Objective: This study aimed to explore the underlying causes for the delays seeking medical treatment experienced by Indonesian women with breast cancer and what kinds of non-medical treatment were pursued instead.Methods: This study used qualitative methods with in-depth interviews among 20 participants to reveal the causes of delaying medical treatment by patients with breast cancer. Subjects were chosen from women diagnosed with breast cancer who had delayed their medical treatment for various reasons and were currently undergoing medical treatment at a hospital.Results: The underlying causes for the delay of medical treatment were varied, including psychological reasons (fear of surgery, being worried about adverse effects of the medicine, making troubles to the other people, afraid of losing breast, or losing husband); lack of knowledge about cancer (unfamiliar with the symptoms of cancer, possible cancer cure by nutritious food, more trust in alternative medicine, myth, participant’s husband did not approve her surgery, only rely on prayer, forgot if she was sick); factors deriving from health service system (limited facilities, a false diagnosis, queue rooms/radiotherapy/for hospitalization, the radiotherapy equipment was out of service, patient unable to walk, high out-of-pocket cost, and doctors were not communicative). During time delay, some patients have also sought non-medical treatment with herbal medicines, non-herbal medicines, and non-conventional treatment (laser, reiki, acupuncture, and vest treatments).Conclusion: Many factors affect the delay of medical care among patients with breast cancer. Often, these delays influence the patients to seek alternative treatments.
Professional Behavior (PB) is an observable behavior which reflects professional values, proven by behavior, speech and appearance that can increase patients" confidence of their doctor. PB is a component of professionalism which receives a lot of attention by the institution of medical education in Indonesia, with special reference to its pluralism, multicultural and multiethnic diversity. This qualitative study was conducted to identify the PB attributes adjusted for the Indonesian context. The data collection included: 1) literature study; 2) in-depth interviews and 3) Focus Group Discussions (FGD). Participants interviewed were the chairman of the Center for Pancasila Study (PSP), chairman of center for religious cross cultural studies (CRCS) , artists and Catholic, Hindu and Muslim religious leaders. Participant selection was purposeful, based on their links with the characteristic aspects of Indonesia. The FGD participants were the pertinent stakeholders and experts associated with the Medical and Health sciences education, health practitioners and physicians. Total of 26 FGD participants were grouped into 3 groups. Following analysis by the researchers, the qualitative data transcripts from FGD and interviews were randomly verified by other researchers. The qualitative data on the PB attributes from the literature and the interviews and FGDs were classified and categorized in three stages to avoid overlap, and collated to obtain the final PB attributes. The results of this study indicated the presence of 34 of 133 identified PB attributes. The five PB attributes found in all sources were: 1) respect, 2) honesty; 3) integrity; 4) responsibility and 5) altruism. There were attributes only obtained from the Indonesian sources, namely a faith or belief in God Almighty. All PB could be realized best when based on the faith in the Lord as internal motivation. Amanah, Siddiq, Tablig, and Fathonah have long been important teachings for one of the biggest religions in Indonesia (Islam) in which honesty, integrity and responsibility are implied within it, three attributes of the five essential attributes gained from this research.
