tujuan: Penelitian ini bertujuan untuk mendeskripsikan dan menginterpretasikan pengalaman perawat Indonesia dalam merawat pasien kanker dengan luka ganas. Metode: Penelitian ini menggunakan pendekatan deskripsi interpretatif yang melibatkan 12 perawat yang dipilih menggunakan teknik purposive sampling dengan wawancara semi- terstruktur dan mendalam antara Januari 2019 dan Juli 2019. Data dianalisis secara tematis. Hasil: Empat tema utama muncul tentang merawat pasien kanker dengan luka ganas: (1) Merawat dalam segala keadaan berkaitan dengan upaya menyesuaikan diri dengan praktik perawatan luka, perasaan empati, dan pelajaran hidup yang didapat dari pengalaman; (2) Perawatan suportif sangat penting berkaitan tentang memotivasi kolega, pasien, dan keluarga; (3) Tantangan dalam merawat luka ganas ketika perawat mengungkapkan apa yang mereka hadapi selama merawat luka; dan (4) Menerima segala suka duka mengenai refleksi terhadap pengalaman menyenangkan maupun tidak menyenangkan.

Background: Caring for malignant wounds, also known as malignant fungating tumours, can be challenging not only for patients and family caregivers but also for nurses. The perspective on Indonesian nurses while caring for cancer patients with malignant wounds is sparse and has a knowledge gap. Objectives: This study aimed to describe and interpret the nurses experiences in caring for cancer patients with malignant wounds. Methods: This study used an interpretive description approach involving 12 nurses selected using purposive sampling technique with semi-structured, in-depth interviews between January 2019 and July 2019 in a general hospital in Indonesia. The data were analysed thematically. Findings: Nurses identified four themes: (1) Caring through thick and thin was achieved by striving to adapt wound care practice, providing empathetic care, and recognising lessons learned; (2) Supportive care is essential was about motivating colleagues, patients and family caregivers; (3) Challenges in treating malignant wounds of cancer patients when nurses reveal what they encountered during wound care; and (4) Take the bad with the good experiences was about the reflection on having the ups and downs. Conclusion: The four themes present the voices of nurses in caring for cancer patients with malignant wounds about the key lessons they have learned from the experiences, supportive care, challenges and clinical insight. The present study stressed that caring for cancer patients with malignant wounds is not only having knowledge and skill but also providing compassionate care as an essential aspect of caring. Specialised wound training is essential to provide effective wound management with adequate resources and policy. Future research examining the experience of patients and family caregivers will provide valuable insights within palliative nursing care in Indonesia.

Kata Kunci : Deskriptif interpretatif, luka ganas, pengalaman, perawat kanker, Cancer nurses, experiences, interpretive description, malignant wounds