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"Tuberkulosis masih menjadi masalah serius di seluruh dunia, termasuk di Indonesia. Seseorang dengan TBC aktif dapat menularkan bakteri TBC kepada 10-15 orang dalam kurun waktu satu tahun. Penelitian ini bertujuan untuk mengetahui hubungan karakteristik dan stigma diri dengan kepatuhan klien TB Paru di Kota Depok. Metode penelitian yang digunakan adalah pendekatan cross sectional dan teknik cluster random sampling. Instrumen yang digunakan dalam penelitian ini adalah instrumen stigma diri dan instrumen kepatuhan. Jumlah sampel penelitian yang digunakan dalam penelitian ini adalah 94 responden klien tuberkulosis paru di Kota Depok yang memenuhi kriteria inklusi. Analisis univariat dan bivariat dalam penelitian ini dilakukan dengan menggunakan uji chi square. Hasil uji chi square untuk variabel karakteristik dan kepatuhan menunjukkan tidak ada hubungan yang signifikan. Hasil uji chi square untuk variabel stigma diri menunjukkan nilai p sebesar 0,000 yang artinya memiliki hubungan yang signifikan. Pengembangan program kesiapan pengobatan untuk klien perlu disiapkan oleh puskesmas. Program tersebut dapat dilaksanakan oleh perawat sebelum memulai pengobatan sehingga tingkat kepatuhan klien terhadap TB Paru dapat ditingkatkan.

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Tuberculosis is still a serious problem throughout the world, including in Indonesia. A person with active TB can transmit TB bacteria to 10-15 people within one year. This study aims to determine the relationship between characteristics and self-stigma with client compliance with pulmonary TB in Depok City. The research method used was a cross sectional approach and cluster random sampling technique. The instruments used in this study were self-stigma instruments and compliance instruments. The number of research samples used in this study were 94 respondents with pulmonary tuberculosis clients in Depok City who met the inclusion criteria. Univariate and bivariate analyzes in this study were carried out using the chi square test. The results of the chi square test for the characteristic and compliance variables showed no significant relationship. The results of the chi square test for the self-stigma variable showed a p value of 0,000 which means that it has a significant relationship. The development of a treatment readiness program for clients needs to be prepared by the puskesmas. The program can be implemented by nurses before starting treatment so that the client's level of adherence to pulmonary TB can be improved."

"ABSTRAKTuberkulosis Paru hingga saat ini masih menjadi penyakit menular yang paling sering merenggut nyawa masyarakat. Beberapa penelitian menyatakan bahwa pengetahuan masyarakat khususnya keluarga mengenai penyakit tuberkulosis masih dibawah rata-rata. Selain itu, dukungan informasional yang diberikan keluarga juga masih kurang. Pemberian dukungan informasional oleh keluarga menunjukkan berfungsinya keluarga dalam hal fungsi perawatan kesehatan. Penelitian ini bertujuan untuk mengetahui hubungan antara pengetahuan keluarga dengan dukungan informasional pada klien Tuberkulosis Paru di Kota Depok. Metode penelitian yang digunakan adalah pendekatan cross sectional dan teknik cluster random sampling. Instrumen kuesioner pengetahuan keluarga dan dukungan informasional pada klien Tuberkulosis Paru digunakan dalam penelitian ini. Jumlah subjek penelitian yang diikutsertakan sebanyak 102 keluarga yang merawat klien Tuberkulosis Paru di Kota Depok. Analisis univariat dan bivariat dilakukan dengan menggunakan uji chi square. Hasil uji chi squaremenunjukkan p value sebesar 0,026 (p<0,05) artinya terdapat hubungan yang signifikan antara pengetahuan keluarga dengan dukungan informasional pada klien Tuberkulosis Paru. Pengembangan program promosi kesehatan terkait Tuberkulosis Paru perlu dirancang oleh pihak puskesmas agar dapat meningkatkan pengetahuan keluarga sehingga mampu memberikan dukungan informasional yang baik pada klien Tuberkulosis Paru.

