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Fahri Gunawan

Pengaruh Intervensi Edukasi Kesehatan Terstruktur Terhadap Dukungan PMO Keluarga dan Kepatuhan Minum Obat Anti Tuberkulosis di Kabupaten Muaro Jambi = The Effect of Structured Health Education Interventions on Family PMO Support and Compliance with Taking Anti-Tuberculosis Medications in Muaro Jambi Regency

"Pendahuluan Penyaktit Tuberculosis (TBC) merupakan penyakit menular yang membutuhkan waktu pengobatan sampai 6 bulan. Dukungan PMO keluarga berperan penting dalam meningkatkan pengetahuan, tindakan pencegahan dan kepatuhan pasien. Salah satu metode yang telah terbukti memberikan efek positif adalah Intervensi edukasi kesehatan terstruktur. Tujuan Mengidentifikasi pengaruh intervensi edukasi kesehatan terstruktur terhadap dukungan PMO keluarga dan kepatuhan minum Obat anti Tuberkulosis (OAT) di Kabupaten Muaro Jambi. Metode Penelitian quasy eksperimen dengan pretest and posttest with control goup. Sampel 38 responden pada kelompok intervensi dan 38 pada kelompok kontrol. Analisa data menggunakan uji independent t-tes.dan Mann Whitney Hasil penelitian menunjukkan terdapat pengaruh edukasi kesehatan terstruktur terhadap dukungan PMO keluarga setelah diberikan intervensi dengan nilai p=0.001 .Terdapat pengaruh edukasi kesehatan terstruktur terhadap kepatuhan minum OAT setelah diberikan intervensi dengan nilai p=0.003. Kesimpulan : edukasi kesehatan terstruktur bertujuan untuk memberikan informasi kepada PMO keluarga akan meningkatkan pendidikan kesehatan, pada akhirnya akan mempengaruhi tindakan yang sehat dalam dukungan keluarga dan meningkatkan kepatuhan minum OAT pada pasien TBC.

Introduction Tuberculosis (TB) is an infectious disease that requires treatment for up to 6 months. Family PMO support plays an important role in increasing knowledge, preventive measures and patient compliance. One method that has been proven to have a positive effect is a structured health education intervention. Objectives To identify the effect of structured health education interventions on family PMO support and adherence to taking anti-tuberculosis drugs (OAT) in Muaro Jambi District. Quasy experimental research method with pretest and posttest with group control. A sample of 38 respondents in the intervention group and 38 in the control group. Data analysis using independent t-test. The results showed that there was an effect of structured health education on family PMO support after being given an intervention with a value of p=0.001. There was an effect of structured health education on adherence to taking OAT after being given an intervention with a value of p=0.003. Conclusion: structured health education aims to provide information to PMO families will improve health education, will ultimately affect healthy actions in family support and increase adherence to taking OAT in TB patients."

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2023

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UI - Tesis Membership Universitas Indonesia Library

Rini Hardiani Noorhizmah

Hubungan tingkat pengetahuan klien tuberkulosis dengan kepatuhan minum obat anti tuberkulosis di puskesmas Kecamatan Makasar, Jakarta Timur = Relationship between the tuberculosis clients knowledge level and anti tuberculosis drugs consumption adherence in the public health center of Makasar District East Jakarta

"Tuberkulosis (TB) merupakan masalah kegawatdaruratan global, World Health Organization melaporkan terdapat 8,6 juta kasus baru dan 1,3 juta kematian ditahun 2012. Saat ini, Indonesia merupakan negara peringkat kelima dengan beban TB terbesar. Penelitian ini bertujuan mengetahui hubungan tingkat pengetahuan klien TB dengan tingkat kepatuhan minum Obat Anti Tuberkulosis (OAT). Desain deskriptif korelasional dengan pendekatan penelitian cross sectional didapatkan 43 klien TB yang berobat di Puskesmas Kecamatan Makasar Jakarta Timur. Hasil penelitian menunjukkan responden memiliki pengetahuan tinggi (65.1%) dan responden yang patuh minum OAT (67.4%). Hasil uji chi square menunjukkan hubungan yang positif antara tingkat pengetahuan dengan kepatuhan minum OAT (p=0,033 α=0,05). Promosi kesehatan terkait TB masih perlu ditingkatkan dalam pelayanan keperawatan komunitas.

Tuberculosis (TB) is a global emergency problem. World Health Organization reported there were 8.6 million new cases and 1.3 million deaths in 2012. Currently, Indonesia is the fifth largest TB burden country. This study was conducted to determine the relationship of the level of knowledge of the TB clients with the level of Anti Tuberculosis Drugs (ATD) consumption adherence. Descriptive correlational design with cross-sectional research approach obtained 43 TB clients who had treatment in the public health center of Makasar District, East Jakarta. The results showed of the respondents had high knowledge (65.1%) and respondents adhere to drink ATD (65.7%). The results of the chi square test showed a significant association between the level of knowledge and the level of ATD consumption adherence (p = 0.033 α = 0.05). TB-related health promotion needs to be improved in the nursing community service. "

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2014

S55659

UI - Skripsi Membership Universitas Indonesia Library

Wahyuningsih

Analisis kinerja pengawas menelan obat (PMO) penderita tuberkulosis oleh tenaga kesehatan di Kabupaten Lampung Selatan tahun 2004

"Tuberkulosis adalah penyakit menular yang disebabkan oleh kuman Mycobacterium tuberkulosis, kuman TBC telah menginfeksi sepertiga penduduk dunia sehingga tahun 1993 WHO mencanangkan kedaruratan global penyakit tuberkulosis. Mulai tahun 1995, Indonesia telah menerapkan strategi DOTS (Directly Observerd Treatment Shortcourse) yang salah satu komponennya yaitu pengobatan dengan Obat Anti Tuberkulosis (OAT) jangka pendek dengan Pengawasan Menelan Obat (PMO). Hasil kegiatan program penanggulangan penyakit Tuberkulosis di Lampung Selatan tahun 2003 yaitu CDR sebesar 30,63%, konversi 79,8% dan Cure Rate 66%. Tetapi jika dibandingkan dengan hasil kegiatan program P2TB di Provinsi Lampung secara keseluruhan, angka cakupan penderita, angka konversi dan angka kesembuhan di Kabupaten Lampung Selatan masih lebih baik, dimana angka cakupan program P2TB di provinsi Lampung tahun 2003 yaitu angka penemuan kasus penderita TBC BTA+ sebanyak 15,5%, konversi 78% dan angka kesembuhan 57%.

