Research centre REACH


Citation for this: Wulandari, S. K., Hermayanti, Y., Yamin, A., & Efendi, F. 2017. FAMILY PROCESS WITH BREAST CANCER PATIENT IN INDONESIA.

Introduction: Breast cancer occupies the first position in Asia’s women cancer cases in recent years. Signs and symptoms experienced by the patient affect the stress condition of the patient as well as the family as a caregiver. The condition changes to deal with problems during patient assistance as a major problem in an outpatient setting. The demands of adaptation to through the needs during the period of assistance by the family is more complex. The study aimed to determine the experience of stress and adaptation of breast cancer patient’s family. Methods: The qualitative method used with in-depth interviews on seven respondents who were the family caregiver of breast cancer patients. Setting carried out at the shelter house in Bandung. The analysis process used thematic analysis based on Braun & Clarke. Results: The results found five main themes are: 1) Stressor on breast cancer patients, 2) Crisis fulfillment of companion needs, 3) Crisis accompaniment, 4) Coping mechanisms of caregiver, and 5) Ability in adaptation. Discussion: Family experience in assisting breast cancer patients who undergo outpatient also impact families tension who traversed with a subjective effort optimally to adapt in accompanying patients and the needs of other resource support system. Suggestions for future step are early recognition of stress by health workers especially nurses to be able to provide targeted interventions to develop positive adaptation to clients. The development through research is needed in applying family center care both the outpatient and inpatient care in an integrated manner.

The Indonesian profile in the WHO (2014) shows the statistics of cancer incidence reaching 103,100 new cases compared to new
cases in the world of 14.1 million cases. Specific cases of breast cancer in West Java show an incidence of 1.0 ‰ of the population (Riskesdas) (2014). Anderson and Jakesz (2008) state that developing countries need practical, cost-effective resource interventions in the treatment of breast cancer. Hopkinson (2016) proven eating disorders often occur in cancer patients and affect the family diet until cachexia syndrome. While the family as an informal caregiver who became the primary
caregiver tended to experience depression,
physical & mental fatigue (Buyck et al. (2011);
Papastavrou, Charalambous, and Tsangari
(2012). Limited resources in socioeconomic
problems made consequence of improper
treatment (Obrist et al., 2014). Especially for
patients with outpatient treatment. The role of
the family to be the companion not only affects
the patient but also the condition of the
resources around the family.

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Hadi, M., Hamid, A. Y. S., Kamso, S., Sutoto, S., Pratiknya, A. W., Nursalam, N., & Efendi, F. (2017). The Improvement of Student Competency in a Clinical Study in Indonesia: What Factors Played An Important Role? Jurnal Ners.

Background: The improvement of nursing student competency currently is still an issue for the majority of nursing education institutions in Indonesia. This is due to their partnership with hospitals having not been supported by adequate policies and other factors. Objectives: The purpose of this study is to identify the appropriate model for improving student competency in a clinical study. The design used in this study was an observational study with cross-sectional approach. Methods: The research design used a cross-sectional approach involving five hospitals and five Universities. Three hundred and eighty-four participants were recruited from these sites. The data were analyzed using multiple logistic regression. Results: The results showed that the partnership contributed 3.36 times, the patient variations 2.96 times, the job description of the clinical educator 2.30 times, a role model 2.28 times, and the expertise of the faculty educator 2.08 times towards the achievement of student competency in the clinical study. Conclusions: It can be concluded that the partnership aspect, patient variation, job description of the clinical educator, role model, the expertise of the faculty educator, and the level of education has a significant role to improve the achievements coming from the level of student competency in the clinical study. The results of this study can be used by nursing educational institutions, hospitals, and the government to organize a nursing education model for the more optimal achievement of the student’s competencies.

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A Comparative Study of the Lived Experiences of Indonesian Caregivers in Japan and the Returnees in Indonesia

citation : Nugraha, S., Tanaka, M., & Efendi, F. (2008). A Comparative Study of Nursing Educational System in Indonesia and Japan. Jurnal Ners3(2), 1-11.

Based on the effective implementation of Economic Partnership Agreement (EPA) between Indonesia and Japan the mobility of caregivers from Indonesia to Japan has started since 2008. From Indonesian perspective, this is the first time for the country to send out nurses to work as caregivers under a bilateral agreement. However, the notion of ‘caregiver’ is often associated with domestic work without professional training which invites debates on the issue of nurse deskilling. The latest data from the National Board for the Placement and Protection (BNP2TKI) in 2014 showed that 167 Indonesian nurses worked as qualified caregivers in Japan. In addition, 295 caregivers have returned home due to some circumstances. Despite the original intention of the EPA that foreign caregivers are expected to pass the examination in order to continue working in Japan, the high proportion of Indonesian caregivers returning to Indonesia challenges the underlying assumption and the sustainability of the EPA.


In term of educational path, there is no specific difference between Indonesian and Japanese nursing educational systems, as shown on Table 3. The basic difference is on the method of qualification for the nurses. Japanese nurses should undertake national board examination to be a qualified nurse, whereas there is no national board examination for Indonesian nurses. In addition, current health condition of the countries remains the majority of the curriculums. Indonesian nursing education is focusing on communicable disease and surgery nursing, whereas Japanese is focusing on gerontology and chronic disease nursing. To be qualified as a nurse in Japan, Indonesian nurse also have to pass Japan nursing national board examination, which is held once a year at the end of February. Upon arrival nurses and caregivers will be taught Japanese language and introduced Japanese nursing systems for six months. For the first period of the arrival in the middle of August, the nurse will have 3 chances of examination, and will finish in the middle of February. The probability of Indonesian nurses to pass the first chance of examinations would be questionable, since there is no special preparation on Japanese language and Japanese nursing systems before coming to Japan. Japanese people are very respect on psychological condition of the patients, and Japanese nurse thought to always pay special attention on their psychological condition. Therefore, intensive learning on Japanese language, culture and Japanese nursing systems in the working field would be an important point to help Indonesian nurses to pass the nursing examination and be accepted to work as a real nurse. Consequently, a regulation from Japanese government is needed for the hospitals which recruit foreign nurses to reach this purpose. People believe it is unreasonable to insist that the Indonesian nurses take exactly same examination that Japanese nurses do, and such a strict requirement could cause a lot of valuable workers to be simply thrown away ( However, based on the long term experiences on sending the nurses abroad, most of Indonesian nurses have been acknowledged by the receiving countries as having good personalities, such as kind, sympathetic attitudes for patients, and are likely to have a good relationship with the patients, and this in turn supports their job effectively. These conditions were believed those Indonesian nurses are able to survive against the language and difference nursing system.

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