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ABSTRACT

Pulmonary Tuberculosis is an infectious disease that most often takes the lives of people. Some studies demonstrate that the knowledge of the community, especially families regarding Pulmonary Tuberculosis disease is still below the average. On the other hand, the informational support provided for Pulmonary Tuberculosis clients is also lacking. Informational support given by family showed that they are implementing family health care function. This study aims to determine the correlation of family knowledge and informational support for Pulmonary Tuberculosis clients in Depok City. The research method used is cross sectional approach and cluster random sampling technique. Family knowledge and informational support questionnaire instrument is used in this study. The number of research subjects conducted as many as 102 families caring for Pulmonary Tuberculosis clients in Depok City. Univariate and bivariate analysis were done using chi square test. The chi square test results showed p value of 0.026 (p<0.05) meaning that there was a significant difference between family knowledge and informational support for Pulmonary Tuberculosis clients. Health promotion program related to Pulmonary Tuberculosis need to be developed by the puskesmas in order to increase family knowledge. Thus, family can provide a better informational support for the clients."

"Tuberkulosis paru berisiko mempengaruhi fungsi fisiologis maupun psikologis klien yang lebih mengarah pada distress psikologis terutama kecemasan dan depresi. Kondisi depresi klien banyak dipengaruhi oleh persepsi penyakit, stigma sosial, dan stigma diri. Penelitian ini bertujuan untuk menganalisis hubungan persepsi penyakit, stigma sosial, dan stigma diri dengan kondisi depresi pada klien tuberkulosis paru. Metode penelitian yang digunakan dalam penelitian ini yaitu cross sectional dengan jumlah sampel sebesar 282 responden. Kecamatan Tallo, Makassar, Tamalate, Rappocini, dan Panakukang menjadi lokasi penelitian setelah terpilih dengan metode cluster sampling. Analisis data menunjukkan bahwa ada hubungan yang signifikan persepsi penyakit (r=0,412), stigma sosial (r=0,607), dan stigma diri (r=0,645) dengan kondisi depresi pada klien tuberkulosis paru di Kota Makassar (p value = <0,010). Hasil uji multivariat menunjukkan bahwa faktor yang paling berpengaruh terhadap kejadian depresi pada klien tuberkulosis paru adalah stigma diri. Intervensi untuk mengurangi persespsi negatif terhadap penyakit, menurunkan stigma sosial dan stigma diri untuk meminimalkan dampak psikologis pad klien tuberkulosis paru direkomendasikan untuk dilakukan perawat di puskesmas.

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Pulmonary tuberculosis that affects the physiological and psychological functions of the client, which is more directed at psychological distress, especially anxiety and depression. The condition of depression in client is much influenced by illness perception, social stigma, and self-stigma. This study aims to analyze the relationship of illness perception, social stigma, and self-stigma with the incidence of depression in clients of pulmonary tuberculosis. The research method used in this study was cross sectional with a total sample of 282 respondents. Tallo, Makassar, Tamalate, Rappocini, and Panakukang sub-districts became the location of the study after being selected using the cluster sampling method. Data analysis showed a significant relationship between illness perceptions (r=0,412), social stigma (r=0,607), and self-stigma (r=0,645) with the incidence of depression in clients of pulmonary tuberculosis in Makassar City (p value = <0,001). Multivariate test results showed the most influential factor in the incidence of depression in clients of pulmonary tuberculosis was self-stigma. Interventions to Reduce Illness Perception, Reduce Social Stigma, and Self-Stigma to minimize the psychological impact on pulmonary tuberculosis are recommended for nurses at the community health center."

"[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]"

"Pengobatan tuberkulosis paru yang memakan waktu kurang lebih 6 bulan membuat klien rentan merasa stres dan bosan. Dukungan keluarga dalam bentuk emosional merupakan dukungan penting bagi klien selama menjalani pengobatan. Pola komunikasi keluarga yang fungsional merupakan salah satu indikator berfungsinya keluarga. Penelitian ini bertujuan untuk mengetahui hubungan antara pola komunikasi keluarga dengan dukungan emosional pada klien TB Paru. Metode penelitian yang digunakan adalah desain penelitian deskriptif komparatif dengan pendekatan cross sectional dan teknik pengambilan sampel yaitu cluster sampling pada 96 keluarga penderita TB Paru di 10 puskesmas di Kota Depok. Hasil uji chi-square menunjukkan bahwa ada hubungan antara pola komunikasi keluarga dengan dukungan emosional (p value 0,001, α 0,05). Upaya pemberdayaan keluarga khususnya pola komunikasi keluarga oleh perawat perlu ditingkatkan agar keluarga dapat memberikan dukungan emosional sesuai kebutuhan klien.

