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Background: Strong family bonds are part of the Indonesian culture. Family members of patients with cancer are intensively involved in caring, also in hospitals. This is considered "normal": a societal and religious obligation. The values underpinning this might influence families' perception of it., Aim: To explore and model experiences of family caregivers of patients with cancer in Indonesia in performing caregiving tasks., Design: A grounded theory approach was applied. The constant comparative method was used for data analysis and a paradigm scheme was employed for developing a theoretical model., Setting/participants: The study was conducted in three hospitals in Indonesia. The participants were family caregivers of patients with cancer., Results: A total of 24 family caregivers participated. "Belief in caregiving" appeared to be the core phenomenon. This reflects the caregivers' conviction that providing care is an important value, which becomes the will power and source of their strength. It is a combination of spiritual and religious, value and motivation to care, and is influenced by contextual factors. It influences actions: coping mechanisms, sharing tasks, and making sacrifices. Social support influences the process of the core phenomenon and the actions of the caregivers. Both positive and negative experiences were identified., Conclusion: We developed a model of family caregivers' experiences from a country where caregiving is deeply rooted in religion and culture. The model might also be useful in other cultural contexts. Our model shows that the spiritual domain, not only for the patient but also for the family caregivers, should be structurally addressed by professional caregivers.

Background: Palliative care in Indonesia is problematic because of cultural and socio-economic factors. Family in Indonesia is an integral part of caregiving process in inpatient and outpatient settings. However, most families are not adequately prepared to deliver basic care for their sick family member. This research is a pilot project aiming to evaluate how basic skills training (BST) given to family caregivers could enhance the quality of life (QoL) of palliative care cancer patients in Indonesia., Methods: The study is a prospective quantitative with pre and post-test design. Thirty family caregivers of cancer patients were trained in basic skills including showering, washing hair, assisting for fecal and urinary elimination and oral care, as well as feeding at bedside. Patients' QoL were measured at baseline and 4 weeks after training using EORTC QLQ C30. Hypothesis testing was done using related samples Wilcoxon Signed Rank. A paired t-test and one-way ANOVA were used to check in which subgroups was the intervention more significant., Results: The intervention showed a significant change in patients' global health status/QoL, emotional and social functioning, pain, fatigue, dyspnea, insomnia, appetite loss, constipation and financial hardship of the patients. Male patient's had a significant effect on global health status (qol) (p = 0.030); female patients had a significant effect on dyspnea (p = 0.050) and constipation (p = 0.038). Younger patients had a significant effect in global health status/QoL (p = 0.002). Patients between 45 and 54 years old had significant effect on financial issue (p = 0.039). Caregivers between 45 and 54 years old had significant effect on patients' dyspnea (p = 0.031)., Conclusions: Basic skills training for family caregivers provided some changes in some aspects of QoL of palliative cancer patients. The intervention showed promises in maintaining the QoL of cancer patients considering socio-economic and cultural challenges in the provision of palliative care in Indonesia.

Purpose: Quality indicators (QIs) for the organization of palliative care (PC) can contribute to quality improvement as they assess the key elements for adequate organization of care. They might differ between health care organization, cultures and economic resources. The aim of this study was face-validate an Indonesian set of QIs based on a European set, to compare the two sets of QIs and to test the applicability of Indonesian set., Methods: A modified two-round RAND Delphi process was conducted in Indonesia. Twenty-four health care professionals from different disciplines were invited as panellists to rate clarity and usefulness of 98 QIs. Next, a applicability pilot test took place in five hospitals., Results: A total of 21 panellists considered 76 QIs (78 %) face-valid and added two new ones. Of the QIs with the highest ratings, eight were evaluated by head nurses and two by reviewing 50 patient records. Each QI was met by at least two hospitals, and only one by all five. Regarding the two QIs on structured clinical record keeping, most medical records contained multidimensional aspects of care., Conclusions: We found that most QIs for the organization of PC developed for European countries were also considered face-valid for Indonesian hospitals. The top 10 QIs were applicable in Indonesia. This suggests that most of the organizational QIs are universal rather than country specific. The Indonesian set of QIs should be considered as a first step in developing, testing, and implementing a set of QIs for PC in Indonesia. We recommend validation in other Asian regions.

