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"ABSTRAKTulisan ini membahas mengenai dukungan sosial komunitas swadaya pasien kanker sebagai pemberdayaan perilaku Self-Help dan Self-Care anggotanya serta merupakan contoh pengobatan alternatif. Fokus tulisan ini mengenai dukungan sosial komunitas Elgeka Jawa Barat terhadap pasien kanker Chronic Myeloid Leukemia (CML) dan Gastrointestinal Stromal Tumor (GIST) dalam melalui perasaan penyangkalan sampai kepada penerimaan sebagai suatu rangkaian tahapan berduka. Setelah mencapai tahapan penerimaan, pasien dapat membuka diri serta melakukan Self-Help dan Self-Care. Tulisan ini menggunakan konsep-konsep yang dikemukakan oleh para tokoh terkait komunitas, pasien, dukungan sosial, Self-Help dan Self-Care di dalam melakukan analisa terhadap data temuan. Temuan dalam tulisan ini ialah komunitas mampu membantu pasien melewati posisi berduka dari tahapan menyangkal hingga penerimaan melalui dukungan sosialnya dan dukungan sosial terus ada meskipun telah mencapai tahapan penerimaan. Pada tahapan penerimaan ini mampu mengembalikan fungsi dan peran sosial seorang pasien diagnosa penyakit kanker sehingga pasien mampu untuk melakukan Self-Help dan Self-Care pada tahapan individu dan komunitas. Pada tulisan sebelumnya lebih membahas kepada peran pasien dilihat berdasarkan dukungan sosial yang diberikan tetapi masih sedikit kajian mengenai peran pasien sebagai anggota komunitas dan tidak melihat aspek pasien yang tidak hanya terbantu dengan adanya komunitas tetapi juga dapat melakukan Self-Help dan Self-Care.

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ABSTRACT

This paper discuss about social support cancer patient community as Self-Help and Self-Care behavioral empowerment for it?s member and constitute as an example of alternative treatment. Focus of this paper is about community social support for cancer patients Chronic Myeloid Leukemia (CML) and Gastrointestinal Stromal Tumor (GIST) in the course of grieving stages into acceptance stages as the stages of grieving. Subsequent to acceptance stages, patient can perform Self-Help and Self-Care. This paper make use of community, patient, social support, and Self-Help and Self-Care Concept to carry out the analysis based on findings data. Core findings in this paper is that community is capable to help patient through grieving stages from denial into acceptance stages with social support and thereafter community social support still remains. At acceptance stages, diagnosed patient can restore their social function and role with the result that they can perform Self-Help and Self-Care on individual or community stages. In past studies, patient role seen by their social support but did not observe patient as a community members and other than as beneficiaries they can perform Self-Help and Self-Care."

"Operasi CABG merupakan salah satu penanganan bedah pada PJK dan meningkatkan kualitas pasien kehidupan baik. Namun pasien yang telah menjalani CABG tetap berisiko untuk kejadian iskemik. Pencegahan sekunder kardiovaskular memainkan peran penting untuk mempertahankan jangka panjang patensi cangkok, memperlambat proses aterosklerotik, dan mencegah hasil kardiovaskular yang merugikan. Perubahan perilaku dipengaruhi oleh keyakinan seseorang untuk berubah dan dukungan disekitarnya. Keyakinan yang dianggap berpengaruh terhadap pola perubahan perilaku adalah perceived benefit dan perceived barrier. Tujuan penelitian ini untuk mengetahui hubungan perceived benefit, perceived barrier dan dukungan sosial terhadap perawatan diri pasien setelah operasi CABG. Metode: desain cross-secrtional, dengan jumlah sampel 75 responden, kriteria inklusi: Pasien operasi CABG lebih dari 6 bulan, Usia lebih dari 30 tahun, Hasil analisis terdapat empat hubungan yang bermakna terhadap perawatan diri, didapatkan pendidikan nilai p 0,015, perceived benefit  nilai p 0,001, perceived barrier dengan nilai p 0,004 , dan dukungan sosial nilai p 0,000. Dan hasi tidak bermakna pada usia nilai p 0.631 dan pengetahuan nilai p 0.418 Jenis kelamin nilai p 0,357. Kesimpulan : terdapat hubungan yang bermakna anatara perceived benefit, perceibved barrier, dan dukungan sosial terhadap perawatan diri pasien setelah operasi CABG

