QUALITY OF LIFE IN

PALLIATIVE CARE
 Tujuan utama perawatan paliatif adalah
meningkatkan kualitas hidup bagi pasien
yang membutuhkan dan mencari
perawatan, & juga mengatasi nyeri dan
optimalisasi kapasitas fungsional.
 Semua aktivitas, seperti; assessing,
evaluating, diagnosing, treating, curing,
comforting and educating, bertujuan untuk
meningkatkan kualitas hidup pasien.
 ARTI KUALITAS HIDUP
 It expresses a value judgment: the
experience of living, as a whole or in
some aspect, is judged to be “good” or
“bad”, “better” or “worse”.
TEORI HEALTH-RELATED QUALITY
OF LIFE (HRQOL)
 Suatu teori multidimensional yang dapat
diterapkan pada beberapa area
keperawatan.
 HRQOL: merepresentasikan perasaan,
sikap/kemampuan untuk mencapai
kepuasan dlm domain kehidupan sbg
kepentingan personal yang terganggu
akibat proses penyakit/defisit fungsi
kesehatan (Peterson & Bredow, 2004)
 MODEL HRQOL

Karakteristik Individu

Faktor Status Status Persepsi Kualitas

Biologi/ Gejala Fungsional Kesehatan Hidup
fisiologi Umum Keseluruhan

Karakteristik Lingkungan

Skema. Model Health-Related Quality Of Life (dikutip dari Peterson & Bredow, 2004).
 MODEL HRQOL…
 Model menjelaskan hub antar konsep
dasar QoL terkait kesehatan.
 Meliputi 5 determinan: Biologi/Fisik,
Status Gejala, Status Fungsional,
Persepsi Kesehatan Umum, & Kualitas
Hidup keseluruhan.
 Dipengaruhi oleh karakteristik individu &
Lingkungan
 KOMPONEN HRQOL
1. Faktor Biologi/Fisik: merujuk pada fungsi
sel, organ, jaringan & sistem organ.
2. Status Gejala: keluhan subyektif yg
dirasakan oleh pasien terkait dengan
kondisi kesehatannya. Gejala
menyangkut perubahan status fisik &
psikologis shg individu dikatakan
abnormal.
 KOMPONEN HRQOL…
3. Status Fungsional: kemampuan untuk
melakukan tugas spesifik. Semakin berat suatu
gejala maka semakin berkurang kemampuan
fungsional individu.
Empat Dimensi Status Fungsional:
A. Fisik
B. Sosial
C. Peran
D. Psikologi
 KOMPONEN HRQOL…
4. Persepsi Kesehatan scr Umum:
menggambarkan integrasi & ekspresi
subyektif individu thd status gejala &
status fungsionalnya.
5. Kualitas hidup scr Keseluruhan: merujuk
pada ekspresi subyektif individu thd
gejala yg dialami dan kemampuannya
melakukan tugas spesifik.
 KOMPONEN HRQOL…

6. Karakteristik Individu & Lingkungan:

mempengaruhi pada semua komponen
dari model HRQOL, tetapi pengaruh
paling besar pada persepsi kesehatan
scr umum & kualitas hidup scr
keseluruhan.
 In general, quality of life can be defined
as a multidimensional construct that
includes “performance and enjoyment of
social roles, physical health, intellectual
functioning, emotional state, and life
satisfaction or well-being.”
 Several important questions:
 who is making the evaluation—the
person living the life or an observer?
 What criteria are being used for
evaluation?
 What types of clinical decisions are
justified by reference to quality-of- life
judgment?
 CONTOH PENGUKURAN
KUALITAS HIDUP
 Skala Kualitas Pasien Stroke (Short
version of stroke specific quality of life
scale / SS-QOL)…terlampir
 Kuesioner kualitas hidup pasien kanker
(European organization for research and
treatment of cancer core quality of life
questionnaire/ EORTC QLQ-
C30)…terlampir.
 the distinction between
treatment and enhancement:

 Treatment attempt to respond to physical,

physiologic, or psychological defects that
deprive persons of normal characteristics.
 Enhancement are made in response to
patient preference and to improve quality
of life.
Palliative care and treatment of
pain
 Palliative care medicine is defined as “an
approach that improves the quality of life
of patients and their families facing the
problems associated with life-threatening
illness, through the prevention and relief
of suffering by means of early
identification and impeccable assessment
and treatment of pain and other problems,
physical, psychosocial and spiritual.
 Relief of pain is a traditional medical goal.
 Increasingly, palliative care medicine
deals with pain and suffering at the end of
life.
 Palliative care medicine uses methods to
achieve global aims: aiding patients to
deal with their impending death and its
effect on others.
 pain relief for terminally ill
patients
 Palliative care includes skilled application
of pain-relieving drugs.
 Competence in palliative care includes not
only science and skill in managing pain
but also understand and application of
ethical principles.
 Quality end-of-life care
requires:
 Appropriate control of pain and symptoms;
 Avoid inappropriate prolongation of dying;
 Enhance the control of patients over their care;
 Rest with family;
 Supported by physicians, nurses, and social
workers.