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"ABSTRAKPada era tahun 90 sampai saat ini terjadi pergeseran kebutuhan dari doctor oriented menjadi customer oriented. Dengan adanya pergeseran pada pelayanan kesehatan manajemen rumah sakit harus juga merubah menjadi pelayanan kesehatan yang berdasarkan customer oriented. Pelayanan jenis ini memerlukan partisipasi aktif seluruh karyawan sehingga mutlak diperlukan motivasi kerja yang erat hubungannya dengan kepuasan kerja karyawan.Masalah yang dihadapi dalam meningkatkan motivasi kerja karyawan antara lain sistem imbalan yang berdasarkan peraturan PNS dan adanya model pemberian insentif yang belum mengacu pada fairness.Penelitian dilaksanakan dengan pendekatan secara kualitatif dan kuantitatif dengan metoda deskriptif analitik dengan rancangan cross sectional. Didapatkan 110 sampel dari total populasi 439 karyawan. Data primer didapat dari angket dan wawancara mendalam, data sekunder dari bagian personalia. Pengolahan data dengan perangkat lunak SPSS versi 7.5 for windows dengan analisis Label silang dua variabel (chi square).Dari hasil penelitian didapatkan ketidakpuasan responden terhadap sistem imbalan yang dinyatakan oleh lebih dan separuh responden (65.5 %), begitu juga dengan faktor pekerjaan (57.3 %).Tidak terdapat hubungan bermakna antara karakteristik karyawan dengan faktor pekerjaan. Pada sistem imbalan terdapat hubungan bermakna antara karakteristik karyawan dengan aspek usia, lama bekerja, pekerjaan, pendidikan dan status perkawinan.Pihak manajemen perlu mengkaji kembali sistem imbalan termasuk premi bidan, perlu dirancang lagi uraian kerja, standar prosedur yang disesuaikan dengan beban kerja, memelihara hubungan antar karyawan / karyawan dengan atasan.Kepustakaan 32 ( 1973 - 1997 )

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ABSTRACT

Employee Satisfaction on Reward System and Job Factor at Budi Kemuliaan Maternity Hospital JakartaIn this globalization era there has been many changes in the health care delivery systems to improve the services quality of health services. The organization has to consider both are internal and external organizational factors. In this situation the organization have to consider the customer-oriented management and also to provide high quality of working life for their members. Essentially, the high quality of working life in the organization will be reflected through the high employee satisfaction to their job and low rate of employee turnover and absenteeism. Employee job satisfaction is important because satisfaction will directly influence motivation to perform well the work.

At the present time has it reward system and job design model nearly identical with the model of the government hospital. A report from the personnel department note that they observed some employee expressed their dissatisfaction with the existing condition. The management should pay attention seriously to this symptom due to its relation to the employee performance. For this reason, research of employee satisfaction should be conducted to evacuate employee altitude to the existing management system.

A cross sectional study was conducted with 110 samples from 439 population. A questioner was constructed to identify employee satisfaction with existing reward system and existing job factors. Beside an closed ended questioner an in-depth interview was also conducted to validate data gathered from the closed ended questioner. Statistical Package for Social Sciences version 7.5 for windows was utilized to process bi variate analysis.

The result of the study indicated 65,5 % of the employee dissatisfied with the existing reward system and 57,3 °/o dissatisfied also with job factors. Bivariate analysis indicated the significance difference between employee characteristics with the reward system, but indicated no significance difference between employee characteristics with the job factors.

Based on this study result, it is advices management has to restructure its reward systems especially its incentive for midwife and also to redesign the work load with the new standard operating procedure.