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CABG surgery is one of the surgical treatments for CHD and improves the patient's quality of life. However, patients who have undergone CABG remain at risk for ischemic events. Cardiovascular secondary prevention plays an important role in maintaining long-term graft patency, slowing the atherosclerotic process, and preventing adverse cardiovascular outcomes. Behavior change is influenced by a person's belief to change and support around him. The beliefs that are considered to have an effect on the pattern of behavior change are perceived benefits and perceived barriers. The purpose of this study was to determine the relationship of perceived benefit, perceived barrier and social support to patient self-care after CABG surgery. Methods: cross-sectional design, with a sample of 75 respondents, inclusion criteria: CABG surgery patients more than 6 months, age more than 30 years, the results of the analysis there are four significant relationships with self-care, education p value is 0.015, perceived benefit value p 0.001, perceived barrier with p value 0.004 , and social support p value 0.000. not significant, namely age p value 0.631 and knowledge p value 0.418 Gender p value 0.357. Conclusion: there is a significant relationship between perceived benefit, perceived barrier, and social support for patient self-care after CABG surgery."

"Status fungsional yang rendah akan mempengaruhi kemampuan pasien gagal jantung dalam melakukan perawatan diri. Dukungan sosial menjadi salah satu faktor yang dianggap dapat mempengaruhi perilaku self care pada pasien gagal jantung. Penelitian ini bertujuan untuk mengetahui hubungan dukungan sosial dengan kemampuan self care pada pasien gagal jantung. Penelitian ini menggunakan desain cross sectional dengan teknik sampel consecutive sampling pada 33 responden di RS PGI Cikini. Hasil penelitian ini menunjukkan bahwa tidak ada hubungan yang bermakna antara dukungan sosial dengan self care pasien gagal jantung (p 0,33; α 0,05). Rekomendasi pada penelitian ini adalah perlunya peran perawat untuk mampu memfasilitasi pemberian dukungan sosial kepada pasien gagal jantung agar kemampuan self care dapat ditingkatkan.

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Deficient functional status will affect heart failure patients ability to perform self care. Social support is one factor can influence the self care behavior in heart failure patients. This research aimed to identify the relationship of social support and self care in heart failure patients. The research used cross sectional design with consecutive sampling technique to 33 respondents in RS PGI Cikini.

The results showed that there was no significant relationship between social support and self care of heart failure patients (p 0.33; α 0.05). The research recommend the necessity of nurses to afford facilitating to give of social support to heart failure patients ability of self care can be improved."

"Penderita diabetes tipe 2 berisiko mengalami depresi yang secara negatif memengaruhi penurunan aktivitas perawatan diri. Bukti terbaru menunjukkan dukungan sosial bermanfaat dalam menurunkan risiko depresi dan meningkatkan aktivitas perawatan diri. Penelitian ini bertujuan untuk mengetahui efek mediasi dukungan sosial antara hubungan gejala depresi terhadap aktivitas perawatan diri penderita diabetes tipe 2 melalui pendekatan cross sectional pada 94 responden. Hasil analisis regresi linier berganda menunjukkan komplikasi penyakit diabetes tipe2 signifikan memengaruhi aktivitas perawatan diri (p=0,000; R2=0,515). Hasil analisis jalur dan tes sobel menunjukkan bahwa dukungan sosial memediasi efek secara signifikan pada hubungan gejala depresi terhadap aktivitas perawatan diri (z=-0,162 > ttabel 1.96; pengaruh langsung -0,499; pengaruh tidak langsung= -0,0789; total efek=40,3%). Skrining gejala depresi dan intervensi yang melibatkan dukungan sosial perlu dilakukan pada pasien diabetes tipe 2 yang dicurigai mengalami penurunan aktivitas perawatan diri.

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People with type 2 diabetes are at risk of experiencing depression which which affects in self-care activities. Recent evidence shows that social support is beneficial in reducing the risk of depression and positively affect the increase in self-care activities. This study aims to determine the mediating effect of social support on the relationship between depressive symptoms and self-care activities of people with type 2 diabetes through a cross sectional approach on 94 respondents. The results of multiple linear regression analysis showed that complications of type 2 diabetes significantly affects activities related to depression treatment (p = 0,000; R2 = 0.515). The results of path analysis and the sobel test show that social support significantly mediates the effect of relationship between depressive symptoms and self-care activities (z = -0,162> table 1.96; direct effect -0,499; indirect effect = -0,0789; total effect = 40, 3%). Screening for depressive symptoms and interventions which involves social support are strongly suggested for patients with type 2 diabetes who are suspected of showing decline in self-care activities."

