Published Works by R Bagas Wicaksono
BMC Palliative Care, 2024
Background: In the last decade, there has been a growing concern to make palliative care more cul... more Background: In the last decade, there has been a growing concern to make palliative care more culturally sensitive and contextually appropriate. This concern is also relevant in Indonesia, where the progress of palliative care, particularly in home-based care, has been slow. Like elsewhere in the world, there has been a growing awareness of the importance of shifting from a curative orientation towards a palliative one, especially in cases where further medical treatment is futile. In this paper we argue that the development of palliative care practices would benefit greatly from learning about the values that are important for patients, families, and health professionals. It is important to understand these values to support forms of care that aim to enhance quality of life. To demonstrate this, we analyse the care values people in rural Java evoke in their home palliative care practices.
Methods: We conducted an eight-month ethnographic study involving forty-nine patients, families, and health professionals.
Results: We identified three specific Javanese Islamic values: making an effort (ikhtiar), being sincere (ikhlas), and being in a state of surrender (pasrah). These values influenced the participants’ activities in a palliative care setting. Based on our findings, we suggest three strategies to incorporate these values into palliative care practices and to better facilitate palliative care’s integration into Javanese Muslim communities. The first strategy is to include efforts to reduce suffering and improve the quality of life using the concept of ikhtiar. The second strategy is to foster sincerity (ikhlas) to help patients and families accept the realities of their condition and provide care for patients at home. The last strategy is to clarify that palliative care is not synonymous with ‘giving up’ but can be seen as an act of pious surrender.
Conclusions: Our study identified three Islamic-Javanese values that can be incorporated to strategies aiming at enhancing palliative care practices, resulting in care focused on improving quality of life rather than futile attempts at a cure.
Papers by R Bagas Wicaksono
Jurnal Respirasi
Introduction: In March 2020, the World Health Organization (WHO) proclaimed coronavirus disease 2... more Introduction: In March 2020, the World Health Organization (WHO) proclaimed coronavirus disease 2019 (COVID-19) a global pandemic. Indonesia is one of the nations that is still dealing with the COVID-19 outbreak. COVID-19 has several complications, including lung abscess in extremely rare cases. We presented the first reported COVID-19 patient in Indonesia with a delayed lung abscess. Case: A 30-year-old man presented to the hospital with breathlessness and tested positive for COVID-19. Chest X-ray revealed typical COVID-19 pneumonia. He was discharged after 16 days of hospitalization and was educated on using oxygen at home lest the breathlessness recurred. We planned to evaluate the patient’s chest X-ray after 2 weeks of being discharged. The follow-up chest X-ray revealed an air-fluid level in the upper lobe of the right lung, indicating a lung abscess. The patient was treated with antibiotics for 2–3 weeks. Clinical follow-up 4 weeks after the treatment revealed no symptoms, and...
Proceedings of the 1st Jenderal Soedirman International Medical Conference in conjunction with the 5th Annual Scientific Meeting (Temilnas) Consortium of Biomedical Science Indonesia
Drug-induced hypersensitivity syndrome (DIHS) is a life-threatening condition. The diagnosis of D... more Drug-induced hypersensitivity syndrome (DIHS) is a life-threatening condition. The diagnosis of DIHS is quite challenging due to highly variable clinical manifestations. This paper was aimed to describe the diagnosis criteria, pathogenesis, and relation of DIHS with cancer. We describe a case of DIHS, probably induced by cefadroxil, in a 50-year-old woman post modified radical mastectomy for her non-specific-type unilateral breast cancer. After four weeks of cefadroxil therapy, the patient started to develop symptoms of drug eruption with elevated liver function tests, direct bilirubin, alkaline phosphatase (ALP), and gammaglutamyl transferase (GGT). The laboratory tests also showed decreased hemoglobin and albumin. The patient's clinical manifestations were highly suggestive of DIHS. Discontinuation of drug consumption and administration of symptomatic therapy did not improve the condition. After four days of postoperative monitoring in the intensive care unit, the patient did not survive the external and internal bleeding due to severe thrombocytopenia. Several hypothetical mechanisms involved in this syndrome include defective detoxifying enzymes, genetic defects related to human leukocyte antigen, viral infections, and concurrent disease processes, such as a neoplasm.
BMC Medical Education, 2021
Background Previous studies show that teachers can feel disturbed by alarming cases brought up by... more Background Previous studies show that teachers can feel disturbed by alarming cases brought up by students during their teaching activities. Teachers may feel uncertain about how to deal with these cases, as they might feel responsible to take action to prevent further harm. This study aims to explore how ethics teachers in medical schools would respond to a student report of unethical or unprofessional behaviour during the clinical training phase (clerkship) that is alarming and potentially harmful for patients or students themselves. Methods This study used qualitative methods with purposive sampling. We conducted in-depth interviews with 17 teachers from 10 medical schools in Indonesia. We asked if they had heard any alarming and harmful cases from students and provided two cases as examples. Results Four teachers shared their own cases, which they perceived as disturbing and alarming. The cases included power abuse, fraud and deception, violation of patient’s rights and autonomy...