Dalam rangka kegiatan program P2TB, terutama pengobatan penderita, salah satu diantaranya yaitu keberadaan Pengawas Menelan Obat agar penderita TBC tidak mangkir dalam pengobatan, didapatkannya konversi kesembuhan bagi penderaita TBC.

Penelitian hanya dibatasi tentang Analisis kinerja PMO penderita TBC oleh Nakes yang bertujuan untuk memperoleh informasi mengenai gambaran kinerja PMO penderita TBC oleh Nakes dan faktor-faktor yang berhubungan dengan kinerja PMO oleh Nakes di Kabupaten Lampung Selatan tahun 2004.

Penelitian dilakukan diseluruh puskesmas di wilayah Kabupaten Lampung Selatan pada bulan Mei-Juni 2004. Desain penelitian yaitu Cross Ceclional, populasi adalah sekaligus sampel penelitian yaitu PMO penderita tuberkulosis oleh Nakes di puskesmas di Lampung Selatan tahun 2004 yang mencakup sebanyak 98 orang.

Hasil penelitian menunjukkan gambaran kinerja PMO penderita tuberkulosis oleh Nakes di Kabupaten Lampung Selatan yaitu sebanyak 44,9% mempunyai kinerja baik dan 55,1% dengan kinerja kurang baik. Dari analisis hubungan antar variabel ditenmkan bahwa variabel yang mempunyai hubungan signifikan dengan kineja PMO oleh Nakes yaitu : urnur, jenis kelamin, motivasi dan beban kerja. Variabel yang tidak mempunyai hubungan signifikan dengan kinerja PMO oleh Nakes yaitu pendidikan, kepemimpinan dan pengetahuan. Variabel yang paling dominan berhubungan dengan kinerja PMO oleh Nakes adalah variabel umur yaitu semakin tua umur Nakes cenderung mempunyai kinerja baik.

Disarankan pemberian reward bagi PMO yang berprestasi dan pemberian dana insentif untuk pelacakan penderita TB mangkir, diperlukan pemberian dana stimulan dalam keterlibatan TOMA dan TOGA serta kader kesehatan dalam program P2TB terutama dalam kegiatan penjaringan. suspek penderita TBC dan keterlibatan mereka sebagai PMO penderita TBC. Kepada Dinas Kesehatan Provinsi Lampung dan Dinas Kesehatan Kabupaten Lampung Selatan hendaknya meningkatkan kerjasama Lintas Program dan Lintas Sektoral terkait dan diaktifkannya Tim GERDUNAS TB yang telah terbentuk. Perlu ditingkatkan Bimbingan Teknis program dan pelatihan kepemimpinan terhadap pimpinan puskesmas oleh Dinas Kesehatan. Kepada Departemen Kesehatan perlu terus dilaksanakan pelatihan terhadap tenaga dokter, paramedis dan analis puskesmas dalam program P2TB dalam rangka peningkatan penemuan penderita penyakit tuberkulbsis di masyarakat dalam rangka penunuian angka kesakitan dan kematian karena penyakit TBC di Indonesia.

Daftar bacaan : 45 ( 1984-2004)

Analyzing the Performance of Drug Taking Inspector (PMO) for Tuberculosis Patients Conducted by Health Personnel in Regency of South Lampung in the Year of 2004Tuberculosis is contagious disease caused by microorganism called Mycobacterium tuberculosis. Today, TBC has infected one-third of people all over the world, so that in 1993 WHO stated an emergency of Tuberculosis epidemic universally. Started in 1995, Indonesia has applied DOTS (Directly Observed Treatment Short Course) strategy that one of its components is medication using short-term anti tuberculosis drug (OAT) observed by Drug Taking controller (PMO). In the year of 2003, the program against Tuberculosis in Lampung had resulted in CDR of equal to 30,63%, conversion of 79,8%, and Cure Rate of 66%. If its compare this result with the result of P2TB program planned in Lampung as a whole, the coverage number of patients, conversion number, and healing number in the District of South Lampung is better, while the coverage number of Tuberculosis patients taken from P2TB program in Lampung, is about 15,5 % for TBC BTA + case, 78 % for conversion, and 57 % for healing number.
In order to conduct P2TB program, especially for medicating patients, one of them is the existence of Drug Taking controller (PMO). The purpose is to keep patients so that they do not stop the medication, further more is to have healing conversion for them.
The research that limited only in analyzing PMO performance for Tuberculosis Patients conducted by health personnel is to obtain information about PMO performance and the factors associated to PMO performance in District of South Lampung in 2004.
This research took places in all of Health Center (Puskesmas) in that District since May to July 2004. The design of this research is Cross Sectional, population, including sample that is 98 members of PMO for Tuberculosis patients in District of South Lampung in 2004.
This research shows that PMO performance for Tuberculosis patients in the Regency is 44,9 % of them has good performance and the rest 55,1 % has less performance. Correlation analysis found that variables having significant connection to PMO performance are: age, sex, motivation, and workload. while variables having no relationship to the performance is: education, leadership, and knowledge. Variable having largest connection to PMO performance is age.
We suggest that a reward should be given to PMO member who has good performance and incentive fund should be available for tracking absent patients, stimulant fund should be given for supporting the existence of TOMA and TOGA and health cadre involved in P2TB program, especially in catching new patient suffer from TBC and their involvement as a PMO for the patient. For Health Officials in Lampung and Health Official in South Lampung District, better cross-program and related cross-sectional cooperation should be implemented, GERDIJNAS team, which is formed before should be activated. Health Officials should develop technical guidance for the program and leadership training toward leaders in Health Center (Puskesmas). They also should carry out training for doctors, paramedics, Puskesmas workers about P2TB program in order to improve ability of finding new patient suffer from TBC among society to reduce morbidity and mortality caused by TBC disease in Indonesia.
Reference: 45 (1984-2004)"