Bibliography 32 ( 1973 - 1997 )"

"ABSTRAK Kepuasan kerja dan Loyalitas Kerja merupakan salah satu elemen kunci pengelolaansumber daya manusia, maka penting bagi penulis menganalisis Kepuasan danLoyalitas kerja untuk melakukan perubahan cara kerja yang sesuai dengan nilai-nilaiKepuasan dan Loyalitas kerja guna meningkatkan kemampuan dan komitmen sesuaidengan tugas pokok dan fungsi pegawai.Berdasarkan latar belakang dan rumusan masalah yang ada penelitian ini bertujuanuntuk Menganalisis pengaruh Gaji, Tunjangan, dan Penghargaan terhadap KepuasanKerja, apakah berpengaruh secara sendiri-sendiri ataukah secara bersama-samamempengaruhi Kepuasan Kerja. Apakah Kepuasan Kerja berpengaruh terhadapLoyalitas Kerja.Penelitian ini termasuk penelitian analitik design cross sectional dimana populasinyaadalah Pegawai Negeri Sipil di Satuan Pol PP Kabupaten Pemalang. Dimana seluruhpersonel Pol PP kabupaten pemalang sebanyak 60 orang.Oleh karena populasi memiliki karakteristik tertentu maka penentuan sampeldilakukan dengan menggunakan teknik simple random sampling. Pengumpulan datadilakukan dengan menggunakan kuesioner. Pengukuran terhadap variabel-variabeldijabarkan dalam item-item pernyataan yang merujuk pada skala Likert, dengankisaran skor antara 1 – 5. Variabel dalam penelitian ini adalah variabel bebas: Gaji(X1), Tunjangan (X2), dan Penghargaan (X3). sedangkan variabel terikatnya adalahKepuasan Kerja (Ŷ) dan Loyalitas Kerja (Ŵ). Data dianalisis menggunakan analisisregresi linear berganda (multiple regresi).Hasil penelitian membuktikan bahwa besarnya pengaruh variabel bebas Gaji,Tunjangan dan Penghargaan terhadap Kepuasan Kerja adalah 0,528 atau 52,8% dannilai F hitung = 5.521 dengan tingkat signifikansi sebesar 0,002 (Sig p < 0,05) yangberarti Gaji, Tunjangan dan Penghargaan mempunyai pengaruh signifikan terhadapKepuasan Kerja. Pengaruh Variabel Kepuasan Kerja terhadap Loyalitas Kerja adalah0.759 atau 75.9% dan nilai F hitung = 10.973 dengan tingkat signifikansi sebesar0,002 (Sig p < 0,05) yang berarti Kepuasan Kerja mempunyai pengaruh signifikanterhadap Loyalitas Kerja.Sedangkan hasil penelitian besarnya pengaruh variabel bebas budaya kerjaterhadap komitmen hanya sebesar 0,044 atau 4,4% dan nilai F hitung = 0,893 dengan tingkat signifikansi sebesar 0,489 (p > 0,05) yang berarti budaya kerja tidakmempunyai pengaruh signifikan terhadap komitmen.

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ABSTRAK Job satisfaction and Job Loyalty is one of the key elements of human resourcemanagement, it is important for authors analyzed Satisfaction and Loyalty of work tomake changes to the way work is in accordance with the values of work satisfactionand loyalty in order to increase the capability and commitment in accordance with theduties and functions employees.Based on the background and the existing formulation of the problem, this study aimsto analyze the influence of Salary , Allowances , and Recognition on Job Satisfaction, affect whether individually or jointly affect job satisfaction . Is Job SatisfactionLoyalty affect the Work.This study includes a cross-sectional analytical study design where the population isthe Civil Service Police Unit PP Pemalang. Where the whole of all district personnelPol PP 60 people.Therefore, the population has a certain characteristic sampling done using simplerandom sampling technique. The data was collected using a questionnaire.Measurement of the variables described in the statement items that refer to a Likertscale, with a score range between 1-5. Variables in this study are independentvariables: Salary (X1), allowances (X2), and Awards (X3). While the dependentvariable is job satisfaction (Ŷ) and Loyalty Work (Ŵ). Data were analyzed usingmultiple linear regression analysis (multiple regression).The research proves that the influence of the independent variable Salary, Allowancesand Recognition on Job Satisfaction is 0.528 or 52.8 % and the calculated F value =5,521 with a significance level of 0.002 (Sig p < 0.05) which means the Salary,Allowances and Awards have significant influence on job satisfaction. VariablesInfluence Job Satisfaction to Loyalty Work is 0.759 or 75.9 % and the value of Fcount = 10 973 with a significance level of 0.002 (Sig p < 0.05) which means that jobsatisfaction has a significant influence on Loyalty Work.The research of the influence of free variables work culture to a commitment of only0,044, or 4.4 % and the calculated F value = 0.893 with a significance level of 0.489(p > 0.05), which means the work culture does not have a significant effect oncommitment ."

