Family Process with Breast Cancer Patient in Indonesia

Sarah Kartika Wulandari, Yanti Hermayanti, Ahmad Yamin, Ferry Efendi

Abstract views = 768 times | views = 495 times


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.

Conclusion: 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.


adaptation; breast cancer; caregiver; stress

Full Text:



(Riskesdas), R. K. D. (2014). Profil Kesehatan Provinsi Jawa Barat Tahun 2014. Indonesia: Dinas Kesehatan Provinsi Jawa Barat.

Alptekin, S., Gonullu, G., Yucel, I., & Yarıs, F. (2010). Characteristics and quality of life analysis of caregivers of cancer patients. Medical Oncology, 27, 607-617. doi: DOI 10.1007/s12032-009-9256-2

Anderson, B., & Jakesz, R. (2008). Breast Cancer Issues in Developing Countries: An Overview of the Breast Health Global Initiative. World Journal of Surgery, 32, 2578-2585. doi: 10.1007/s00268-007-9454-z

Anggraeni, M., & Ekowati, W. (2010). Peran keluarga dalam memberikan dukungan terhadap pencapaian integritas diri pasien kanker payudara post radikal mastektomi. The Soedirman Journal of Nursing, 5(2), 105-114.

Barker, P. (2009). Psychiatric and mental health nursing: The craft of caring (2 ed.). London-UK: Hodder Arnold (Publishers) Ltd.

Beaver, K., Williamson, S., & Briggs, J. (2016). Exploring patient experiences of neo-adjuvant chemotherapy for breast cancer. European Journal of Oncology Nursing, 20(1), 77-86. doi:

Belgacem, B., Auclair, C., Fedor, M.-C., Brugnon, D., Blanquet, M., Tournilhac, O., & Gerbaud, L. (2013). A caregiver educational program improves quality of life and burden for cancer patients and their caregivers: A randomised clinical trial. European Journal of Oncology Nursing, 2013, 1-7. doi:

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77-101. doi: 10.1191/1478088706qp063oa

Burridge, L. H., Barnett, A. G., & Clavarino, A. M. (2009). The impact of perceived stage of cancer on caregivers’ anxiety and depression during the patients’ final year of life. Psycho-Oncology, 18, 615–623. doi: 10.1002/pon.1435

Buyck, J.-F. M. D. M., Bonnaud, S. M., Boumendil, A. P., Andrieu, S. M. D. P., Bonenfant, S. M., Goldberg, M. M. D. P., . . . Ankri, J. M. D. P. (2011). Informal Caregiving and Self-Reported Mental and Physical Health: Results From the Gazel Cohort Study. American Journal of Public Health, 101(10), 1971-1979.

Chongsuvivatwong, V., Phua, K. H., Yap, M. T., Pocock, N. S., Hashim, J. H., Chhem, R., . . . Lopez, A. D. (2011). Health and health-care systems in southeast Asia: diversity and transitions. Lancet, 377, 429-437. doi: DOI:10.1016/S0140-6736(10)61507-3

Fletcher, B. S., Miaskowski, C., Given, B., & Schumacher, K. (2012). The cancer family caregiving experience: An updated and expanded conceptual model. European Journal of Oncology Nursing, 16, 387-398. doi: 10.1016/j.ejon.2011.09.001

Govina, O., Kotronoulas, G., Mystakidou, K., Katsaragakis, S., Vlachou, E., & Patiraki, E. (2015). Effects of patient and personal demographic, clinical and psychosocial characteristics on the burden of family members caring for patients with advanced cancer in Greece. European Journal of Oncology Nursing, 19, 81-88. doi:

Govina, O., Vlachou, E., Kavga-Paltoglou, A., Kalemikerakis, I., Papageorgiou, D., Fasoi, G., & Patiraki, E. (2014). Exploring the factors influencing time and difficulty of tasks provided by family caregivers of patients with advanced cancer in Greece. Health Science Journal, 8(4), 438-451.

Hopkinson, J. B. (2016). Food connections: A qualitative exploratory study of weight- and eating-related distress in families affected by advanced cancer European Journal of Oncology Nursing, 20, 87-96. doi:

Jaafar, N. R. N., Din, S. H. S., Saini, S. M., Ahmad, S. N. A., Midin, M., Sidi, H., . . . Baharudin, A. (2014). Clinical depression while caring for loved ones with breast cancer. Comprehensive Psychiatry, 55, S52-S59. doi:

Jones, L. W., Eves, N. D., Haykowsky, M., Freedland, S. J., & Mackey, J. R. (2009). Exercise intolerance in cancer and the role of exercise therapy to reverse dysfunction. The Lancet Oncology, 10, 598-605. doi:

Kaakinen, J. R., Gedaly-Duff, V., Coehlo, D. P., & Hanson, S. M. H. (2010). Family health care nursing : theory, practice, and research (4th ed.). United States of America: F. A. Davis Company.

Kaplan, S. A., Madden, V. P., Mijanovich, T., & Purcaro, E. (2013). The Perception of Stress and its Impact on Health in Poor Communities. Journal of Community Health, 38(1), 142-149. doi:

Kardiyudiani, N. K. (2012). Phenomenology Study; Hope of breast cancer patients who have chemotherapy about family support in cancer Dharmais Hospital Jakarta. (Master), University of Indonesia, Jakarta-Indonesia.

