Eksplorasi Kebutuhan Perawatan Paliatif pada Pasien dengan Penyakit Stroke Menurut Perspektif Keluarga di Yogyakarta

Raditya Bagus Septian, Dr. Heny Suseani Pangastuti, S.Kp., M.Kes; Dr. Wenny Artanty Nisman, S.Kep., Ns., M.Kes

2024 | Tesis | S2 Magister Keperawatan

Latar Belakang: Pasien stroke memiliki permasalahan yang beragam dan kompleks. Permasalahan ini memerlukan perawatan paliatif untuk mengoptimalkan kualitas hidup pasien. Identifikasi kebutuhan perawatan paliatif merupakan hal pertama yang perlu dilakukan dalam melakukan perawatan paliatif. Keterlambatan dalam mengidentifikasi dapat berdampak negatif terhadap kualitas hidup pasien dan perawatan tidak sesuai dengan kebutuhan pasien. 

Tujuan: Mengeksplorasi kebutuhan perawatan paliatif pada pasien dengan penyakit stroke menurut perspektif keluarga di Yogyakarta. 

Metode: Penelitian ini menggunakan metode kualitatif dengan pendekatan fenomenologi. Penelitian ini dilakukan pada bulan Oktober - November 2023. Terdapat 13 partisipan, yaitu 10 partisipan keluarga yang merawat pasien stroke di rumah dan 3 partisipan triangulasi. Partisipan diperoleh melalui teknik purposive sampling dari homecare RSUP Dr. Sardjito, Yogyakarta. Pengambilan data dilakukan dengan wawancara semi terstruktur dan observasi tak terstruktur hingga data jenuh. Transkrip wawancara selanjutnya dianalisis menggunakan metode colaizzi. Pelaporan penelitian ini didasarkan pada Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Hasil: Temuan penelitian mengidentifikasi tujuh tema kebutuhan perawatan paliatif pada pasien stroke. Pasien stroke memerlukan pemenuhan kebutuhan fisik meliputi fisioterapi, pengobatan non-agresif, perawatan luka, pencegahan dekubitus dan kenyamanan fisik. Kebutuhan psikologis berupa emotional support dari keluarga, konseling melalui perantara keluarga. Kebutuhan sosial meliputi strategi komunikasi khusus, companionship support dan terapi wicara. Kebutuhan kognitif untuk mengatasi demensia melalui terapi farmakologis dan melibatkan pasien dalam perawatan. Pasien juga memerlukan kebutuhan spiritual, kebutuhan perawatan end of life, dan kebutuhan layanan homecare.

Kesimpulan: Pasien stroke memiliki kebutuhan perawatan paliatif yang harus dipenuhi. Kebutuhan paliatif meliputi kebutuhan fisik, psikologis, sosial, kognitif, spiritual, perawatan end of life dan layanan homecare menjadi aspek yang diidentifikasi dari keluarga yang merawat. Tindak lanjut penelitian ini adalah perlunya tenaga kesehatan memberikan perawatan paliatif pada pasien stroke sesuai dengan kebutuhannya. 

Background: Stroke patients have diverse and complex problems. Complex problems in stroke patients require palliative care to optimize the patient's quality of life. Identifying palliative care needs is the first thing that needs to be done in carrying out palliative care. Delays in identification can have a negative impact on the patient's quality of life and treatment that is not appropriate to the patient's needs.

Objective: To explore the need of palliative care in patients with stroke according family perspective in Yogyakarta.

Method: This research qualitative design with a phenomenological approach. This research was conducted in October - November 2023. There were 13 participants, 10 family participants who cared for stroke patients at home and 3 triangulation participants. Participants were obtained through a purposive sampling technique from homecare of RSUP Dr. Sardjito, Yogyakarta. Data collection was carried out using semi-structured interviews and unstructured observations until the data was saturated. The interview transcript then analized using Colaizzi method. Reporting of this research is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Results: Research findings identified seven themes of palliative care needs in stroke patients. Stroke patients require provision of physical needs including physiotherapy, non-aggressive treatment, wound care, pressure ulcer prevention and physical comfort. Psychological needs in the form of emotional support from the family, counseling through family intermediaries. Social needs include special communication strategies, companionship support and speech therapy. Cognitive needs to cope with demensia through pharmacological therapy and involving the patient in care. Patients also need spiritual needs, end-of-life care needs, and homecare service needs.

Conclusion: Stroke patients have palliative care needs that must be meet. Palliative needs include physical, psychological, social, cognitive, spiritual needs, end-of-life care and homecare services are aspects identified by the family caregiver. follow-up to this research is the need to provide palliative care to stroke patients according to their needs.

Kata Kunci : Kebutuhan, Keluarga, Pasien Stroke, Perawatan Paliatif