"PURPOSE: Laparoscopic fundoplication (LF) has become a standard operative procedure for GERD-related diseases in Japan, although meta-analyses have mainly evaluated findings from Western countries. The propensity score matching method was used to compare and investigate the treatment outcomes of two fundoplication procedures (the Nissen and Toupet methods).METHODS: Among 474 patients who underwent initial LF from December 1994 to April 2016, we extracted 401 cases (Nissen: 92 cases, Toupet: 309 cases), excluding 73 patients in whom follow-up was insufficient. We then matched 126 of these patients (63 per group).RESULTS: The esophageal acid reflux time (%) was 12.2:2.8, being higher in the Nissen group than in the Toupet group (p < 0.001). Regarding the surgical outcome, the amount of bleeding was higher in the Nissen group (p = 0.001), and the number of hospitalization days following surgery was longer (p = 0.003). Furthermore, a significantly rate of postoperative difficulty in swallowing (%) was observed in the Nissen group, at 13:0 (p = 0.004). The recurrence rate (%) was 8:3, with no difference between the two groups (p = 0.243).CONCLUSIONS: Although there was no marked difference in the recurrence rate between the two procedures, postoperative dysphagia was observed at a higher frequency with the Nissen method than the Toupet method."

"PURPOSE: To identify the possible roles of carcinoembryonic antigen (CEA) testing after liver resection for synchronous colorectal liver metastasis (CLM).METHODS: The subjects of this retrospective study were patients who underwent complete resection of primary tumors and synchronous CLM between 1997 and 2007 at 20 institutions in Japan. We studied the associations between perioperative CEA levels and the characteristics of recurrence.RESULTS: Recurrence was detected during the median follow-up time of 52 months in 445 (73.7%) of the total 604 patients analyzed. A postoperative CEA level >5 ng/ml was an independent predictor, with the highest hazard ratio (2.25, 95% confidence interval 1.29-3.91, P = 0.004). A postoperative CEA level >5 ng/ml had a specificity of 86.2% and a positive predictive value of 84.2% for recurrence. Patients with a high postoperative CEA level had a significantly higher recurrence rate, with a shorter time until recurrence and a higher frequency of multiple metastatic sites than those with a low postoperative CEA level. Among the patients with recurrence, 173 (52.7%) had an elevated CEA level (>5 ng/ml) when recurrence was detected.CONCLUSIONS: A postoperative CEA level >5 ng/ml was an independent predictor of recurrence; however, CEA testing was not a reliable surveillance tool to identity recurrence after liver resection."

"PURPOSES: The purpose of this study was to evaluate the influence of comorbidities on the surgical outcomes of early cholecystectomy for acute cholecystitis.METHODS: Data were retrospectively collected for patients with acute cholecystitis who underwent early cholecystectomy. Patients were separated into three groups based on the cholecystitis severity grade, and the surgical outcomes of early cholecystectomy were analyzed. Patients with mild and moderate cholecystitis were subdivided into a comorbidity group (n = 10) and a non-comorbidity group (n = 83).RESULTS: There were 57 (55.3%) patients with mild cholecystitis, 36 (35.0%) with moderate cholecystitis, and 10 (9.7%) with severe cholecystitis. The surgical outcomes were significantly worse for patients with severe cholecystitis than for patients with mild or moderate cholecystitis. There were no postoperative deaths after cholecystectomy. There were no significant differences in the complication rate (P = 0.629), conversion rate (P = 0.114), or intraoperative blood loss (P = 0.147) between the comorbidity and non-comorbidity groups.CONCLUSION: Our findings suggest that early cholecystectomy can be performed safely for patients with mild and moderate cholecystitis even if comorbidities are present. Early cholecystectomy may be an alternative treatment strategy for patients with severe cholecystitis who are candidates for anesthesia and surgery."