"Self care penderita gagal jantung merupakan penentu keberhasilan perawatan. Self care membutuhkan pengetahuan dan keterampilan yang dapat diberikan melalui discharge planning sejak penderita dirawat. Discharge planning yang tidak maksimal memberikan pengaruh langsung dan menyebabkan rehospitalisasi serta penambahan lama perawatan. Discharge planning membutuhkan kolaborasi multidisiplin, pasien harus terlibat aktif dalam pelaksanaannya. Di Indonesia, rumah sakit mempunyai kewenangan mengatur pelaksanaan discharge planning, namun pada kenyataannya discharge planning disusun hanya dalam bentuk ringkasan yang akan disampaikan seperti jadwal kunjungan dan obat – obatan. Tujuan: mengidentifikasi pengaruh discharge planning terstruktur terhadap self care. Metode: quasy experiment dengan 46 menggunakan 3 kuisioner dan analisis meliputi univariat dan bivariat (beda 2 mean). Hasil: terdapat beda mean yang signifikan sebelum dan sesudah interevensi pada kelompok intervensi. Kesimpulan: terdapat pengaruh pemberian discharge planning terhadap self care. Rekomendasi: dalam perawatan gagal jantung, discharge planning menjadi bagian penting untuk memaksimalkan perawatan dan self care. 

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Self-care of patients with heart failure is a determinant treatment to success. Patient’self-care requires knowledge and skills that can be provided through a program of discharge planning since the patient is admitted to the hospital. The discharge planning program that is not optimally given to the patient will produce direct effect and cause re-hospitalization and possible extended hospital stay. The implementation of the discharge planning requires multidisciplinary collaboration and the patient must be actively involved in the practice. In Indonesia, hospitals have authorities to regulate the implementation of discharge planning program, but in reality, what they said a discharge planning is consists of only a form of medical summary that concluded with a schedule of visits and medicines to be consumed. The objective of the study was to identify the effect of structured discharge planning structured on self-care of patients with heart failure. Method: A quasy experimental study has involved 46 subjects, used 3 different questionnaire and analysis included univariate and bivariate (Two Difference mean). The result showed that there is a significant difference mean before and after intervention in the treatment group. Conclusion: There is a significant effect of structured discharge planning on self-care. Recommendation: A structured discharge planning program becomes an important part of caring for patients with heart failure in order to maximize nursing care and self-care ability of the patients."

"Gagal jantung merupakan salah satu penyakit kronis yang paling sering memerlukan pengobatan ulang di rumah sakit. Tingginya tingkat readmission pada pasien gagal jantung sering terjadi karena keterlambatan dalam mengenal gejala, ketidakpatuhan terhadap diet dan pengobatan, kurangnya keterampilan dan pengetahuan dalam self care. Self care dapat mencegah terjadinya perburukan sehingga readmission tidak terjadi, selain itu self care juga berdampak terhadap kualitas hidup. Individu dalam melakukan self care dipengaruhi beberapa faktor dari dalam maupun luar individu. Tujuan penelitian ini adalah mengetahui hubungan karakteristik responden, status fungsional, komorbiditas, tingkat depresi, dukungan sosial, persepsi penyakit dengan self care pasien gagal jantung yang readmission. Penelitian menggunakan desain cross sectional dengan tehnik purposive sampling pada 93 responden pasien gagal jantung yang readmission di Ruang Rawat Inap dan Poliklinik Jantung RSUP Persahabatan. Hasil penelitian setelah dianalisis dengan Chi-square menunjukkan status perkawinan (p 0,028; α 0,05), pendidikan (p 0,018; α 0,05), komorbiditas (p 0,034; α 0,05), tingkat depresi(p 0,006; α 0,05), dukungan sosial (p 0,000; α 0,05), dan persepsi penyakit (p 0,002; α 0,05) memengaruhi self care responden secara signifikan. Kesimpulan penelitian ini adalah perlunya meningkatkan follow up setelah pasien pulang dan melibatkan keluarga dalam upaya self care.

