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"Indonesia menjadi darurat kejahatan seksual anak dalam 4 tahun terakhir. Jumlah kasus setiap tahunnya menunjukan peningkatan dengan tren semakin dini usia korban yang meninggal akibat kejahatan seksual bayi dan balita (KPAI,2014). Tujuan penelitian ini adalah mengembangkan model intervensi pendidikan kesehatan bagi ibu balita melalui kader posyandu dalam pencegahan kekerasan seksual balita. Desain penelitian ini eksperimen semu dengan 3 kelompok yatu intervensi model individu, intervensi model kelompok dan kelompok kontrol. Penelitian dilaksanakan di 3 Kecamatan Kota Bogor yaitu Kecamatan Bogor Utara dan Bogor Timur sebagai wilayah intervensi dan Kecamatan Bogor Tengah sebagai kontrol. Penelitian dibagi menjadi dua tahap yaitu pengembangan media 6 bulan dan intervensi 6 bulan. Pengukuran terhadap pengetahuan, sikap dan praktik ibu balita diukur sebanyak 4 kali yaitu sebelum intervensi dan 3 kali setelah intervensi selama 4 bulan. Hasil penelitian menunjukan bahwa intervensi pendidikan kesehatan pencegahan kekerasan seksual anak di posyandu dapat meningkatkan pengetahuan, sikap dan praktik kader dan ibu balita baik dengan model pendidikan individu maupun kelompok. Metode pendidikan individu terbukti meningkatkan pengetahuan, sikap dan praktik ibu balita lebih tinggi di bandingkan metode kelompok pada bulan pertama intervensi. Media buklet merupakan media yang paling mudah dipahami dan paling sering dimanfaatkan ibu balita dibandingkan media poster dan lembar balik. Model intervensi ini diharapkan dapat diaplikasikan dalam program Kementrian Kesehatan dan Kementrian Pemberdayaan Perempuan dan anak serta Komisi Perlindungan Anak dalam koordianasi upaya pencegahan, pelaporan dan pengobatan korban.

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Sexual abuse among children in Indonesia is worrying within the last 4 years where the number of cases increased each year. In addition, its trend increasingly occurred among early ages (KPAI,2014). This study aimed to develop the intervention model of health behavior for mothers with children under five (CU5) through Posyandu cadre in preventing child sexual abuse. The study design used quasy-experiment among three group; group of individual intervention model, group intervention model, and control group. The study was conducted in three different sub-districts in Bogor City ; North Bogor and East Bogor as intervention group, and Central Bogor as control group; and consisted of two phases; media development and intervention in 12 months. Knowledge, attitude, and practice (KAP) of mothers with CU5 were measured 4 times before the intervention and 3 times after the intervention within four months. The result showed that the intervention of sexual child abuse education in Posyandu cadre escalated KAP in both group and individual intervention as well. The individual intervention increased KAP higher than group intervention. Booklet was more understandable and commonly used ineducating than poster or flipchart. This study expects the model is possibly implemented as a formal program of Ministry of Health, Ministry of women and children empowerment and Child Protection Commisionare in preventing, reporting and recovering child sexual abuse."

"Angka bunuh diri di Indonesia jauh lebih rendah dibandingkan dengan negara lain, sehingga upaya kesehatan yang tepat untuk dilakukan adalah upaya promotif dan preventif bunuh diri yang dimulai dari usia remaja. Tujuan penelitian diketahuinya efektiftas model sistem pencegahan risiko bunuh diri pada remaja awal dalam konteks keluarga. Penelitian terdiri dari eksplorasi pengetahuan remaja awal, keluarga, guru, dan tenaga kesehatan tentang bunuh diri pada remaja awal, desain penelitian kualitatif deskriptif, partisipan dua puluh enam orang. Penyusunan model dan ujicoba efektifitas model dengan desain penelitian quasi eksperimen with control group. Responden 155 remaja awal dan 155 orang tua remaja awal, dipilih secara acak di wilayah DKI Jakarta. Hasil penelitian eksplorasi menghasilkan tema faktor risiko internal, faktor risiko eksternal, keyakinan religius, kebutuhan sistem pendukung, risiko bunuh diri pada remaja awal, tanda dan gejala sebagai respon primer terhadap stresor penyebab risiko bunuh diri, dan cara mencegah risiko bunuh diri. Model yang dihasilkan adalah model sistem pencegahan risiko bunuh diri yang menggabungkan edukasi pencegahan risiko bunuh diri, terapi kelompok terapeutik, terapi thought stopping, dan terapi kognitif. Prevalensi risiko ide bunuh diri remaja awal yang diperoleh adalah 29%. Model efektif menurunkan risiko ide bunuh diri dan meningkatkan kemampuan remaja dalam mencegah risiko bunuh diri.

