Ambar Mudigdo

Biopsychosocial Determinants of the Quality of Life of Patients With Breast Cancer: A Path Analysis Evidence from Surakarta, Central Java

Background: Breast cancer is the most common cancer among women worldwide. Women are now diagnosed with the disease earlier and live longer. Quality of life has become a well-accepted outcome measure for cancer patients and an integral part of cancer patient management. It has been shown that assessing quality of life in cancer patients could contribute to improved treatment and could even serve as a prognostic factor along with medical parameters. The study aimed to analyze the influence of education level, stage of cancer, social support, and coping strategy, on the quality of life of breast cancer patients. Subjects and Method: This was a quantitative-qualitative study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from August to October 2017. A sample of 150 breast cancer patients was selected for the quantitative study by stratified random sampling. A sample of 3 informants were selected for the qualitative study by purposive sampling. The dependent variable was quality of life. The independent variables were education level, stage of cancer, social support and coping strategy. Quantitative data were collected by questionnaire. Social support was measured by Multidimensional Scale of Perceived Social Support (MSPSS) questionnaire. Coping strategy was measured by brief COPE questionnaire. The quality of life was measured by WHOQOL BREF questionnaire. Data qualitative collection was by means in-depth interview. The quantitative data were analyzed by path analysis. Qualitative data was analyzed by Miles and Huberman interactive model. Results: Quality of life increased with higher education level (b= 8.69, SE= 1.84, p<0.001), stronger social support (b= 1.03, SE= 0.34, p= 0.003), good coping strategy (b= 2.07, SE= 0.43, p<0.001). Quality of life decreased with higher stage of cancer (b= -6.41, SE= 2.94, p= 0.029). Conclusion: Quality of life increases with higher education level, stronger social support, good coping strategy, but decreases with higher stage of cancer. Keywords: social support, coping strategy, quality of life, path analysis

The Effect of Self-Efficacy, Family Support, and Socio-Economic Factors on the Quality of Life of Patients with Breast Cancer at Dr. Moewardi Hospital, Surakarta

Background:Breast cancer is the highest cancer among women in the world. Patients with breast cancer experience various changes, including physical, psychological and social changes. This changes affect their quality of life. This study aimed to determine the effect of self-efficacy, family support, and socio-economic factors on health-related quality of life of patients with breast cancer.Subjects and Method: This was an analytic observational study with cross sectional design. The study was conducted at Dr Moewardi Hospital, Surakarta. A total of 63 patients with breast cancer diagnosis were selected for this study by purposive sampling. The dependent variable was health-related quality life, consisting of global health status, physical function, role function, emotional function, social function, fatigue, pain, body image, financial hardship, and future perspective. The independent variables were self-efficacy, family support, education, and family income. The data were collected by questionnaire and medical record, and then were analyzed by multiple logistic regression.Results: Average age (and standard deviation) of the breast cancer patients under study was 50.21±7.67 years. Average score of quality of life in the global health status dimension was 73.81±10.97. Multiple logistic regression analysis showed positive effect of self-efficacy (OR=3.45;95% CI=0.98 to 12.12; p=0.053), family support (OR=2.67; 95%CI=0.84 to 8.46; p=0.096), education (OR=3.99; 95%CI=1.15 to 13.79; p=0.028), and family income (OR=1.51; 95%CI=0.43 to 5.26; p=0.518) on global health status.Conclusion:Self-efficacy, family support, education, and family income have positive and significant effects on global health status.Keywords: self-efficacy, family support, social economy, quality of life, breast cancerCorrespondence: Lusiatun. Masters of Public Health, Sebelas Maret University, Surakarta. Email: lusiatun12@gmail.com. Mobile: 085743778941Journal of Epidemiology and Public Health 2016, 1(3): 182-194https://doi.org/10.26911/jepublichealth.2016.01.03.05

Mid-face location of primary basal cell carcinoma related to cancer aggressivity

Abstract Objective To study the aggressiveness of basal cell carcinoma (BCC) on the mid-face location. Methods A total of 30 patients were diagnosed using specimen biopsy with hematoxylin-eosin stain at Moewardi Public Hospital in Surakarta, Central Java, Indonesia. The age, gender distribution, site of the lesion, as well as clinic-pathological appearance were analyzed. Results There were 30 patients consisting of 46.7% males and 53.3% females with ages ranging from 33 to 91 years old and with the most common occupation, such as farmers (53.6%) and housewives (26.7%). Morpheaform subtypes BCC were more frequent than other types. Based on the predilection, most of the BCC were found to be in the mid-face (76.7%) and using determined criteria of histopathological examination, the aggressive appearance was 77% and non-aggressive BCC was 23%. The BCC on the mid-face location was more aggressive than the other sites ( P Conclusions BCC is the most common skin tumor in humans with rare metastases, which might cause significant damage due to its local recurrences and aggressiveness. BCC on the mid-face is significantly more aggressive than that on the other predilection sites.