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2004

T12786

UI - Tesis Membership Universitas Indonesia Library

Titi Sekarindah

Pengaruh pemberian Vitamin A terhadap profil imun pasien Tuberkulosis Paru dengan terapi obat anti Tuberkulosis = The effect of vitamin A supplementation on the immune profile of pulmonary Tb patient during oral anti tuberculosis treatment

"ABSTRAK

Ruang Lingkup dan Cara Penelitian : Penyakit tuberkulosis paru masih merupakan masalah di negara berkembang termasuk Indonesia. Tuberkulosis menduduki urutan ke 2 sebagai penyebab kematian menurut hasil survey nasional 1992. Dari kepustakaan diketahui bahwa pada penderita tuberkulosis didapati kelainan imunitas seluler, sehingga untuk penyembuhan penyakit tuberkulosis diperlukan pengaktifan sistem imun testa imunitas seluler. Vitamin A sudah lama dikenal sebagai imunomodulator. Dari penelitian terdahulu pemberian retinoid dapat meningkatkan respon imun seluler antara lain kenaikan sel T penolong dan T penolong/supresor. Pada penelitian ini diharapkan pemberian vitamin A sejumlah 2x 200000IU pada penderita TB paru dengan OAT dapat meningkatkan imunitas seluler. Tujuan penelitian ini adalah menilai pengaruh pemberian vitamin A pada penderita tuberkulosis paru yang sedang mendapat OAT terhadap jumlah limfosit total, limfosit T total, sub populasi limfosit T, kadar retinol plasma, dan keadaan klink penderita. Vitamin A 200.000 IU diberikan pada awal penelitian dan setelah 4 minggu. Penelitan dilakukan secara uji klinik tersamar ganda pada 40 penderita TB paru. Penderita dibagi dalam 2 kelompok masing-masing 20 orang yang diberi vitamin A dan placebo. Pada akhir penelitian yaitu setelah 8 minggu, ada 5 orang drop out.

Hasil dan kesimpulan : Dari 40 orang peserta penelitian 10% kadar retinol plasma rendah (<20pg/dl), 30%normal, rendah(20-30pg/d.l), 60% normal. Pada pemeriksaan imunitas seluler 53,85% ada gangguan dan 46,15% normal. Nilai rata rata hitung (X) retinal plasma kelompok placebo dan perlakuan sebelum pemberian vit. .A/placebo berturut-turut adalah 30,24 ± 7,51 µg/dl dan 30,82 ±7,31 µg/dl. Setelah pemberian adalah 36,85 ± 9,74 µg/dl dan 38,02 ± 8,29 µg/dl. Pada uji t berpasangan dari kelompok perbkkan kenaikannya bermakna (p

ABSTRACT
Scope and Method of Study : Pulmonary tuberculosis is still a major health problem in the developing countries including Indonesia. Tuberculosis is number 2 as cause of death (National Survey's data, 1992). According to literature study tuberculosis patients are suffering from an immune defect. To recover from the disease the immune response especially the cellular immune response needs to be activated, because mycobacterium TB are living intracellular. Vitamin A is known as an immunomodulator. From earlier research it is known that retinoid could enhance cellular immune response, ie. increasing T helper cells and the ratio Thelperffsupresor. The hypothesis is that supplementation of vitamin A 2x2000001U to pulmonary TB patients could increase the cellular immunity. The aim of this study was to asses the vitamin A supplementation on the immune?s profile of pulmonary TB patient who are on oral anti tuberculosis treatment. Plasma retinot, nutrients intake, BMI, clinical findings were examined. Vitamin A 200.000M was given twice, in the beginning of the study and after 4 weeks. The design of the study was a randomized double blind clinical trial. Forty patients were selected and divided into 2 groups, a placebo and treatment (vitamin A) group. At the end of the study (after the 8th week), 5 patients dropped out.
Findings and Conclusions : Among 40 patients 10% showed plasma ret noK20 p g/dl), 30% normal low (20-30pgldl) and 60% normal. (03011g041). The cellular immunity was 53,85% abnormal and 46,15% normal The means (X) of plasma retinol of the placebo and study group before supplementation were 30.24 ± 7,51 µg/dl and 30.82 ± 7.31µg/dl respectively; after supplementation 36.85±9.74µg/dl and 38.02 ± 8.29µgldl respectively. Statistical analysis using paired t test showed that the study group was increasing s' 0,05), however there was no Significant difference between the 2 groups. The mean (X) of total lymphocyte before supplementation of the placebo and study group were 22.61 ± 6.51% and 22.63 ± 8,62%; after supplementation 38.09 ± 19.91% and 35.20 + 10.71%. Both were increasing significant; however there was no significant difference between the 2 groups. The T lymphocyte, T helper and ratio Thelper CT supresor were decreasing. T helper more in the placebo group 5.75% 2.29% but there was no significant difference. This study concluded that although vitamin A supplementation 2 X 200.000 IU could increase the plasma retinol but could not yet improve the immune response and clinical status significantly."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 1996