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Latar belakang: Terapi karsinoma nasofaring (KNF) yang adekuat dan efektif tidak selalu tercapaidi negara berkembang. Ketersediaan alat radioterapi yang tidak seimbang dengan jumlah penderita KNFmenyebabkan keterlambatan jadwal terapi, sehingga berakibat pada buruknya hasil terapi. Alternatifterapi lain perlu dikembangkan untuk mengatasi permasalahan tersebut. Photodynamic therapy (PDT)telah digunakan untuk terapi tambahan pada berbagai kanker, termasuk KNF residu maupun rekuren.Tujuan: Mengetahui respon terapi lokal dan angka harapan hidup 5 tahun penderita KNF residu ataurekuren yang mendapatkan PDT.Metode: Kohort retrospektif dengan data rekam medis penderita KNFresidu atau rekuren yang mendapatkan PDT di Departemen THT-KL RSUP Dr. Sardjito Yogyakarta tahun2005–2011.Hasil: Local response rate sebesar 83,9% dan angka harapan hidup 5 tahun penderita sebesar60,7%. Angka harapan hidup 5 tahun penderita laki-laki lebih tinggi (73,5%) dibandingkan penderitaperempuan (42,2%), perbedaan ini bermakna secara statistik (p=0,045). Angka harapan hidup 5 tahunpenderita berusia <40 tahun lebih tinggi (76,2%) dibandingkan penderita berusia > 40 tahun (53,0%),meskipun tidak signifikan (p=0,417). Angka harapan hidup penderita yang masih terdapat tumor padanasofaring lebih baik (80%) dibandingkan penderita dengan hasil biopsi nasofaring negatif (57,8%),namun tidak signifikan (p=0,638). Angka harapan hidup penderita berdasarkan stadium saat ditegakkandiagnosis KNF, penderita stadium awal mempunyai angka harapan hidup lebih kecil (53,3%) dibandingkanpenderita stadium lanjut (62,1%), meskipun tidak signifikan (p=0,521).Kesimpulan: Local responserate PDT 83,9% dan angka harapan hidup 5 tahun sebesar 60,7%. PDT merupakan modalitas terapi yangefektif untuk KNF residu maupun rekuren. Kata kunci: Karsinoma nasofaring, photodynamic therapy, angka harapan hidup ABSTRACTBackground: Adequate and effective nasopharyngeal carcinoma (NPC) treatment cannot bereached in developing countries. The lack of radiotherapy apparatus cause delayed treatment thatbring about bad treatment results. An alternative treatment modality should be created to overcome theproblem. Photodynamic therapy (PDT) has been conducted for many malignancies including recurrentor residual NPC. Purpose: To find out the local response rate and 5-year overall survival amongrecurrent or residual NPC patients who got PDT. Method: Retrospective cohort, data was taken frommedical records of patients with PDT in ENT-H&N Surgery Department Sardjito Hospital since 2005until 2011. Results: Local response rate was 83.9%. Five-year overall survival was 6.7%. The 5-yearoverall survival among men was significantly higher than women (73.5%:42.2%) p=0.045. The 5-yearoverall survival among patients <40 years old was higher than patients > 40 years old (76.2%:53.0%)even though it was not significant (p=0.417). The 5-year overall survival among patients with tumor washigher than patients without tumor (80%:57.8%) although it was not significant (p=0.638). The 5-yearoverall survival among patients with previous early stage NPC was lower than previous advanced stage (53.3%:62.1%) although it was not significant (p=0.521). Conclusion: Local response rate of PDT was83.9% and the 5-year overall survival was 60.7%. PDT was found as an effective treatment modalityfor recurrent or residual NPC. Keywords: Nasopharyngeal carcinoma, photodynamic therapy, 5-year overall survival
Background: One of the most important factors in providing health services is communication. Effective communication between patient-physician will have an impact on health outcomes. Nevertheless, a gap still occurs in patient-physician communication.Objective: This study aimed to determine the correlation between the core concepts of the well-established Health Belief Model: perceived susceptibility, perceived severity, perceived benefits, perceived barriers and cues to action with the concept of self-efficacy in applying the newly developed Indonesian Model of Assertive Communication called “CERDAS”.Methods: A cross sectional study was conducted with 202 eligible women of the Family Welfare Programme in Yogyakarta, Indonesia. The samples were selected using quota sampling. Data were analyzed using Pearson correlation test.Results: Results of the Pearson correlation tests between self efficacy and perceived susceptibiliy showed r: 0.191, perceived severity r: 0.239, perceived benefits r: 0.256, perceived barriers r: 0.272, and cues to action r: 229; with all values p0.05.Conclusion: There was a significant correlation between perceived vulnerability, perceived severity, perceived benefits and perceived barriers, as well as cues to action with self-efficacy in applying the new Model of Assertive Patient-Physician Communication, “CERDAS”.