 

Kata kunci : model pencegahan risiko bunuh diri; remaja awal; risiko bunuh diri; gabungan terapi keperawatan jiwa

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Indonesia's suicide rate is still considerably lower than other nations, suicide prevention and promotion programs should be conducted commencing from adolescence. The study purpose was to examine the effectivity of the suicide prevention model in early adolescents. The first study used a descriptive qualitative research design to explore understanding regarding adolescent suicide behavior. Twenty-six participants were reqruited. The second study was the development of a model. A quasi-experimental research design with a control group was used to assess the effectiveness of the suicide prevention strategy in early adolescent. 155 early adolescents and 155 adolescent parents that were randomly selected from DKI Jakarta. The study's findings theme, internal risk factors, external risk factors, religious beliefs, support system necessitates, early adolescent suicide risk, signs and symptoms as primary responses to stressors that caused suicide risk, and strategies for reducing early adolescent suicide risk.  The final result is a suicide risk reduction program model for early adolescence that integrates suicide prevention education with therapeutic group therapy, thought stopping therapy, and cognitive therapy. 29 percent of early adolescents reported having suicidal thoughts. The model is effective in reducing the risk of suicidal thoughts and improving adolescents' capabilities to reduce the risk of suicide.

 

Keywords: combination mental health nursing therapy; early adolescence; suicide risk; suicide risk prevention system model

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"Kesehatan psikologis seorang ibu berdampak positif terhadap ikatan emosional ibu dan janin dalam mencapai peran transisi menjadi seorang ibu. Masalah kesehatan psikologis ibu serta kurangnya dukungan suami merupakan faktor utama terganggunya interaksi ibu dan janin. Penelitian ini bertujuan menghasilkan intervensi keperawatan untuk meningkatkan ikatan emosional orang tua dan janin berbasis mobile health yang berpengaruh terhadap kesehatan psikologis, keharmonisan suami istri serta jalinan kasih orang tua dan janin. Penelitian terdiri dari tiga tahap. Desain penelitian tahap pertama descriptive qualitative dengan 14 partisipan yang terdiri dari ibu hamil dan pasangannya. Tahap kedua, mengembangkan rancangan intervensi menjalin ikatan emosional dengan janin  berbasis mobile health berdasarkan analisis tahap satu dan konsultasi pakar. Tahap ketiga menggunakan desain quasi experiment pre-post test with control group. Sebanyak 82 pasang ibu hamil sebagai responden, terdiri dari kelompok berpasangan (26 pasang), kelompok mandiri (27 pasang) dan kelompok kontrol (29 pasang). Kelompok berpasangan: mendapatkan intervensi bersama pasangan, kelompok mandiri: mendapatkan intervensi sendiri tanpa pasangan, kelompok kontrol: melakukan kegiatan sesuai kebiasaan sehari-hari. Hasil penelitian kualitatif ditemukan 3 tema yaitu 1) Keterbatasan pengetahuan dan informasi dalam  menjalin ikatan emosional dengan janin, 2) Memperoleh dukungan internal dan eksternal dalam menjalin ikatan emosional dengan janin dan 3) Menjalin ikatan emosional dengan janin membutuhkan berbagai kebutuhan. Intervensi keperawatan untuk meningkatkan ikatan emosional orangtua dan janin berbasis mobile health berpengaruh menjadi lebih baik kesehatan psikologis ibu dan ayah, keharmonisan suami istri menurut ibu dan ayah, serta jalinan kasih orang tua dan janin dibanding kelompok kontrol. Nilai perbaikan kesehatan psikologis ibu kelompok berpasangan dan mandiri (β = -2.68, p < 0.001 ;I² = -3.03, p < 0.001), keharmonisan suami istri menurut ibu kelompok berpasangan dan mandiri (β = -7.46, p = 0.002 ; I² = -9.11, p = 0.001) dan jalinan kasih orang tua dan janin kelompok berpasangan dan mandiri (I² = 6.77, p = 0.013 ; I² = 9.73, p < 0.001). Nilai perbaikan kesehatan psikologis ayah kelompok berpasangan dan mandiri (I² = -5.80, p < 0.001 ; I² = -3.95, p < 0.001), keharmonisan hubungan suami istri menurut ayah kelompok berpasangan dan mandiri (I² = -7.04, p < 0.001 ; β = -3.74, p = 0.024). Disimpulkan bahwa ibu kelompok mandiri lebih besar nilai perbaikan variabelnya dibanding kelompok berpasangan, sebaliknya pada kelompok ayah. Merekomendasikan intervensi keperawatan MIESRA berbasis mobile health dapat digunakan untuk meningkatkan kesehatan psikologis, keharmonisan suami istri serta jalinan kasih orang tua dan janin di tatanan layanan kesehatan

