KONSEP DASAR

KEPERAWATAN
PALIATIF
Ns SUKRAANDINI MNS
TUJUAN PEMBELAJARAN
 Mahasiswa memahami pengertian
keperawatan paliatif
 Mahasiswa mampu memahami
perkembangan keperawatan paliatif
 Mahasiswa mampu memahami
perkembangan hospice care
 Mahasiswa mampu memahami trend
keperawatan paliatif
 Mahasiswa mampu memahami tugas
perawat dalam paliatif care
STUDY CASE
Anda merawat dua orang pasien yang
keduanya menderita kanker.
Satu pasien baru saja diberitahukan tentang
diagnosanya
Pasien satunya sudah menjalani
pengobatan kanker sdh satu tahun.
Apa yang ada di pikiran anda???
KEMUNGKINAN
 Kondisi fisik pasien ??
 Kondisi psikologis pasien??
 Kondisi keluarga pasien ??
 Bagaimana proses perawatanya??
Kondisi saat ini
 Masih susahnya penyakit terminal dengan
segera
 Kurang lebih 40 juta orang membutuhkan
asuhan paliatif, 78% penduduk miskin dan
menengah
Goal of caring
 to achieve the peaceful death and
enhance quality of life by decrease the
symptom distress using the comfort care
(Hodo & Buller as cited in Lewis, 2013).
 to provide medical, spiritual, emotional
and palliative care for anyone who is
nearing death (Izumi et al 2012).
Goal of end of life care
 Thegoal of end of life care is can be
concluded as a caring aimed at patients
who are in terminal disease, where this
caring focuses on meeting the needs of
patients both biology, psychologically,
and spiritually. It’s been expected to be
able in improving the quality and comfort
care of patients and families, and also
helped patients to die peacefully.
Paliatif

 Berasal
dari kata “pallium” yang berarti
menyelubungi atau menutup

 Tomitigate suffering of the patient, not

affect a cure”
Paliative care
 Provides relief from pain pain and distresssing
symptom
 Affirm life and regards as normal process
 Intend to neither hasten nor postpone death
 Integrates the psychological and spiritual
aspect of patient care
 Offers a support system to help the family
cope during the patient illness and in their
own bereavement
Keperawatan paliatif
 Apa itu keperawatan??
 Henderson (1997) mengatakan “nursing is
primarily assiting the individual in the
perfomance of those activities
contributing to health and its recovery or
to peaceful death”.
Perkembangan paliatif
 Hari perawatan paliatif sedunia jatuh pada
tanggal 6 oktober setiap tahunya
 According the Ministry of health decision of
Republic Indonesia Number 812 (2007)
proposed that health facilities is a place that
provides health care services are medically
for society. In Indonesia palliative care is still
limited in five of the provincial capital of
Jakarta, Yogyakarta, Surabaya, Denpasar
and Makassar.
 Strategy of palliative care in Indonesia aimed
as the legal basis and direction for palliative
care, implementation of palliative care
quality according to prevailing standards, the
drafting of guidelines for the implementation
or operational guidelines for palliative care,
availability of medical personnel and non
medically trained, availability of facilities and
infrastructure required (Ministry of health
decision of Republic Indonesia Number 812,
2007).
 Type of palliative care activities includes:
management of pain, other physical
complaints management, nursing care,
psychological support, support social,
cultural and spiritual support, support the
preparation and during grief
(Ministry of health decision of Republic
Indonesia Number 812, 2007).
 Uses a team approach to address the
needs of patients and their families,
including bereavment counseling; if
indicated
 Will enhanced quality of life, and may
positively influence the core of illness
(Kemenkes, 2007)
Nurses' role
 Based on the previous study the roles of
nurses in caring for patients at the end of
life are as follows: educators, advocates,
collaborator and provide care.
 thegoal of nurse as educator is to
change the knowledge, attitude and skill
occurs in which the focused nurse as
educator is how nurse teaching as their
planning based on their assessment and
client needs (Bastable, 2008).
 Nurses
can empower patients to
advocate for themselves by encouraging
them to express their wishes to the
healthcare team. Study by King and
Thomas (2013) with
 Therole of nurses as a collaborator is how
nurse work in a team. Based on Baggs
and Schmitt as cited in Petri. (2010) said
that the nurses as collaborator is the
condition which the nurses and physicians
were working together with cooperative
and making decision to express and
transmit out in plans for patient care, i
 Nurses are a vital component in giving
care for comfort care. Provide basic care
can begin with comfort and open and
frequent communication when possible
with patient and families (Vanderspank et
al., 2011).
HOSPICE
 Menurut PERMENKES (2007)
Hospis adalah tempat dimana pasien
dengan penyakit stadium terminal yang tdk
dpt drawat d rmh namun tdk melakukan
tindakan yang harus dilakukan d RS
 Pelayanan yg dberikan tidak spt d rs
tetapi memberikan pelayanan
mengedalikan gejala yang ada, dgn
kondisi spt d rmh sndr
Trend palliative care
 Penyakit berubah : menular ; tidak
menular
 Usia harapan hidup meningkat
 Perawatan spt drmh akan sangat dminati
 Peluang kerja akan terbuka
Nurses’ problems or barriers
Communication,
 According to Steinhauser as cite in Hodo and
Buller (2012) said that communication skill is the
basis to support in provide end of life experience.
 Effective communication is a strong factor of the
quality of care at the end of life, and that patients
value non-verbal communication such as
sensitivity, presence, and warmth (Cavaye &
Watts, 2010). G
 ood communication by nurses can help to
promote coordinated between health care teams
and coordinate the treatment plan (Lewis, 2013).
Knowledge and Education
 Knowledge is the basis for advancement
professionalism in caring for patients with
end of life care.
 Lack of knowledge of nurses would be an
obstacle in treating patients with end of
life. According to White and Coyne (2011)
s
Experience
 Thelack of experience of nurses would be
a barrier, nurses who don’t have
adequate training about end of life care
do not feel confident in dealing with
patients in the end of life (Frey et al as cite
in Raphael, Waterworth, & Gott, 2014).
 Keberhasilan keperawatan paliatif tidak
bergantung pada intervensi medis,
lingkungan yang spesial atau bahkan
pengobatan yg mahal
 Perwatan paliatif mlibatkan penialian semua
karakteristik dan pengalamn masa lalu pasien
tsb
 Kombinasi antara pengetahuan, ketrampilan,
dan kasih sayang dalam ukuran yang sama,
yg sensitif penuuh harpan bermakna dan
dinamis
TUGAS PERAWAT
 Perawat membantu untuk proses
adaptasi
 Menerima kenyataan kehilangan
 Menjalani pedihnya berduka
 Penyerusian terhadap lingkungan
 Relokasi emosional
(Brunner & Suddarth, 2008)
Any Question ?