T-Pdf

UI - Tesis Membership Universitas Indonesia Library

Lopulalan, Stevanie Hermine

Analisis pemberian intervensi pendidikan kesehatan terhadap kepatuhan penggunaan obat anti tuberkulosis di puskesmas kecamatan Cimanggis kota Depok = Provision analysis of health education interventions on adherence to anti tuberculosis drugs use at sub-district public health center of Cimanggis in Depok City

"Penyakit Tuberkulosis (TB) memerlukan penggunaan Obat Anti Tuberkulosis (OAT) minimal 6 bulan. Kepatuhan pasien dalam menggunakan OAT merupakan kunci keberhasilan terapi penyakit ini. Penelitian ini bertujuan membandingkan efek pemberian intervensi pendidikan kesehatan terhadap kepatuhan penggunaan OAT pada pasien TB di Puskesmas Kecamatan Cimanggis Kota Depok.

Pasien yang bersedia menjadi responden penelitian dibagi menjadi dua kelompok perlakuan. Kelompok satu terdiri dari 34 pasien yang menerima intervensi pendidikan kesehatan berupa leaflet. Kelompok dua terdiri dari 32 pasien yang menerima intervensi berupa kombinasi leaflet dan ceramah. Tingkat kepatuhan responden diukur menggunakan kuesioner Morisky scale sebelum dan sesudah pemberian intervensi.

Berdasarkan analisis hasil uji Wilcoxon, kelompok perlakuan satu tidak menunjukkan perubahan kepatuhan yang bermakna secara statistik (p=0,089) namun terlihat adanya arah peningkatan status kepatuhan (p=0,044). Sedangkan kelompok perlakuan dua menunjukkan arah peningkatan kepatuhan (p=0,002) penggunaan OAT yang bermakna (p=0,004). Kedua kelompok bersifat setara secara statistik jika tidak memperhitungkan keberagaman jenis kelamin dan pekerjaan responden.

Oleh karena itu, dapat disimpulkan pemberian intervensi kombinasi leaflet dan ceramah meningkatkan kepatuhan secara bermakna dan lebih baik dibandingkan intervensi leaflet terhadap kepatuhan penggunaan OAT pada pasien TB di Puskesmas Kecamatan Cimanggis Kota Depok. Berdasarkan analisis bivariat, karakteristik responden tidak mempengaruhi peningkatan kepatuhan kecuali tingkat pendidikan responden pada kelompok satu.

Tuberculosis (TB) requires the use of Anti Tuberculosis Drugs (ATD) for at least 6 months. Patients adherence to ATD treatment is the key to ensure this treatment success. This study aimed to compare the provision effect of health education interventions on adherence to ATD used in TB patients at sub-district health center of Cimanggis in Depok.
Patients who were would to be the respondent, were divided into two treatment groups. The first group consisted of 34 patients who received health education interventions in the form of leaflets. The second group consisted of 32 patients who received health education interventions in the combination form of leaflets and lectures. The respondent compliance status was measured by Morisky's guided interview questionnaires scale method before and after the intervention.
Based on the Wilcoxon test analysis, the first group's treatment showed no significantly increases on adherence to ATD used (p = 0.089). However, compliance changes seen increased (0.044). While the second group showed significantly (p = 0.004) increases on adherence to ATD used (p = 0.002). Both group is statistically equal if not take into account the diversity of respondent's gender and employment.
Thus, it can be concluded that the combination form of leaflets and lectures gives a better effect than the form of leaflets on increased adherence to ATD used in TB patients at Sub-district Public Health Center of Cimanggis in Depok. Based on the bivariate analysis, there is no association between the adherence increases and respondent's characteristic except for education background of the first group's respondent."

Depok: Fakultas Farmasi Universitas Indonesia, 2012

S42801

UI - Skripsi Open Universitas Indonesia Library

Ike Silviana

Hubungan lingkungan fisik dalam rumah dengan kejadian TB paru BTA (+) di Kabupaten Muaro Jambi tahun 2005 = Relation of physical environment of the house with the occurence of pulmonary TB in Muaro Jambi District, Province of Jambi 2005

"Latar belakang: Penyakit TB Paru adalah penyakit menular langsung yang disebabkan oleh Mycobacterium Tuberculosis. Lebih dari 90% kasus TB Paru ditemukan di negara berkembang. Di Indonesia penyakit TB Paru masih menjadi masalah utama kesehatan masyarakat. Di Kabupaten Muaro Jambi jumlah penderita TB Paru pada tahun 2003 adalah 61.84 per 100.000 meningkat menjadi 106.16 per 100.000 penduduk pada tahun 2004. Peranan faktor lingkungan fisik dalam rumah menentukan penyebaran penyakit TB Paru, sehingga dalam penanggulangan TB Paru yang komprehensif harus melibatkan faktor lingkungan fisik dalam rumah. Pada tahun 2004, cakupan rumah sehat di Kabupaten Muaro Jambi hanya 36.9%, hal ini di duga memperbesar timbulnya penularan TB Paru.

Tujuan: Penelitian ini untuk melihat hubungan lingkungan fisik dalam rumah dengan kejadian TB Paru BTA (+) di Kabupaten Muaro Jambi tahun 2005.

Metode: Desain studi kasus kontrol dengan 95 kasus yang diambil dari penderita TB Paru BTA (+) dari 18 Puskesmas di wilayah Kabupaten Muaro Jambi dan 95 kontrol yang diambil dari tetangga kasus dengan BTA (-).