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The psychological health of a mother has a positive impact on the emotional bond of the pregnant mother and her baby in achieving the transitional role of being a mother. Psychological health problems of the mother and the lack of husband's support are the main factors that interfere with the interaction of the mother and baby. This study aimed to create nursing interventions to increase the emotional bond of parents and babies based on mobile health that could affect psychological health, the harmonious relationship of husbands and wives and the love relationship between parents and babies. The research consisted of three stages. The first phase of the research design was descriptive qualitative with 14 participants consisting of pregnant women and their partners. The second stage was to develop an intervention to build an emotional bond with the babies using mobile health application based on stage one analysis and expert consultation. The third stage used a quasi-experimental pre and post-test design with a control group. Eighty two pairs participated as respondents, consisting of the paired group (26 pairs), the independent group (27 pairs) and the control group (29 pairs). The paired group received intervention with their partner, the independent group received intervention alone without a partner, and the control group performed daily activities as usual. The results of the qualitative research found 3 themes, namely 1) Limited knowledge and information in establishing an emotional bond with the babies, 2) Obtaining internal and external support in establishing an emotional bond with the babies and 3) Establishing an emotional bond with the babies requires various needs. Interventions for establishing emotional bonds between parents and babies using mobile health application have an effect on better psychological health of mothers and fathers, harmonious relationship between husband and wife according to mothers and fathers, and the relationship between parents and babies compared to the control group. The value of psychological health improvement for paired and independent mothers (I² = -2.68, p < 0.001 ; = -3.03, p < 0.001), harmonious marital relationship according to paired and independent group mothers (I² = -7.46, p = 0.002 ; = -9.11, p = 0.001) and the relationship between parents and babies in paired and independent groups (I² = 6.77, p = 0.013 ; = 9.73, p < 0.001). The psychological health improvement value of fathers in the paired and independent group (I² = -5.80, p < 0.001 ; = -3.95, p < 0.001) and the harmonious marital relationships according to the fathers of the paired and independent group (I² = -7.04, p < 0.001 ; = -3.74, p = 0.024). It was concluded that the independent group mothers had a higher improvement value for the variable than the paired group, on the contrary in the father group. It is recommended that mobile health-based MIESRA nursing interventions can be used to improve psychological health, marital harmonious relationship and the love of parents and babies in health care settings."

"Remaja mengalami gangguan mental emosional sebanyak 4.3%, namun pelayanan kesehatan jiwa disekolah belum menjadi prioritas. Penelitian ini bertujuan untuk mengetahui efektifitas model promotif dan preventif dalam meningkatkan kesehatan jiwa pada remaja. Penelitian ini menggunakan desain operational research yang terdiri dari 3 tahapan yaitu tahap pertama studi kuantitatif dan kualitatif, tahap kedua pengembangan model, dan tahap ketiga studi kuantitatif quasy experiment pre-post test with control group pada remaja SMP. Hasil penelitian menunjukkan bahwa sebagian besar remaja memiliki kesejahteraan emosi, psikis dan sosial yang tinggi, namun 53.20% memiliki gejala prodromal. Remaja memiliki faktor risiko (masalah teman sebaya dan masalah berasal dari dalam diri), faktor protektif (remaja berupaya mengatasi masalah dengan kemampuan diri dan dukungan keluarga dalam perkembangan remaja), dan upaya pelayanan kesehatan jiwa remaja (guru memahami kebutuhan remaja dan puskesmas memberi edukasi, memantau dan menerima rujukan). Intervensi model P2KJ, kemampuan prososial, masalah emosi berpengaruh terhadap kesehatan jiwa remaja. Rekomendasi penggunaan model P2KJ untuk peningkatan kesehatan jiwa remaja dengan melaksanakan usaha kesehatan jiwa sekolah (UKJS). Pelibatan perawat sekolah, guru, orang tua diperlukan sehingga membentuk sistem dukungan yang baik secara berkelanjutan dalam menjaga kondisi kesehatan fisik, psikis dan sosial remaja disekolah.