Background: Educational institutions must promote the learning of professional behavior as early as possible and conduct evaluation of the implementation, including evaluation of the academic integrity implementation. This study aims to determine the academic integrity perception, behavior and intention of students and their relation to mental capacity and basic personality of students based on the MMPI-2 measurements.Method: This was a non-experimental, conducting quantitative survey involving 209 medical students from one of Faculty of Medicine in Indonesia.Results: The relationship between mental capacity and basic personality based on the measurement of MMPI-2 and the perceptions, attitude and intentions of academic integrity were found. On mental capacity, a correlation was found between potential performance and perceptions (r = 0.169 and p = 0.014) and academic integrity behavior (r = 0.170 and p = 0.014), between adaptability and perception of academic integrity of fellow students (r = 0.149 and p = 0.032), between psychological constraints and academic integrity behavior score (r = 0.137 and p = 0.049) and between moral integrity and perception score of academic integrity (r = - 0.220 and p = 0.001). On the basic personality, there was a correlation between openness to pressure and perceptions of academic integrity of fellow students (r = 0.141 and p = 0.041), as well as between basic personality and perception (r = 0.169 and p = 0.014) and academic integrity behavior (r = 0.154 and p = 0.026).Conclusion: There is a correlation in some variables of mental capacity and basic personality based on MMPI-2 to perception and academic integrity behavior.
Background: Derogation of professional behavior (PB) increased in education, even in medical education revealed cheating during in educational process as best predictor when the students at work placed in the future. The aim of this study is to know the students’ perspective on cheating, altruism and plagiarism.Method: This study was conducted using a qualitative approach. Sampling technique was purposeful sampling with criterion reference. Fifty-two year-one students of medical school of faculty of medicine and health sciences (FMHS) divided into 5 groups, each group consists of 10 to 11 students. The students received teaching learning of PB (three times tutorial with trigger film, reflection and expert panel). Qualitative data from students’ reflection analized using constant comparative method. Results: The results of this study indicated the presence of 6 final themes (i.e., learning value, learning approach, student preparedness, examination strategy, learning spiritual, study plan. Students who had the ability to understand various learning events would have a good study plan, and then could choose appropriate examination strategy to reach success and could avoid blamable event such as cheating. The students who had good learning spiritual and learning value to dilemmatic event, they would be motivated and their heart would be touched, so in their future plan they would try to be altruistic and professional doctor in all situation. There would be influence on positive study plan, make more effort and pried to God, also respect others work, so plagiarism could be avoided.Conclusion: There were 6 final themes of students’ reflection on cheating, altruism and plagiarism after they exposure by teaching learning of PB. They were learning value, learning approach, student preparedness, examination strategy, learning spiritual and study plan.
A study on the type and frequency of injuries in preschool-age children was conducted in a sample of households representing population of Purworejo district. A two stages cluster (wilcah) method was used to select 4.354 preschool-age children living in 12,721 households in the district. The mother or other child caretakers provided responses about injuries occurring during the 3 months period to interview. Injuries among these preschool-age children included trauma by cutting or sharp object (6.5%), falls (5.7%), bums (0.6%), bites (0.4%), traffic accident (0.4%), unconsciousness (0.2%) and poisoning (0 .1 %). The typical injury in under the 12 months olds was falls. Children aged 12 to 23 month accounted for 18% of the injury episodes which were typical fall and trauma. Children aged 24 to 59 months accounted for 76.6% of injury episodes which were typically trauma, falls, bums, bites and traffic accident. No statistical differences in the frequency and type on injuries were observed between urban and rural areas. The relative frequency in age-grouped and type of injuries from this population-based study can be used in planning injury prevention especially for family health education program.
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