Hasil: Analisis multivariat lingkungan fisik dalam rumah yang berhubungan dengan kejadian TB Paru BTA (+) adalah: kelembaban rumah <40% atau >70% (OR:4,87;95%CI:1,58-15,04),ventilasi kamar <10% (OR:3,83 ; 95%C1:1,23-11,93), pencahayaan rumah <60 Iuks (OR;2,47;95%CI:0,55-11,16), ventilasi dapur <10% (OR:2,21;95% CI:0,8-6,13), ventilasi rumah <10% (OR:2,2;95% CI:0,63-7,81), dan pencahayaan kamar <60 Iuks (OR:1,61;95% CI:0,37-7).

Saran: Kerjasama lintas sektaral dalam penataan desain dan konstruksi rumah sehat bila ada penataan ulang serta penyuluhan mengenai rumah sehat.

Background: Pulmonary TB, is an infective-contagious disease caused by Mycobacterium Tuberculosis. More than 90% of global pulmonary TB cases occur in the developing countries. TB remains an important public health problem in Indonesia. The occurrence of pulmonary TB in Muaro Jambi District in the year of 2003 is 61,84 per 100.000 population and increased to 106,16 per 100.000 population in 2004. Physical Environment condition of the house is one factor that playing important role in Pulmonary TB spreading, especially the coverage of healthy housing in Muaro Jambi District only 36,9% in 2004.
Objectives: to investigate the relation between physical environment of the house with occurrence of pulmonary TB in Muaro Jambi District.
Methods: This case-control study design used 95 cases and 95 controls. Those respondents had been taken from 18 Primary Health Centers in Muaro Jambi District.
Results: Based on multivariate analysis housing conditions that influenced the risk of pulmonary TB are : the level of humidity of the house less than 40% or more than 70% (OR:4,87;95%Cl: 1,58-15,04), bedroom ventilation less than 10% (OR;3,83;95% CI:1,23-11,93), house with low level of light exposure / less than 60 luks (OR:2,47;95%CI:0,55-11,16), kitchen ventilation less than 10% (OR:2,21;95%CI:0,8-6,13), house ventilation less than 10% (OR:2,2;95%C1:0,63-7,81), and bedroom with low level of light exposure/less than 60 luks (OR:1,61;95% CI: 0,37-7).
Suggestion: TB control program in Muaro Jambi District should coordinates with other departments to improve housing designs and give health promotion activities about healthy house."

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2006

T19113

UI - Tesis Membership Universitas Indonesia Library

I Gusti Ayu Putu Desy Rohana

Pengaruh edukasi kesehatan terstruktur terhadap pelaksanaan fungsi perawatan kesehatan dan perilaku pencegahan penularan TB paru pada keluarga di Kabupaten Bogor = The influence of structured health education toward the implementation of health care function and the prevention behavior of pulmonary tuberculosis transmission in family at Bogor Regency

"TB Paru dinyatakan sebagai kedaruratan global bagi kemanusiaan oleh WHO.Keluarga yang tinggal serumah dengan klien TB Paru merupakan population atrisk. Penelitian ini menggunakan desain kuasi eksperimen pretest and posttest withcontrol group, dan metode consecutive sampling. Intervensi edukasi kesehatanterstruktur meliputi pemberian materi TB Paru dan pencegahannya, fungsiperawatan kesehatan, dan penyusunan kegiatan harian yang diberikan selama 5minggu, dengan besaran sampel 62 responden.

Hasil penelitian menunjukkanbahwa karakteristik responden didominasi oleh perempuan 93,6, usia 18-40tahun 64,5, tingkat pendidikan dasar 61,3, penghasilan keluarga dibawahUMK Bogor 74,2, dan lama pengobatan >6 bulan 48,4. Penelitian inimembuktikan adanya peningkatan yang bermakna pada pelaksanaan fungsiperawatan kesehatan keluarga p value 0,00 dan perilaku pencegahan penularanTB Paru p value 0,00 pengetahuan, p value 0,01 sikap, dan p value 0,00keterampilan di kelompok intervensi. Edukasi kesehatan terstruktur terkait TBParu dapat menjadi alternatif pilihan intervensi keperawatan untuk keluarga dikomunitas.

Behavior of Pulmonary Tuberculosis Transmission in Family atBogor RegencyPulmonary TB is stated as global emergency for humanity by WHO. Families wholive at home with Pulmonary TB clients are population at risk. This study usedquasi experimental pretest and posttest with control group design, and consecutivesampling method. Structured health education interventions included thepresentation of materials on Pulmonary TB and its prevention, health care functionand daily activities preparations. Intervention was given for 5 weeks with samplesize 62 respondents.
The result of study showed that the characteristics ofrespondents were dominated by women 93.6, age 18 40 64.5, primaryeducation level 61.3, low family income UMK Bogor regency 74.2, andtreatment duration 6 months 48.4. This study proved significant increases inthe implementation of family health care functions p value 0.00 and the preventionbehavior of Pulmonary TB transmission p value 0,00 knowledge, p value 0,01attitude, and p value 0,00 skill in intervention group. Structured health educationrelated to Pulmonary TB could be an alternative choice of nursing intervention forfamilies in the community."

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2017

T-Pdf

UI - Tesis Membership Universitas Indonesia Library

Wirdani

Hubungan keberadaan Pengawas Menelan Obat (PMO) dengan keteraturan minum obat fase intensif penderita TB paru di Puskesmas Kabupaten Pandeglang tahun 2000 = The relationship between treatment observer with the regulate took medicine, intensive phase for lung tuberculosis sufferer in community health center, Pandeglang District, 2000

"Pemerintah telah menyediakan paduan obat yang efektif untuk membunuh kuman tuberkulosis dalam waktu yang relatif singkat, sekitar enam bulan secara cuma-cuma dengan penerapan Pengawas Menelan Obat (PMO) atau strategi Directly Observed Treatment Shortcourse (DOTS). Di Kabupaten Pandeglang penemuan kasus meningkat dari tahun 1999 sampai tahun 2000, namun angka konversi masih rendah dimana angka konversi tahun 1999 baru 48% dan tahun 2000 adalah 54,5%. Ketidakteraturan minum obat merupakan salah satu penyebab kegagalan program penanggulangan TB Paru.