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Adolescents experience mental emotional disorders as much as 4.3%, but mental health services in schools have not become a priority. This study aims to determine the effectiveness of promotive and preventive models in improving mental health in adolescents. This study uses an operational research design which consists of 3 stages, namely the first stage of quantitative and qualitative studies, the second stage of model development, and the third stage of a quantitative study of quasi experiment pre-post test with control group in junior high school adolescents. The results showed that most of the adolescents had high emotional, psychological and social well-being, but 53.20% had prodromal symptoms. Adolescents have risk factors (peer problems and problems that come from within), protective factors (adolescents try to overcome problems with their own abilities and family support in adolescent development), and efforts to provide adolescent mental health services (teachers understand the needs of adolescents and health centers provide education, monitor and receive referrals). The P2KJ model intervention, prosocial abilities, emotional problems affect adolescent mental health. Recommendations for using the P2KJ model to improve adolescent mental health by implementing school mental health efforts (UKJS). The involvement of school nurses, teachers, parents is needed so as to form a good support system on an ongoing basis in maintaining the physical, psychological and social health of adolescents at school."

"Gangguan sendi temporomandibula (GSTM) adalah istilah untuk Temporomandibular Disorders (TMD), yaitu kumpulan gangguan yang melibatkan sendi temporomandibula, otot, dan struktur di sekitarnya. Dokter gigi dan dokter gigi spesialis merasakan hambatan dalam menangani pasien GSTM. Saat ini belum diketahui bagaimana pengetahuan, sikap, dan perilaku dokter gigi dan dokter gigi spesialis di Indonesia dalam menangani pasien GSTM. Etiologi GSTM multifaktorial dan salah satu penanganannya adalah perawatan ortodonti. Namun di sisi lain perawatan ortodonti diduga menjadi salah satu penyebab GSTM akibar perubahan posisi gigi, mandibula, dan letak kondil. Hal ini dapat dilihat melalui kondisi klinis dan radiograf sefalometri. Gangguan sendi temporomandibula dapat menjadi suatu inflamasi sehingga biomarker inflamasi banyak diteliti. Tujuan: Penelitian ini terdiri dari dua tahap. Penelitian tahap I (Kualitatif) bertujuan mendapatkan alat ukur/kuesioner kemampuan operator (dokter gigi dan dokter gigi spesialis) tentang pengetahuan, sikap, dan perilaku terhadap pasien dengan GSTM, yang valid dan reliabel. Penelitian tahap II (Kuantitatif) bertujuan memperoleh indeks prediksi risiko GSTM berdasarkan kemampuan operator (skor kuesioner), kondisi klinis terkait faktor klinis (usia, jenis maloklusi, overjet, overbite, dan indeks etiologi GSTM), kondisi klinis terkait faktor mekanis (jenis bracket, kasus ekstraksi, dan alat tambahan), radiograf sefalometri (sudut ANB, SN-MP, Go Angle, I-I dan Y-Axis), dan biomarker inflasi (IL-1β dan CRP) Metode: Penelitian disetujui Komite Etik Kedokteran Gigi, FKG-UI, No: 11/Ethical Approval/FKGUI/III/2022 dan dilakukan di Klinik Ortodonti dan Laboratorium Biologi Oral, RSKGM, FKG UI, Jakarta, Indonesia, pada November 2021-Januari 2024. Penelitian tahap I, pembuatan kuesioner melalui telaah pustaka, observasi, dan diskusi kelompok terarah (FGD) oleh 10 orang dokter gigi dan dokter gigi spesialis. Hasil FGD dianalisis menggunakan metode Framework dilanjutkan uji face dan content validity menggunakan analisis Aiken’s V, I-CVI, dan I-CVR. Kuesioner juga dilakukan uji validitas (korelasi Spearman) dan uji reliabilitas (Cronbach’s Alpha dan CITC). Setiap tahap pengujian dilakukan diskusi dan revisi terkait substansi oleh pakar. Kuesioner akhir (Kuesioner PSP-GSTM) diujikan pada 370 responden dan PPDGS Ortodonti (operator) yang merawat subjek pada penelitian tahap II. Penelitian tahap II, dilakukan pada 105 subjek pasien pascaperawatan ortodonti yang dipanggil kembali untuk menandatangani informed consent, mengisi indeks etiologi GSTM, dilakukan pemeriksaan DC/ TMD, dan swab mukosa bukal. Data lainnya dilengkapi dari skor kuesioner, rekam medis, dan radiograf sefalometri. Dilakukan analisis bivariat untuk melihat hubungan setiap variabel dengan GSTM dan multivariat regresi logistik berganda. Hasil: Alat ukur/kuesioner PSPGSTM berisi 73 pernyataan, terdiri dari 50 pernyataan domain pengetahuan, 14 pernyataan domain sikap, dan sembilan pernyataan domain perilaku. Domain pengetahuan terdiri dari 12 pernyataan subdomain tanda dan gejala, 14 pernyataan subdomain etiologi, 11 pernyataan subdomain diagnosis, dan 13 pernyataan subdomain perawatan. Kuesioner PSP-GSTM memiliki validitas dan reliabilitas yang baik. Dihasilkan indeks prediksi risiko GSTM dengan empat faktor prediktor yaitu indeks etiologi GSTM, alat tambahan, SN-MP, dan Go Angle. Kesimpulan: Kemampuan dokter gigi dan dokter gigi spesialis terkait pengetahuan, sikap, dan perilaku terhadap pasien dengan GSTM dapat diukur menggunakan kuesioner PSP-GSTM. Indeks prediksi risiko GSTM yang terdiri dari indeks etiologi GSTM, alat tambahan, SN-MP, dan Go Angle dapat digunakan untuk memprediksi faktor risiko terjadinya GSTM.