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Heart failure is the chronic diseases most often requires repeat treatment at the hospital. The high level of readmission patients heart failure often occurs due to delays in recognizing symptoms, noncompliance diet and treatment, lack of skills and knowledge self care. Self care can prevent deterioration so the readmission does not occur, besides it affects the quality of life. Individuals doing self care influenced by several factors from inside and outside. The purpose of this study to know the relationship of respondent characteristics, functional status, comorbidity, depression, social support, illness perception with self care patients heart failure readmission. The study used design cross sectional with purposive sampling technique in 93 patients heart failure readmission at Inpatient and Outpatient Care RSUP Persahabatan. The results this study after being analyzed by Chi square showed marital status (p 0,028; α 0.05), education (p 0,018; α 0,05), comorbidity (p 0,034; α 0,05), depression (p 0,006; α 0,05), social support (p 0,000; α 0,05), and illness perception (p 0,002; α 0,05) significantly influenced self care. The conclusions this study need to improve follow up after the patient returns home and involves the family effort to self care."

"Kejadian penyakit kulit pada santri di pondok pesantren masih banyak terjadi. Hal ini disebabkan karena masih rendahnya tingkat pengetahuan santri mengenai kebersihan diri dan lingkungan sehingga dapat berpengaruh terhadap perilaku perawatan diri. Penelitian ini bertujuan untuk mengetahui hubungan tingkat pengetahuan kebersihan diri dan lingkungan dengan perilaku perawatan diri santri di pondok pesantren X Kabupaten Bogor. Penelitian ini menggunakan desain cross-sectional dengan 107 sampel yang diambil menggunakan stratified random sampling. Penelitian ini juga menggunakan lembar observasi mengenai sanitasi lingkungan untuk mendukung hasil penelitian. Analisis statistik menggunakan chi-square mendapatkan bahwa tingkat pengetahuan kebersihan diri dan lingkungan memiliki hubungan yang sangat bermakna dengan perilaku perawatan diri p=0,001; OR=5,924. Penelitian ini merekomendasikan agar perawat dapat meningkatkan pengetahuan kebersihan diri dan lingkungan melalui promosi kesehatan berupa penyuluhan kesehatan.

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The incidence of skin diseases in students at boarding schools is still common. It was because the students have poor knowledge about personal hygiene and environment so it can affect the behavior of self care. Research aimed to analize relationship between level of knowledge of personal hygiene and environment with Self Care in Students at Boarding School X Bogor Regency. The research used design cross sectional with 107 samples which is chosen by stratifed random sampling. This research also used an observation sheet on environmental sanitation to support the research results. Statistic analized used chi square with the result that level of knowledge of personal hygiene and environment had correlation with self care practice p 0,001 OR 5,924. This study recommended the nurses to improved the knowledge of personal hygiene and environment with heath promotion in order to avoid skin disease."

"Penelitian ini bertujuan untuk mengembangkan dan menguji pengaruh model peningkatan kemandirian pasien stroke untuk pengelolaan faktor risiko kekambuhan terhadap pengetahuan, self-efficacy dan kemandirian. Penelitian dilakukan melalui dua tahap, yaitu tahap 1 berupa penelitian deskriptif kualititatif dan pengembangan model, serta tahap 2 berupa penelitian kuasi dengan pre-post test control design. Metode sampling yang digunakan adalah purposif sampling. Pada penelitian tahap 1, didapat 8 orang partisipan sedangkan pada tahap 2 didapat sebanyak 32 orang (kelompok kontrol) dan 35 orang (kelompok perlakuan). Pengambilan data pada tahap 1 dilakukan dengan wawancara mendalam, adapun pada tahap 2, data diambil 3 kali, yaitu pre test, post test pada akhir bulan 1 dan post test pada akhir bulan 2. Analisi data dilakukan dengan metode dari Giorgi (tahap 1) serta uji Friedman dan Wilcoxon (tahap 2).Hasil penelitian pada tahap 1 didapat 4 tema yang mendukung keberhasilan pasien mengelola faktor risiko kekambuhannya dan tersusun model peningkatan kemandirian pasien stroke. Pada tahap 2 didapat peningkatan nilai mean pada variabel pengetahuan (x2 = 31,087; p=0,000) dan kemandirian (x2 = 24,569 ; p=0,000). Tidak terjadi peningatkan mean pada variabel self-efficacy (x2 = 4, 947; p=0,84). Kesimpulan, model peningkatan kemandirian terbukti efektif untuk meningkatkan kemandirian dan pengetahuan pasien stroke. Model ini dapat direkomendasikan untuk diaplikasikan pada perawatan pasien stroke di poliklinik.