Semenjak tahun 1995 Program Penanggulangan TB Paru strategi DOTS yang salah satu komponennya PMO di Kabupaten Pandeglang sudah diterapkan. Namun hubungan keberadaan PMO dengan keteraturan minum obat penderita TB Paru terutama fase intensif belum diketahui.

Penelitian ini bertujuan untuk melihat hubungan keberadaan PMO dengan keteraturan minum obat fase intensif penderita TB Paru di Puskesmas Kabupaten Pandeglang tahun 2000. Rancangan penelitian adalah kasus kontrol dengan perbandingan jumlah kasus dan kontrol 1 : 2. Jumlah sampel keseluruhan adalah 213 prang, yang terdiri dari 71 kasus dan 142 kontrol. Sampel adalah penderita TB Paru yang berumur 15 tahun atau lebih yang mendapat terapi strategi DOTS kategori 1 atau kategori 3 yang berobat ke puskesmas sejak 1 Januari 2000 sampai 31 Desember 2000 dan telah menyelesaikan pengobatan fase intensif.

Kasus adalah sampel yang tidak teratur minum obat dihitung dari tanggal mulai minum obat sampai tanggal selesai minum obat fase intensif dimana penderita minum obat kurang dari 60 hari atau lebih dari 70 hari termasuk penderita putus obat, sedangkan kontrol adalah sampel yang minum obat teratur selama 60 - 70 hari pada fase intensif.

Hasil penelitian, variabel yang berhubungan dengan keteraturan minum obat secara bermakna adalah keberadan PMO di mana penderita tanpa PMO berisiko tidak teratur minum obat 2,13 kali dibanding ada PMO, penderita yang merasakan efek samping obat berisiko 3,93 kali tidak teratur dibanding penderita tanpa efek samping, dan penderita tidak mengerti penyuluhan berisiko 4,27 kali tidak teratur dibanding penderita mengerti penyuluhan secara bersama-sama, sedangkan yang tidak bermakna adalah umur, jenis kelamin, pendidikan, jenis kategori obat dan frekuensi penyuluhan.

Disimpulkan bahwa tidak ada PMO (OR:2,13 ; 95%CI:1,00-4,53), ada efek samping obat (OR:3,93 ; 95%CI:2,00-6,82), dan tidak mengerti penyuluhan (OR:4,27 ;95%CI:2,05-8,93) bersama-sama berhubungan secara bermakna dengan ketidakteraturan minum obat (p<0,05) di Puskesmas Kabupaten Pandeglang tahun 2000.

Disarankan keberadaan PMO masih sangat diperlukan. Disamping itu perlu penyuluhan yang sederhana sesuai bahasa dan tingkat pendidikan penderita yang sebagian besar rendah agar bisa dimengerti serta perlu waktu khusus untuk konseling. Selain itu perlu penanganan yang serius terhadap efek samping yang dirasakan penderita untuk meningkatkan keteraturan minum obat penderita TB Paru.

The Relationship between Treatment Observer with the Regulate Took Medicine, Intensive Phase for Lung Tuberculosis Sufferer in Community Health Center, Pandeglang Distric, 2000The Government has provided the effective drug manual to kill bacteria of tuberculosis within a short time, nearly six months given to them free of charged by using application of Treatment Observer as Directly Observed Treatment Short course (DOTS) strategy. In Pandeglang district the case findings increased from 1999 to 2000, however, the conversion rate were still low, where the conversion rate in 1999 were just 48% and in 2000 were 54,5%. Irregular of drug swallow was as one of the failures of The Lung Tuberculosis Programs.
Since 1995 the program on overcame the Lung Tuberculosis used DOTS strategy which one of the components was Application of the Treatment Observer, it has been applied in Pandeglang District. However, the availability of it in giving the revision of obedience took the medicine for sufferers of Lung Tuberculosis especially to intensive phase have unknown yet.
The Objective of study knew the relationship between the availability of the Treatment Observer with regulate took the medicine for Lung Tuberculosis intensive phase in Community Health Center, Pandeglang District in 2000. The Design of study is case-control with the comparison that the cases amount and control 1:2. Total sample were 213, which total cases 71 and total control 142. The sample were the Lung Tuberculosis sufferers whose 15 years old or greater that obtained the therapy DOTS strategy, category one or three that took treatment to Community Health Center since January 1st - December 31st, 2000 and finished the treatment of intensive phase. Case was the sample who irregular took medicine, it calculated from the date of starting took the medicine from 60 days or more than 70 days, it was including the dropped out sufferer, while the control was the sample who took medicine regularly during 60-70 days on intensive phase.
The result of this research, the variable that related to regulate in taking medicine significantly were the availability of treatment observer which wasn't the treatment observer have 2.13 times risk for irregular took medicine than was the treatment observer, side effect of medicine which was side effect of the drug have 3.93 times risk for irregular took medicine than wasn't side effect of the drug, and illumination which didn't know the illumination have 4.27 times risk for irregular took medicine than knew the illumination, while that insignificantly were age, sex, education, kind of drug category and the frequency of illumination.
The conclusion, that there wasn't the treatment observer (OR:2.13 ; 95%CI: 1.00-4.53), there was side effect of the drug (OR:3.93 ; 95%CI: 2.00-6.82), and didn't know the illumination (OR:4.27 ; 95%CI:2.05-8.93). They were together connecting significantly to irregular took the medicine (P<0.05) in Community Health Center, Pandeglang District, 2000.
Considering, it's suggested that the availability of treatment observer is still needed. It also needs simply illumination that appropriates to language and education level of the sufferers who mostly lower education can easily understand the message. Besides those mentioned above, it needed management seriously to the side effect that felt by the sufferers to increase there regulate to take the medicine."