Background and Objectives: The proactive activities of professional organizations have significantly contributed to improving nurses' knowledge related-specialty in order to improve health care services quality offered by nurses. Since the palliative care improvement and development in Indonesia remain still in their infancy, and the organization of palliative care for Indonesian nurses has not been established yet, it is imperative to investigate the Indonesian nurses' viewpoints concerning the importance of establishing a palliative nursing organization in fostering palliative care services in Indonesia. This study aimed to identify what kind of palliative care related activities are carried out by Indonesian nurses and what are the perspectives of nurses regarding the importance of establishing palliative nursing organizations in Indonesia. Materials and Methods: A national study was conducted using an embedded mixed-methods design, for which the quantitative and qualitative data were collected and analyzed in the same time period from October - December 2020. Results: There were a total of 552 (92%) respondents who participated through WhatsApp, and Telegram platforms, and completed our online survey. There were four themes and nine sub themes found in this study: namely, services improvement (quality improvement, and literacy improvement sub themes), human resource development (knowledge development, individual nurse development, and professional development sub-themes), boarding and information source (boarding, and information source sub themes), and policy and legality (policy, and legality sub themes). Conclusion: While barriers exist, respondents confirmed the importance of establishing an Indonesian palliative nursing organization. Establishing a palliative nursing organization could be an important step in developing palliative care in Indonesia. [ABSTRACT FROM AUTHOR]

Although the concept of 'cancer-related problems' is complex, few studies compare nurses' and caregivers' perspectives on cancer-related problems, particularly in eastern cultures. The study aimed to identify the perceptions of patients and nurses concerning to what extent the problems of patients with cancer were assessed and addressed during hospitalization in Indonesia. A descriptive correlational study with cross-sectional comparisons was conducted in three major cities in Indonesia. With a convenience sample of 119 patients (response rate = 79.3%) with cancer and 147 nurses (response rate = 71%). The domains of validated Problems and Needs of Palliative Care – short version were used to measure the perceptions of the patients and nurses regarding the assessing and addressing of patients' problems. The patients stated that their physical and psychological problems were very often assessed (>84%) and addressed (>90%). Patients who reported difficulties spontaneously had a lower prevalence of problems than patients who reported problems to a professional, except for the psychological subscale (P-value 0.05). The open assessment reported that the problems exhibited lower frequency than structure assessment, while nurses addressed all sub-scale problems (P-value < 0.005). Patients' educational status, age, gender, and time of diagnosis had positive correlations with their perceptions of cancer-related problems, which they voluntarily stated. These findings indicate essential similarities and incongruities between patients with cancer and nurses perceive cancer-related problems. The results highlight the complex technical directions of cancer nursing care in Indonesia. [ABSTRACT FROM AUTHOR]

The provision of palliative care in the intensive care unit (ICU) is increasing. While some scholars have suggested the goals of palliative care to not be aligned with the ICU, some evidence show benefits of the integration. This review aimed to explore and synthesize research that identified barriers and facilitators in the provision of palliative care in the ICU. This review utilized Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines based on population, concept, and context. We searched for eligible studies in five electronic databases (Scopus, PubMed, ProQuest, Science Direct, and Sage) and included studies on the provision of palliative care (concept) in the ICU (context) that were published in English between 2005-2021. We describe the provision of palliative care in terms of barriers and facilitators. We also describe the study design and context. A total of 14 papers was included. Several barriers and facilitators in providing palliative care in the ICU were identified and include lack of capabilities, family boundaries, practical issues, cultural differences. Facilitators of the provision of palliative care in an ICU include greater experience and supportive behaviors, i.e., collaborations between health care professionals. This scoping review demonstrates the breadth of barriers and facilitators of palliative care in the ICU. Hospital management can consider findings of the current review to better integrate palliative care in the ICU. [ABSTRACT FROM AUTHOR]

Aim: The study is aimed to perform a cross-cultural adaptation of the palliative care quiz for nurses in an Indonesian context to evaluate its psychometric properties. Methods: A two-phase design was used in this study, including cross-cultural adaptation and psychometric testing. The PCQN-I was tested on a convenience sample of health-care providers recruited from 20 primary health-care (PHC) centers in Yogyakarta, Indonesia, from July to October 2017. Results: The cross-cultural adaptation ultimately resulted in a total of 20 items from the PCQN-I. An expert committee revised the words in Item 4 from "adjuvant therapies" to "adjuvant therapies/additional therapies," in Item 5 from "bowel regimen" to "gastrointestinal therapies," and Item 16 from "Demerol" to "Pethidine" based on the Indonesian context. The experts retained Item 5 "It is crucial for family members to remain at the bedside until death occurs," although none of the participants (n = 40) involved in the pilot testing could answer it correctly, and Item 19 "The loss of a distant or contentious relationship is easier to resolve than the loss of one that is close or intimate" although few participants responded correctly. A total of 150 health-care providers consisting of 100 nurses and 50 physicians were involved in the psychometric testing. The scale-level content validity index/Ave of the PCQN-I was 97 and 93 in terms of its relevancy and clarity, respectively. The reliability was calculated as the Kuder–Richardson formula 20 score was 0.71. Conclusions: The PCQN-I is a valid and reliable instrument for assessing palliative care knowledge among PHC providers. Further research is warranted to examine its reliability in different clinical settings. [ABSTRACT FROM AUTHOR]