"PURPOSE: To clarify the risk factors for complications after diverting ileostomy closure in patients who have undergone rectal cancer surgery.METHODS: The study group comprised 240 patients who underwent a diverting ileostomy at the time of lower anterior resection or internal anal sphincter resection, in our department, between 2004 and 2015. Univariate and multivariate analyses of 18 variables were performed to establish which of these are risk factors for postoperative complications.RESULTS: The most common complications were intestinal obstruction and wound infection. Univariate analysis showed that an age of 72 years or older (p = 0.0028), an interval between surgery and closure of 6 months or longer (p = 0.0049), and an operation time of 145 min or longer (p = 0.0293) were significant risk factors for postoperative complications. Multivariate analysis showed that age (odds ratio, 3.4236; p = 0.0025), the interval between surgery and closure (odds ratio, 3.4780; p = 0.0039), and operation time (odds 2.5179; p = 0.0260) were independent risk factors.CONCLUSIONS: Age, interval between surgery and closure, and operation time were independent risk factors for postoperative complications after diverting ileostomy closure. Thus, temporary ileostomy closure should be performed within 6 months after surgery for rectal cancer."

"Purpose: The body mass index (BMI) before lung transplantation (LT) is a benchmark of the post-LT survival. The aim of the study is to determine the BMI inadequate for the post-LT survival.Methods: We examined the survival after LT in patients grouped into the following BMI categories: <18.5 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal weight), 25-29.9 kg/m2 (overweight), and ≥30.0 kg/m2 (obese) according to the World Health Organization (WHO) criteria. A more detailed categorization was made for further evaluation of the underweight group: mild (17.0 ≤ BMI < 18.5 kg/m2) and severely underweight (BMI <17.0 kg/m2).Results: There was no statistically significant difference in the post-LT survival between underweight and normal-weight patients (5-year survival: 78.7 vs. 76.1%). Patients with BMI <17.0 kg/m2 had a worse prognosis than those with 17.0 ≤ BMI < 18.5 kg/m2 (5-year survival: 70.3 vs. 90.0%).Conclusions: Standard BMI categorization per the WHO criteria is inadequate for determining the post-LT survival, especially in underweight patients. For the nutritional evaluation of underweight pre-LT patients, BMI <17.0 kg/m2 should be used instead of BMI <18.5 kg/m2."

"PURPOSE: A proposed etiopathogenesis of biliary atresia (BA) involves T-cell-mediated inflammatory bile duct damage and progressive hepatic fibrosis. Pediatric surgeons often observe swelling of the hepatic hilar lymph nodes during the Kasai procedure. Given the importance of regulatory mechanisms in immune responses, the present study was designed to analyze the quantitative changes of regulatory T cells (T reg cells) in the hepatic hilar lymph nodes (hepatic hilar LNs) and peripheral blood (PB) in BA.METHODS: The hepatic hilar LNs and PB obtained during the Kasai procedure were analyzed by flow cytometry. The ratios of total and active Tregs to the total CD4+ cells in the PB and the hepatic hilar LNs were compared.RESULTS: In patients with BA, the ratios of both the total and active T reg cells in the hepatic hilar LNs were higher than those in the PB (total T reg cells: PB vs. LN; P < 0.001; active T reg cells: PB vs. LN; P = 0.001). In BA patients, the increase in the ratio of active T reg cells to the CD4 + cells in the LNs in comparison to the PB was greater than that in control patients. The ratio observed in the BA patients was almost double the ratio observed in the control patients. The median LN/PB ratio in the BA patients was 3.1, while that in controls was 1.6 (P = 0.03).CONCLUSION: The present study showed that the ratios of both total T reg cells and active T reg cells were higher in the hepatic hilar lymph nodes of BA patients. This finding could shed light on the pathogenesis of BA."