Persepsi kesakitan dan kematian pada pasien dalam perawatan paliatif di RSUP Prof. Dr. I.G.N.G. Ngoerah Denpasar

Background: Every year, there is an increase in the number of people living with cancer, so there is a need for palliative services to reduce the suffering of patients at the end of their lives. Patients' perception of illness is statistically associated with better physical, social, and psychological well-being and quality of life. Differences in perceptions due to cultural, ethnic, and religious backgrounds regarding suffering and death lead to different concepts regarding the acceptance of pain and death in palliative patients. Method: This research is qualitative research with a phenomenological approach. The study was conducted in December 2023 - May 2024. Data was collected through semi-structured interviews. The interview results were analyzed using the data triangulation method, ensuring the depth or quality of the information by re-reading the transcript, checking information that was unclear to the informants (member checking), and discussing it with colleagues and supervisors (peer debriefing). Based on the results of in-depth interviews with 8 informants, 74 codes, 18 sub-themes, and 7 themes were found related to perceptions of pain and death and palliative care. Results: The informant experienced shock, weakness, and sadness, did not expect to be seriously ill, had a resigned attitude, and felt that he might not recover. Sadness, anger, annoyance, confusion, pain, discomfort, and fear are also felt along with pain. From a cultural perspective, there is a view of illness because of karma or tasks that ancestors have not carried out. The informant also experienced changes in financial conditions while undergoing the treatment process. The informant's knowledge about palliative services still needed to be improved. Still, the informant felt good acceptance as a patient and safe during the treatment, so there was no disappointment during the treatment. Conclusion: Patients in palliative care perceive illness and death differently based on their understanding of illness and death, living conditions, age, culture, religion, financial conditions, and expectations in care. The informants' knowledge about palliative services still needed to be improved, but they were not disappointed during treatment. Latar Belakang: Setiap tahun terjadi peningkatan pada jumlah penderita kanker, sehingga diperlukan adanya layanan paliatif untuk mengurangi penderitaan pasien pada masa akhir hidupnya. Persepsi mengenai penyakit oleh pasien diketahui memiliki hubungan dengan kesejahteraan fisik, sosial dan psikologis yang lebih baik secara statistik dan kualitas hidup. Perbedaan persepsi karena latar belakang budaya, suku, dan agama mengenai kesakitan dan kematian menyebabkan adanya perbedaan konsep mengenai penerimaan kesakitan dan kematian pada pasien paliatif. Metode: Penelitian ini merupakan penelitian kualitatif dengan pendekatan fenomenologi. Penelitian dilakukan pada bulan Desember 2023 - Mei 2024. Data dikumpulkan melalui wawancara semi-struktur. Hasil wawancara dianalisis dengan metode triangulasi data, memastikan kedalaman atau kualitas informasi dengan membaca ulang transkrip, pemeriksaan kembali informasi yang kurang jelas kepada para informan (member checking), serta mendiskusikan dengan teman sejawat serta pembimbing (peers debriefing). Berdasarkan hasil wawancara mendalam pada 8 informan, ditemukan sebanyak 74 kode, 18 sub tema, dan 7 tema terkait persepsi kesakitan dan kematian serta persepsi terhadap perawatan paliatif. Hasil: Informan mengalami syok, lemas dan sedih, tidak menyangka mengalami sakit berat, memiliki sikap pasrah dan merasa bahwa mungkin tidak sembuh. Kesedihan, marah, jengkel, bingung, sakit, tidak nyaman, dan takut juga dirasakan bersama dengan nyeri juga dialami. Dari segi budaya ditemukan pandangan sakit akibat karma atau tugas yang belum dijalankan dari leluhur. Informan juga mengalami perubahan kondisi keuangan ketika menjalani proses pengobatan. Pengetahuan informan tentang pelayanan paliatif masih kurang, namun informan merasakan penerimaan yang baik sebagai pasien dan merasa aman dalam perawatan sehingga tidak ada rasa kecewa yang dirasakan selama menjalani perawatan. Simpulan: Persepsi kesakitan dan kematian pada pasien dalam perawatan paliatif sangat beragam, berdasarkan pemahaman penyakit dan kematian, kondisi hidup, usia, budaya, agama, kondisi keuangan, dan harapan dalam perawatan. Pengetahuan informan tentang pelayanan paliatif masih kurang namun tidak ada rasa kecewa yang dirasakan selama menjalani perawatan.