Khanjari, S., Langius-Ekl€of, A., Oskouie, F., & Sundberg, K. (2014). Family caregivers of women with breast cancer in Iran report high psychological impact six months after diagnosis. European Journal of Oncology Nursing, 1-6.doi:

Kumar, R. V., & Bhasker, S. (2015). Health-care related supportive-care factors may be responsible for poorer survival of cancer patients in developing countries. Journal of Cancer Policy, 5, 31-47. doi:

Lee, K.-C., Yiin, J.-J., & Chao, Y.-F. (2016). Effect of integrated caregiver support on caregiver burden for people taking care of people with cancer at the end of life:A cohort and quasi-experimental clinical trial. International Journal of Nursing Studies, 56, 17-26. doi:

Lee, Y. S., Akhileswaran, R., Hock, M. O. E., Wah, W., Hui, D., Ng, S. H.-X., & Koh, G. (2017). Clinical and socio-demographic predictors of home hospice patients dying at home: A retrospective analysis of Hospice Care Association’s database in Singapore. Journal of Pain and Symptom Management, 2017. doi: 10.1016/j.jpainsymman.2017.01.008

LoBiondo-Wood, G. (2008). Theory of Family Stress and Adaptation Middle Range Theory fo Nursing (2 ed.). New York, USA: Springer Publishing Company, LLC.

Moffatt, S., Noble, E., & White, M. (2012). Addressing the Financial Consequences of Cancer: Qualitative Evaluation of a Welfare Rights Advice Service. PLoS One, 7(8). doi: 10.1371/journal.pone.0042979

Ng, C., Pathy, N. B., Taib, N., Teh, Y., Mun, K., Amiruddin, A., . . . Yip, C. (2011). Comparison of Breast Cancer in Indonesia and Malaysia – A Clinico-Pathological Study Between Dharmais Cancer Centre Jakarta and University Malaya Medical Centre, Kuala Lumpur. Asian Pacific Journal of Cancer Prevention, 12, 2943-2946.

Obrist, M., Osei-Bonsu, E., Ahwah, B., Watanabe-Galloway, S., Merajver, S. D., Schmid, K., & Soliman, A. S. (2014). Factors Related to Incomplete Treatment of Breast Cancer in Kumasi, Ghana. Breast, 23(6), 821-828. doi: 10.1016/j.breast.2014.08.014

Papastavrou, E., Charalambous, A., & Tsangari, H. (2012). How do informal caregivers of patients with cancer cope: A descriptive study of the coping strategies employed. European Journal of Oncology Nursing, 16(1), 258e263. doi: doi:10.1016/j.ejon.2011.06.001

Parker, M., & Smith, M. C. (2010). Nursing theories and nursing practice (3 ed.). USA: F.A. Davis Company.

Potter, P. A., & Perry, A. G. (2010). Fundamental Keperawatan (7 ed.). Jakarta: Salemba Medika.

Regan, T., Levesque, J. V., Lambert, S. D., & Kelly, B. (2015). A Qualitative Investigation of Health Care Professionals', Patients' and Partners' Views on Psychosocial Issues and Related Interventions for Couples Coping with Cancer. PLoS One, 10(7). doi: 10.1371/journal.pone.0133837

Rha, S. Y., Park, Y., Song, S. K., Lee, C. E., & Lee, J. (2015). Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. European Journal of Oncology Nursing, 2015, 1-7. doi:

Tachi, T., Teramachi, H., Tanaka, K., Asano, S., Osawa, T., Kawashima, A., . . . Goto, C. (2015). The Impact of Outpatient Chemotherapy-Related Adverse Events on the Quality of Life of Breast Cancer Patients. PLoS One, 10(4). doi: 10.1371/journal.pone.0124169

Taib, N. A., Yip, C. H., Ibrahim, M., CJ, N., & Farizah, H. (2007). Breast Cancer in Malaysia : Are Our Women Getting The Right Message? 10 Year-Experience in A Single Institution In Malaysia. Asian Pacific Journal of Cancer Prevention, 8, 141-145.

Townsend, M. (2008). Essentials of psychiatric mental health nursing (4 ed.). USA: F. A. Davis Company.

Tsitsis, N., & Lavdaniti, M. (2014). Quality of Life in Women with Breast Cancer. International Journal of Caring Sciences, 7(1), 38-42.

Vahidi, M., Mahdavi, N., Asghari, E., Ebrahimi, H., Ziaei, J. E.,

Hosseinzadeh, M., . . . Kermani, I. A. (2016). Other Side of Breast Cancer: Factors Associated with Caregiver Burden. Asian Nursing Research, 10, 201-206. doi:

Walshe, C., Roberts, D., Appleton, L., Calman, L., Large, P., Lloyd-Williams, M., & Grande, G. (2017). Coping Well with Advanced Cancer: A Serial Qualitative Interview Study with Patients and Family Caregivers. PLoS One, 12(1). doi: 10.1371/journal.pone.0169071

WHO. (2014). Indonesia World Health Organization- Cancer Country Profiles (Vol. 2014): WHO.

Zhang, Q., Yao, D., Yang, J., & Zhou, Y. (2014). Factors Influencing Sleep Disturbances among Spouse Caregivers of Cancer Patients in Northeast China. PLoS One, 9(10). doi: 10.1371/journal.pone.0108614


  • There are currently no refbacks.

Copyright (c) 2017 Jurnal Ners

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This journal is indexed by:





Creative Commons License

This journal (p-ISSN:1858-3598; e-ISSN:2502-5791) is licensed under a Creative Commons Attribution 4.0 International License


Current Stats

Previous Stats