Jakarta: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2001

T10009

UI - Tesis Membership Universitas Indonesia Library

Aisyah

Hubungan persepsi, pengetahuan TB paru , dan PMO dengan kepatuhan berobat pasien tb paru di Puskesmas Kecamatan Jatinegara Jakarta Timur tahun 2001 = Relationship between perception, lung tuberculosis knowledge, PMO, and lung tuberculosis patient`s medication compliance in Puskesmas Kecamatan Jatinegara, East Jakarta of 2001

"Penyakit tuberkulosis di Indonesia masih menjadi masalah kesehatan masyarakat. Pemerintah memperkirakan saat ini setiap tahun terjadi 583.000 kasus bare dengan kematian 140.000 orang. Untuk mengatasi hal tersebut pemerintah telah melaksanakan program penanggulangan TB dengan strategi DOTS (Directly Observed Treatment, Shortcourse) sejak tahun 1995.

Untuk mengetahui keberhasilan program DOTS, menggunakan indikator atau tolok ukur angka konversi pada akhir pengobatan tahap intensif minimal 80%, angka kesembuhan minimal 85% dari kasus baru BTA positif, Di Puskesmas Kecamatan Jatinegara, angka kesembuhan tahun 2001 baru mencapai 80% dan angka konversi sebesar 90,65%. Angka kesembuhan tersebut sangat berkaitan dengan kepatuhan berobat penderita TB paru bersangkutan. Oleh karena itu secara umum tujuan penelitian ini adalah untuk memperoleh informasi tentang hubungan persepsi , pengetahuan penderita, dan Pengawas Menelan Obat dengan kepatuhanberobat penderita TB paru di Puskesmas Kecamatan Jatinagara tahun 2001.

Penelitian ini menggunakan desain cross sectional dengan memanfaatkan data primer dan sekunder. Penulis melakukan pengumpulan data dengan wawancara berpedoman pada kuesioner pada tanggal 29 Maret 2002 sampai 8 Mei 2002 dad seluruh penderita TB paru BTA positif sebanyak 92 orang yang mendapat pengobatan kategori-1 dan telah selesai berobat di Puskesmas tersebut tahun 2001. Variabel dependen adalah kepatuhan berobat, dan variabel independen adalah persepsi kerentanan, persepsi keseriusan, persepsi manfaat minus rintangan , persepsi ancamanlbahaya, pengetahuan dan pengawas menelan obat. Sedangkan variabel confounding terdiri dari umur, jenis kelamin, pendidikan dan pekerjaan. Untuk pengolahan data, penulis menggunakan analisis univariat, bivariat dan multivariat dengan regresi logistik Banda.

Hasil penelitian menunjukkan bahwa responden yang patuh berobat 73,9 % dan tidak patuh berobat 26,1%_ Dui basil analisis bivariat didapatkan variabel yang mempunyai hubungan bermakna dengan kepatuhan berobat adalah variabel persepsi kerentanan P value=4.045 dan OR=0,314 , persepsi keseriusan P value 0,034 dan OR=3,26 , persepsi manfaat minus rintangan P value-0,023 dan OR=3,70 , persepsi ancamanl bahaya P value~,030 dan OR=0,310 dan pengawas menelan obat P value-0,008 dan OR=0,171. Sedangkan basil analisis multivariat mendapatkan tiga variabel yang berhubungan dengan kepatuhan berobat yaitu keseriusan P value=0,013 dan OR=6,221, manfaat minus rintangan P value 0,019 dan OR=5,814 , dan pengawas menelan obat P value= 0,024 dan OR ,174. Namun yang paling dominan diantara ketiga variabel tersebut adalah variabel keseriusan P value-0,013 dan OR-6,221.

Peneliti menyarankan kepada pengelola program penanggulangan TB pare di Puskesmas untuk memberikan informasi yang cukup dan lebih jelas lagi tentang TB pare kepada setiap penderita dengan menggunakan bahasa sederhana agar penderita mudah memahami dan melaksanakannya. Sebaiknya di ruang tunggu Puskesmas diadakan penyuluhan TB paru melalui TV dan poster. Meningkatkan pecan PMO melalui penyuluhan dan pertemuan yang efektif dengan kader kesehatan , TOMA dan terutama dengan PMO dari keluarga. Mensosialisasikan Pedoman Umum Promosi Penanggulangan TB yang dikeluarkan oleh Direktorat Jenderal Pemberantasan Penyakit Menular dan Penyehatan Lingkungan Tahun 2000 .