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The purpose of this study were to develop the Stroke self-care model for stroke recurrent risk factor management and to examine the effect of the model on on knowledge, self-efficacy and self-care for stroke recurrent risk factor management. There were two phase on this research. The first phase was phase to develop Stroke self-care model for stroke recurrent risk factors management and modules through study literature and a qualitative research. The second phasee was a quasi experiment with pre-post test control design. Eight participant were involved in the first phase, while in second phase there were 32 respondents in control group and 35 respondents in intervention group whom recruited by purposive sampling. Data in first pahse were colected using in-depth interview, and in second phase, data were collected at three points: pre test; one month and two month after intervention. Data in first phase were analyzed with Giorgi methode; and in the second phase using Friedman, and Wilcoxon test.The results in fist phase identified four themes that contribute to success story stroke patient in a manage stroke risk factors. In second phase, data showed the significant increase of patients? knowledge mean (x2 = 31,087; p=0,000) and self-care mean (x2 = 24,569 ; p=0,000) after 1 dan 2 month after intervention. There was no incrase in patients? self-efficacy mean (x2 = 4, 947; p=0,84). In conclusion, stroke self-care model for stroke recurrent risk factor management is effective to increase stroke patients? knowledge and self-care. This research recomend that, this model can be applied in nursing care for stroke patient in outpatient clinic."

"[Pengendalian TB paru di Kota Depok masih berorientasi pada pelaksanaan program pengendalian TB nasional, belum terintegrasi dengan pelaksanaan Perawatan Kesehatan Masyarakat sehingga klien TB belum mandiri melakukan perawatan TB. Model P2K3 dikembangkan berdasarkan integrasi model perawatan diri, model perawatan berbasis komunitas dan pendekatan perawatan yang berpusat pada klien. Penelitian ini bertujuan untuk mengetahui efektivitas model pemberdayaan perawat, kader, keluarga dan klien (P2K3) terhadap tingkat kemandirian klien dalam perawatan TB Paru, menggunakan desain kuasi eksperimen pre-post test pada dua kelompok. Penelitian dilakukan di 15 wilayah kerja Puskesmas di Kota Depok dengan kasus TB tertinggi. Penelitian terdiri dari tahap pengembangan model dan pengujian efektivitas model. Sampel diambil secara purposif sebanyak 108, terdiri dari 54 kelompok kontrol dan 54 kelompok intervensi. Hasil menunjukkan model P2K3 efektif untuk meningkatkan kemandirian klien TB Paru sebesar 40,2%. Penerapan model ini perlu didukung dengan kebijakan pelayanan kesehatan dari Dinas Kesehatan. Model P2K3 dan modulnya direkomendasikan digunakan oleh perawat di komunitas sebagai acuan pemberdayaan kader, keluarga dan klien TB Paru;

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Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients? self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients? self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model?s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients? level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients;Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients, Pulmonary tuberculosis control in Depok has not been integrated to the implementation of the Community Health Care Program, so that the clients’ self-care independence in their TB treatment still low. The nurse, community workers, family and clients empowerment model was developed based on integration of self-care model, community based care model, and patient centered care approach. This study aims to determine the effectiveness of nurse, health volunteers, family and clients empowerment model to the level of pulmonary tuberculosis clients’ self-care independence that applied quasi-experimental design with nonequivalent group pretest-posttest method. This study consisted of model development and testing of the model’s effectiveness. It was held in 15 areas of Public Health Centers in Depok that have high prevalence of TB cases. The samples size were 108 that taken purposively. It was consisted of 54 the control group and 54 intervention group. The result showed that the model is effective for improving pulmonary tuberculosis clients’ level of self-care independence as 40,2%. The application of this model needs to be supported by the policy of the Health Office Authority. This model was recommended to implement by nurses in the community as referral to empower community workers, family and pulmonary TB clients]"