EKSPLORASI PENGALAMAN PERAWAT MANAJER DALAM MENDUKUNG BREAKING BAD NEWS (BBN) PADA PASIEN KANKER DI RS YAKKUM DI KOTA YOGYAKARTA
Yogi Januriswanti, Martina Sinta Kristanti, S.Kep., Ns. M.N., Ph.D.
2025 | Tesis | S2 Magister Keperawatan
Latar Belakang : Breaking bad news (BBN) merupakan penyampaian informasi negatif mengenai kondisi pasien yang secara serius mempengaruhi pandangan seseorang terhadap masa depannya termasuk pada pasien kanker. Fasilitator yang berperan dalam komunikasi pasien dengan perhatian khusus dirumah sakit adalah perawat manajer.
Tujuan: Untuk mengeksplorasi pengalaman perawat manajer dalam mendukung BBN kepada keluarga pasien kanker di ruang rawat inap di duda rumah sakit swasta di Kota Yogyakarta.
Metode : Penelitian ini menggunakan penelitian kualitatif dengan pendekatan fenomenologi. Metode pengambilan data dengan wawancara mendalam, observasi/shadowing dengan menggunakan protocol SPIKES dan focus group disscussion. Partisipan terdiri dari 9 perawat manajer. Analisis data menggunakan analisis Colaizzi.
Hasil : Penelitian ini menemukan 4 tema yaitu fase aktif pelaksanaan BBN, variasi perasaan dalam mendampingi BBN, dinamika hambatan BBN, harapan peningkatan kualitas BBN. Fase aktif BBN meliputi persiapan sebelum BBN, metode BBN, esensi BBN, proses komunikasi selama BBN. Tema variasi perasaaan saat mendampingi BBN meliputi kategori fokus perhatian, keterlibatan emosi perawat manajer selama BBN serta reward internal dan eksternal. Dinamika hambatan berasal dari personal perawat manajer, interprofesi, institusi serta dari keluarga pasien. Harapan peningkatan kualitas BBN didukung dengan kebutuhan personal perawat manajer dan juga dukungan dari institusi.
Kesimpulan : Peran perawat manajer dalam mendukung BBN sangat kompleks sehingga memerlukan ketrampilan komunikasi yang efektif, dukungan dari tim kesehatan serta institusi. Perlu adanya pengembangan pelatihan dan kebijakan dalam manajemen keperawatan terkait komunikasi BBN.
Background: Breaking bad news (BBN) refers to the delivery of negative information regarding a patient's condition that seriously affects a person's outlook on their future, including for cancer patients. The facilitator who plays a key role in patient communication with special attention in the hospital setting is the nurse manager.
Research Objective: To explore the experiences of nurse managers in supporting BBN to the families of cancer patients in inpatient wards at a private hospital in Yogyakarta.
Methods: This research employed a qualitative design with a phenomenological approach. Data were collected through in-depth interviews, observation/shadowing using the SPIKES protocol, and focus group discussions. The participants consisted of nine nurse managers. Data were analyzed using Colaizzi’s method.
Results: The study identified four themes: the active phase of BBN implementation, emotional variations during BBN support, the dynamics of BBN barriers, and expectations for improving BBN quality. The active phase included preparation before BBN, BBN methods, the essence of BBN, and communication processes during BBN. Emotional variations included categories such as focus of attention, emotional involvement of nurse managers during BBN, and both internal and external rewards. The dynamics of barriers originated from personal nurse manager factors, interprofessional relationships, institutional challenges, and family-related issues. Expectations for improving BBN quality were supported by the personal needs of nurse managers as well as institutional support.
Conclusion: The role of nurse managers in supporting BBN is highly complex, requiring effective communication skills, support from the healthcare team, and institutional backing. There is a need for the development of training and policies within nursing management related to BBN communication
Kata Kunci : perawat, breaking bad news, kanker, pasien, penelitian kualitatif