Tuberculosis remains to become a large public health problem in Indonesia. This time the government estimates that there are 583.000 new cases of tuberculosis and up to 140.000 persons die from tuberculosis annualy. Solving this problem the government has carried out the program to fight against tuberculosis by DOTS (Directly Observed Treatment Short course) strategy since 1995.
To know the success of DOTS program we use indicator or yard stick i.e. conversion rate at the end of intensive medication stage is minimal 80% and cure rate is minimal 85% of acid-fast bacilli positive new cases. In Puskesmas Kecamatan Jatinegara in 2001, the cure rate achieved 80% and the conversion rate was 90,65%. The cure rate is closely related to medication compliance of those lung tuberculosis patients. Therefore in general, the aim of this study is to obtain information about the relationship between perception, patient's knowledge , PMO (Drug Swallowing Observer), and medication compliance of lung tuberculosis patients in Puskesmas Kecamatan Jatinegara, year of 2001.
This study used cross sectional design employing both primary and secondary data. The writer collected data based on interview with questionnaires on 29 March 2002 to 8 May 2002 from all smear-positive lung tuberculosis patients as much as 92 persons who have received category-1 therapy and have completed the medication in the Puskesmas in the year 2001. The dependent variable is the medication compliance, and the independent variables are the perceived susceptability, perceived seriousness, perceived benefits minus barriers, perceived threat, knowledge of TB, and PMO. Whereas the confounding variables consist of age, gender, education and job. Processing the data the writer used univariate, bivariate analysis and multivariate analysis with multiple regression logistic.
The result of this study showed that respondents who complied with medication was 73,9% and those who uncomplied with medication was 26,1%. From the result of bivariate analysis found variables which had significant relationship to medication compliance. Those variables were perception of susceptability P value=4,045 and OR=0,314 , perception of seriousness P value= 0,034 and OR=3,26 , perception of benefits minus barriers P value 0,023 and ORO,370 , perception of threat P value x,030 and OR=0,310 ,and PMO P value-3,008 and OR=0,171. Whereas the result of multivariate analysis found three variables which had significant relationship to medication compliance i.e. persception of seriousness P value=0,013 and OR=6.221, benefits minus barriers P value-A019 and OR=5,814 , and PMO Pvalue=0,024 and OR=0,174. Nevertheless the most dominant amongst those three variables was perception of seriousness P value 0,013 and OR=6,221.
The writer suggests the management of the program to fight against lung tuberculosis in Puskesmas to give adequate and clearer information about lung tuberculosis to each patients using simple and plain language in order the patients to understand and practice it easily_ It is best that Puskesmas carries out lung tuberculosis counseling by TV and poster in the waiting room. To increase the role of PMO by the way of effective counseling and meeting with health cadres or volunteers , TOMA (public vigors) and especially with PMO who comes from family. Socialization of Pedoman Umum Promosi Penanggulangan TB published by Direktorat Jenderal Pemberantasan Penyakit Menular dan Penyehatan Linglcungan year of 2000.
BibIiograhy : 41 (1965 - 2001)"

Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia, 2003

T620

UI - Tesis Membership Universitas Indonesia Library

Anance Kotouki

Gambaran perilaku penderita dan resiko tuberkulosis dengan kepatuhan minum obat dan kebiasaan membuang dahak di wilayah Puskesmas Ciomas Kabupaten Bogor Propinsi Jawa Barat tahun 2012 = Description behavior of patient and the risk of tuberculosis with adherence drinking drug and habits throw phlem in the regional health center Ciomas Regency Bogor of West Java Province in 2012

"Tuberkulosis paru adalah penyakit infeksi paru-paru yang mengakibatkan kematian. Data dari WHO tahun 2006 kasus tuberkulosis di Indonesia setiap tahun bertambah 25% dan sekitar 140.000 jiwa terjadi kematian. Prevalensi Tuberkulosis nasional adalah 725/ 100.000 penduduk/tahun. Propinsi Jawa Barat yaitu 937/100.000 penduduk/ tahun. (Riskesdas, 2010). Temuan kasus TB paru BTA positif di puskesmas Ciomas (110/ 100.000 penduduk/ tahun) di atas temuan kasus TBC paru BTA positif oleh Kabupaten Bogor 107/ 100.000 penduduk/ tahun. Sehingga peneliti ingin meneliti tentang ?Gambaran Perilaku Penderita dan Resiko Tuberkulosis BTA Positf Dengan Kepatuhan Minum Obat dan Kebiasaan Membuang Dahak di Wilayah Puskesmas Ciomas?.

Penelitian kuantitatif deskriptif, menggunakan kuesioner, analisis deskriptif univariat. Lebih dari separuh responden penderita tuberkulosis di puskesmas Ciomas kabupaten Bogor berumur ≥45 tahun 57,7%. Lebih dari separuh berjenis kelamin laki-laki 60,6%. Hampir separuh ibu rumah tangga 31,0%. Sebagian besar pada tingkat pendidikan rendah 78,9%. Sebagian besar tidak mendapat imunisasi 77,5%. Hampir separuh tidak tahu penatalaksanaan minum obat 29,6%. Setengah dari separuh tidak tahu dahak dapat menular 23,9%. Setengah dari separuh tidak patuh minum obat 25,4%. Lebih dari sepruh buang dahak sembarang 52,1%.

Pulmonary tuberculosis is a disease of the lung infection that resulted in death. Data from the 2006 WHO TB cases each year in Indonesia increased 25% and death occurred about 140,000 souls. Data Riskesdaskes the 2010 national TBC prevalence is 725 / 100,000 population / year. West Java province is 937 / 100,000 population / year. Data discovery of smear positive pulmonary TB cases in health centers is still above Ciomas (110/100 000 population / year) while the data is the discovery of smear-positive pulmonary tuberculosis cases by the Bogor District 107/100 000 population / year. Therefore, researchers wanted to explore more about " Description Behavior of Patient and the Risk of Tuberculosis With Adherence Drinking Drug and Habits Throw Phlem in the Regional Health Center Ciomas Regency Bogor of Province West Java In 2012?.
Knowledgeable illustration purposes the behavior of respondents and the risk of tuberculosis with drug compliance and dispose of sputum in patients with pulmonary tuberculosis AFB (+) at the health center Ciomas Bogor regency of West Java province in 2012. This type of research is descriptive quantitative research. Data collection using questionnaires. Data analysis using descriptive univariate Analysis. Some respondents tuberculosis clinic in the region of Bogor district Ciomas ≥ 45 years old 57.7%. Some of the male sex 60.6%. Some of the work of the housewife has 31.0%. Most of the low educational level 78.9%. Most are not immunized 77.5%. Some do not know the medication management of 29.6%. Some do not know can infection sputum 23,9%. Some do not take medication adherence 25.4%. Most of any sputum mebuang 52.1%."

Depok: Universitas Indonesia, 2012

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