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The temporomandibular disorders (TMD) are a group of disorders involving the temporomandibular joint, muscles, and surrounding structures. Dentists or dental specialists often encounter challenges when dealing with TMD patients. It is unknown how the knowledge, attitudes, and behavior of dentists and dental specialists in Indonesia are in dealing with TMD patients. The etiology of TMD is multifactorial and one of the treatments is orthodontic treatment. On the other hand, orthodontic treatment is thought to be one of the causes of TMD due to changes in the position of the teeth, mandibles, and the location of the condyle. This can be seen through clinical conditions and cephalometric radiographs. Temporomandibular joint disorders can become inflammatory so inflammatory biomarkers are widely studied. Objective: The research consists of two stages. Phase I (Qualitative) aims to obtain a measurement/questionnaire of operator’s ability (dentists and dental specialists) about knowledge, attitudes, and behavior towards patients with TMD (PSP-TMD Questionnaire), which is valid and reliable. Phase II (Quantitative) aims to obtain TMD risk prediction index based on operator capability (PSP-TMD questionnaire score), clinical conditions related to clinical factors (age, malocclusion type, overjet, overbite, and TMD etiology index), clinical conditions related to mechanical factors (bracket type, extraction case, and auxiliary tools), cephalometric radiographs (ANB, SN-MP, Go Angle, I-I and Y-Axis angles), and biomarkers of inflammation (IL-1β and CRP) Method: The research was approved by the Dental Ethics Committee, FKG-UI, No: 11/Ethical Approval/FKGUI/III/2022 and conducted at the Orthodontics Clinic and Oral Biology Laboratory, RSKGM, FKG UI, Jakarta, Indonesia, in November 2021-January 2024. Phase I involves creating questionnaires through literature review, observation, and focus group discussion (FGD) by 10 dentists and dental specialists. The FGD results were analyzed using the Framework method followed by face and content validity tests using Aiken's V, I-CVI, and I-CVR analysis. Questionnaires were tested using validity tests (Spearman correlation) and reliability tests (Cronbach's Alpha and CITC). Every stage and testing related to the substance is discussed and revised by experts. The final questionnaire (PSPGSTM Questionnaire) was tested on 370 respondents and Orthodontics residents (operators) who treated subjects in phase II research. The phase II study was conducted on 105 subjects of orthodontic post-treatment patients who were called back to sign an informed consent and fill in the TMD etiology index, DC/TMD examination, and buccal mucosal swabs. Other data were supplemented from questionnaire scores, medical records, and cephalometric radiographs. Bivariate analysis was performed to see the relationship of each variable with TMD and multivariate multiple logistic regression. Results: The PSP-TMD measurement tool/questionnaire contained 73 statements, consisting of 50 knowledge domain statements, 14 attitude domain statements, and nine behavior domain statements. The knowledge domain consists of 12 sign and symptom subdomain statements, 14 etiology subdomain statements, 11 diagnosis subdomain statements, and 13 treatment subdomain statements. The PSP-TMD questionnaire has good validity and reliability. The TMD risk prediction index was generated with four predictor factors, namely the TMD etiology index, auxiliary tools, SN-MP, and Go Angle. Conclusion: The capability of dentists and dental specialists regarding knowledge, attitudes, and behavior towards patients with TMD can be measured using the PSP-TMD questionnaire. The TMD risk prediction index consisting of the TMD etiology index, auxiliary tools, SN-MP, and Go Angle can be used to predict risk factors for TMD"