Palliative care is often started late in patients with life-threatening conditions, particularly in patients with advanced cancer. However, with the emergence of the early palliative care (EPC) paradigm, their quality of life (QoL) may be better. Although several previous meta-analyses support the effectiveness of EPC in increasing QoL, essential issues related to the optimisation of EPC interventions are still needed. A systematic review and meta-analysis of randomised controlled trials (RCTs) were conducted to determine the effectiveness of EPC on the QoL of patients with advanced cancer. PubMed, ProQuest, MEDLINE through EBSCOhost and Cochrane Library and clinicaltrials.gov (register website) were searched for RCTs published before May 2022. Data synthesis used the Review Manager 5.4 to generate pooled estimates of effect size. A total of 12 empirical trials met the eligibility criteria and were included in this study. The results showed that EPC intervention had a significant effect (standard mean difference = 0.16, 95% confidence interval: 0.04, 0.28, Z = 2.68, P < 0.05). However, the secondary outcomes showed including mood (mean difference = −0.90, 95% CI: −2.32, 0.51, P > 0.05) and symptom controls (MD = −1.49, 95% CI: −3.81, 0.81, P > 0.05) had no significant effect. EPC is effective in improving the QoL of patients with advanced cancer. However, other outcomes still need to be reviewed, because the review of QoL is not enough to generalise the benchmarks for the effectiveness and optimisation of EPC interventions. Another notable aspect is to consider the most effective and efficient duration for starting and ending EPC interventions.

Background: E-learning method could develop student’s self-directed learning abilities, as its advantage. Self-directed learning (SDL) becomes essential in education since it encourages student to learning, skill development, and professional practice. Educators need to combine current learning process with information technology and e-learning to promote student readiness for SDL abilities.Objective: To describe self-directed learning readiness (SDLR) for nursing students during e-learning implementation in clinical rotation nurse professional program.Method: This was a descriptive-quantitative study with a cross-sectional design conducted at PSIK FK-KMK UGM. Total sampling was applied and included 102 respondents. They were nurse professional program students who were taking basic nursing practice and nursing management courses from August to December 2018. Self-Directed Learning Readiness Scale (SDLRS) was used as data collection instrument which consisted of 40 items. Data was analysed using univariate approach.Result: There were 60,8% of Nurse Professional Program students who took e-learning courses had high SDLR scores (Mean=152,75; SD=13,362; Min=121; Max=195). The average SDLR scores in each subscale were reaching 3,61 on self-management, 3,98 on the desire to learn, and 3,86 on self-control.Conclusion: The SDLR level of nurse professional program students who took basic nursing practice and nursing management courses showed high results in the implementation of e-learning. ABSTRAKLatar belakang: E-learning memiliki keunggulan dalam mengembangkan kemampuan belajar mandiri siswa (self-directed learning). Self-directed learning (SDL) penting dalam pendidikan karena memotivasi mahasiswa untuk belajar, mengembangkan keahlian, serta melatih profesionalitas. Pendidik perlu menggabungkan proses pembelajaran dengan teknologi informasi dan e-learning guna memfasilitasi kesiapan mahasiswa terhadap kemampuan SDL (self-directed learning readiness).Tujuan: Untuk mengetahui gambaran SDLR mahasiswa profesi ners.Metode: Penelitian ini merupakan penelitian descriptive-quantitative dengan rancangan cross sectional yang dilakukan di PSIK FK-KMK UGM. Pengambilan responden secara total sampling, responden sebanyak 102 mahasiswa profesi ners stase praktik keperawatan dasar dan manajemen keperawatan pada periode Agustus-Desember 2018. Instrumen yang digunakan adalah Self-Directed Learning Readiness Scale (SDLRS) yang terdiri atas 40 pertanyaan. Data penelitian dianalisis menggunakan analisis univariat.Hasil: Sebanyak 60,8% mahasiswa profesi ners pada pembelajaran e-learning ini memiliki nilai SDLR yang cenderung tinggi (Mean=152,75; SD=13,362; Min=121; Max=195). Rata-rata skala SDLR pada tiap sub-skala adalah 3,61 pada manajemen diri, 3,98 pada keinginan untuk belajar, dan 3,86 untuk kontrol diri.Simpulan: Tingkat SDL mahasiswa profesi ners menunjukkan kecenderungan tinggi pada pembelajaran e-learning.

Background: E-learning as a learning method with a flexible and interactive pedagogical approach has a positive impact on the value of self-confidence of nursing students. School of Nursing, Faculty of Medicine Public Health and Nursing Universitas Gadjah Mada (FMPHN UGM) develop e-learning for nursing students in clinical practice learning which requires an evaluation to e-learning implementation by describing the self-confidence of the nursing student after use e-learning. The purpose of this study was to describe self-confidence (SC) of the clinical nursing students based on 3 selfconfidence’s components that consist of cognitive, affective, and psychomotor.Methods: A Descriptive study with a cross-sectional design toward 95 clinical nursing students in the stage of nursing management and basic nursing practice in September 2018 period at the School of Nursing FMPHN UGM. Data analysis used the univariate analysis with descriptive statistic test to describe respondent characteristic and variable. Student Satisfaction and Self-Confidence in Learning Instrument by National League for Nursing (NLN) in 2005 was used in this study. The instrument was through cultural adaptation and modification first.Results: The self-confidence of nursing students as e-learning evaluation found that the majority of respondents (90,5%) had high levels of self-confidence. Components of self confidence, consist of cognitive, affective and psychomotor also showed that the majority of respondents were in the high category (84,2%; 88,4%; 66,3%).Conclusion: Clinical nursing students have high self-confidence after going through e-learning.

IntroductionPatients with cancer undergoing chemotherapy experience various physical and psychological problems and discomfort. Virtual reality (VR) can be used in technology-based non-pharmacological therapy that can serve as a potential distractor in the symptom management of patients with cancer undergoing chemotherapy. We propose a smartphone-based virtual reality relaxation (S-VR) technique as a complementary modality to provide comfort to patients with cancer, and we will evaluate its effect on patients with cancer undergoing chemotherapy.Methods and analysisWe will recruit 80 patients from the One Day Chemotherapy ‘Tulip’ Center of Dr. Sardjito General Hospital, Yogyakarta, Indonesia. This will be a two-arm parallel randomised controlled trial, with a 1:1 allocation and the primary outcome assessor blinded. This study will be divided into two groups: (1) an intervention group, with participants receiving 360° panoramic video content and music relaxation intervention through a VR device (head-mounted display) placed on their head during chemotherapy for ±10 min plus standard care and (2) a control group, with participants receiving guided imagery relaxation therapy in the form of a leaflet plus standard care. We will measure the outcomes after one chemotherapy cycle for each participant. The primary outcome is the effectiveness of the S-VR in improving the comfort of patients. The secondary outcome is the effect of the S-VR on the patients’ symptom management self-efficacy, pain, anxiety, blood pressure (systolic blood pressure and diastolic blood pressure) and pulse rate.Ethics and disseminationThis study was approved by the Medical and Health Research Ethics Committee of the Faculty of Medicine, Public Health and Nursing of Universitas Gadjah Mada—Dr. Sardjito General Hospital, Yogyakarta, Institutional Review Board (approval number: KE/FK/0301/EC/2023). Written informed consent will be obtained from all participants who enrol in the study. Dissemination will be conducted through peer-reviewed publications and conference presentations.Trial registration numberNCT05756465.