Proceedings of the International Conference on Medical Education (ICME 2021), 2021
Clerkship rotation is one of the most important phases in medical education. In this phase, medic... more Clerkship rotation is one of the most important phases in medical education. In this phase, medical students learn authentically under a health practitioner how to treat patients in a full context, and in the process, they will encounter various ethical or professional problems that arise during the learning. This study was conducted to examine the attitudes of medical students relating to ethical issues while participating in the clerkship rotation. In addition, a phenomenology methods with in-depth interviews was used to find out students' feelings, judgments and wishes toward ethical issues encountered in clerkship rotation and how they deal with the situation. The subjects were 10 medical students that at least had attended 4 departments in clerkship rotation. The result showed that students have decided to remain silent on ethical issues. Instead of criticizing, they prefer to question the situation with the doctors or discuss it with other students. Aside being felt as vulnerable groups because their future (graduation) were determined by the doctors, they chose to remain silent for some reasons. Hierarchy was the major problem to communicate the feeling of inconvenience in dealing with ethical issues. The second reason was group conformity, student can reduce the discomfort feelings when everyone else seemed not to care. They also noted that they became indifferent as to the effect of burnout on thinking about the same situation all the times. The courage to discuss the situation commonly depends on the characteristics of the doctors. Although students chose to remain silent in facing ethical issues in clerkship rotation, it was evident that they were learning, absorbing and more aware of what they were observing.
Jurnal Pendidikan dan Teknologi Indonesia
SCL (student centered learning) merupakan strategi pembelajaran yang menempatkan peserta didik se... more SCL (student centered learning) merupakan strategi pembelajaran yang menempatkan peserta didik sebagai subyek yang aktif, mandiri dan bertanggung jawab sepenuhnya dalam proses belajarnya. Peserta didik beserta proses belajarnya menjadi tokoh utama dalam proses pembelajaran. Semakin kompleksnya materi belajar dan tantangan kebutuhan jaman yang dinamis menuntut adanya kemampuan belajar yang mandiri. Oleh karena itu, kesiapan mahasiswa untuk belajar atas keinginan sendiri (self directed learning readiness) merupakan salah satu komponen penting dalam menentukan keberhasilan belajar. Penelitian ini bertujuan untuk mengeksplorasi karakteristik kesiapan belajar mandiri mahasiswa Kedokteran Umum. Desain penelitian ini ialah mixed methods secara analitik observasional dengan pendekatan cross sectional dan pendekatan fenomenologi untuk mendalami hasil penelitian kuantitatif. Metode pengumpulan data yang digunakan yaitu pengisian kuesioner Self Directed Learning Readiness Scale dan wawancara s...
Journal of Medical Ethics and History of Medicine, 2021
Although ethics is an essential part of medical education, little attention has been paid to ethi... more Although ethics is an essential part of medical education, little attention has been paid to ethics education during the clerkship phase, where medical students observe how physicians make decisions regarding various ethical problems. Specific nuances and cultural contexts such as working in a rural setting can determine ethical issues raised. This phenomenology study aimed to explore ethical issues experienced by Indonesian students during clinical clerkship in a rural setting. In-depth interviews were used to explore students’ experiences. Participants were ten students, selected on gender and clerkship year variations. Data saturation was reached after eight interviews, followed by two additional interviews. Thematic analysis was used in this study, and trustworthiness was ensured through data and investigator triangulation, member checking, and audit trail. Three main themes found in this study were limited facilities and resources, healthcare financing and consent issues, as we...
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Published Works by R Bagas Wicaksono
Methods: We conducted an eight-month ethnographic study involving forty-nine patients, families, and health professionals.
Results: We identified three specific Javanese Islamic values: making an effort (ikhtiar), being sincere (ikhlas), and being in a state of surrender (pasrah). These values influenced the participants’ activities in a palliative care setting. Based on our findings, we suggest three strategies to incorporate these values into palliative care practices and to better facilitate palliative care’s integration into Javanese Muslim communities. The first strategy is to include efforts to reduce suffering and improve the quality of life using the concept of ikhtiar. The second strategy is to foster sincerity (ikhlas) to help patients and families accept the realities of their condition and provide care for patients at home. The last strategy is to clarify that palliative care is not synonymous with ‘giving up’ but can be seen as an act of pious surrender.
Conclusions: Our study identified three Islamic-Javanese values that can be incorporated to strategies aiming at enhancing palliative care practices, resulting in care focused on improving quality of life rather than futile attempts at a cure.
Papers by R Bagas Wicaksono
Methods: We conducted an eight-month ethnographic study involving forty-nine patients, families, and health professionals.
Results: We identified three specific Javanese Islamic values: making an effort (ikhtiar), being sincere (ikhlas), and being in a state of surrender (pasrah). These values influenced the participants’ activities in a palliative care setting. Based on our findings, we suggest three strategies to incorporate these values into palliative care practices and to better facilitate palliative care’s integration into Javanese Muslim communities. The first strategy is to include efforts to reduce suffering and improve the quality of life using the concept of ikhtiar. The second strategy is to foster sincerity (ikhlas) to help patients and families accept the realities of their condition and provide care for patients at home. The last strategy is to clarify that palliative care is not synonymous with ‘giving up’ but can be seen as an act of pious surrender.
Conclusions: Our study identified three Islamic-Javanese values that can be incorporated to strategies aiming at enhancing palliative care practices, resulting in care focused on improving quality of life rather than futile attempts at a cure.