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Pulmonary tuberculosis treatment which takes approximately 6 months makes clients vulnerable to feeling stressed and bored. Family support in the form of emotional is an important support for clients during treatment. The functional family communication pattern is one indicator of family functioning. This study aims to determine the relationship between family communication patterns with emotional support for clients with pulmonary tuberculosis. The research method used was a comparative descriptive research design with cross sectional approach and the sampling technique was cluster sampling on 96 families with pulmonary tuberculosis in 10 health centers in Depok City. The results of the chi-square test showed that there was a relationship between family communication patterns and emotional support (p value 0.001, α 0.05). Efforts to empower families, especially family communication patterns by nurses, need to be improved so that families can provide emotional support according to client needs."

"Tuberkulosis paru/TB paru merupakan salah satu penyakit infeksi paru menular yang hingga saat ini masih menjadi perhatian. Penyakit TB paru merupakan salah penyakit yang masih menimbulkan stigma di masyarakat. Stigma yang muncul di masyarakat akan dapat berkembang menjadi stigma diri. Stigma diri yang dialami oleh klien TB akan menghambat kepatuhan pengobatan dan mencegah diagnosis TB yang tepat waktu, sehingga dibutuhkan suatu intervensi salah satunya adalah coaching. Penelitian ini bertujuan untuk mengetahui pengaruh coaching terhadap stigma diri dan kualitas hidup klien TB paru. Penelitian dilakukan menggunakan kuasi eksperimen dengan kelompok kontrol. Sampel sebanyak 31 klien TB pada kelompok intervensi dan 31 pada kelompok kontrol. Teknik pengambilan sampel dengan purposive sampling. Hasil penelitian menunjukkan bahwa coaching berpengaruh signifikan dalam menurunkan stigma diri dan meningkatkan kualitas hidup klien TB paru (p= 0,000). Hasil uji mancova menunjukkan jenis kelamin mempengaruhi stigma diri dan kualitas hidup (p= 0,000). Hasil penelitian menyarankan bahwa intervensi coaching dapat dilakukan untuk meminimalkan dampak psikologis akibat penyakit TB dan meningkatkan kualitas hidup klien TB paru.

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Pulmonary tuberculosis is a contagious lung infection disease that still becomes public concern. Pulmonary tuberculosis poses stigma in the community. The stigma that appears may develop into self-stigma. Self-stigma will hamper TB treatment adherence and prevent timely diagnosis of TB. Therefore, it needs an intervention such as coaching.

This study aims to determine the effect of coaching on self-stigma and quality of life for pulmonary tuberculosis clients. This research applied a quasi-experimental design with a control group with 62 pulmonary TB clients as samples. The intervention and control groups consisted of 31 persons in each group. The sampling technique was purposive sampling.

The results showed that coaching has a significant effect to reduce the self-stigma and improve quality of life within pulmonary tuberculosis clients (p = 0.000). MANCOVA test result also showed that gender affects self-stigma and quality of life (p = 0.000). The results of the study suggest that the intervention of coaching need to be done to minimize the psychological impact of pulmonary TB and improve quality of life among pulmonary tuberculosis clients."

"ABSTRAK Nama : Enggar PurnaningsihProgram Studi : Magister KeperawatanJudul : Hubungan Efikasi Diri Dan Stigma Dengan Kepatuhan Pasien Multidrug Resistant Tuberculosis Dalam Menjalani Pengobatan Fase Lanjutan Salah satu faktor yang mempengaruhi keberhasilan pengobatan Multidrug Resistant Tuberculosis TB MDR adalah kepatuhan menjalani pengobatan, termasuk pada fase lanjutan. Efikasi diri dan stigma berperan dalam kepatuhan menjalani pengobatan TB MDR fase lanjutan. Tujuan penelitian ini adalah untuk mengetahui hubungan efikasi diri dan stigma dengan kepatuhan pasien TB MDR dalam menjalani pengobatan fase lanjutan. Penelitian ini menggunakan metode kuantitatif analitik dengan pendekatan cross sectional yang melibatkan 80 responden. Hasil penelitian menunjukkan terdapat hubungan positif bermakna antara efikasi diri r = 0.470; p < 0.001 dan stigma r = 0.602; p < 0.001 dengan kepatuhan menjalani pengobatan TB MDR fase lanjutan. Hasil analisis multivariat didapatkan efikasi diri dan stigma menjadi prediktor kepatuhan menjalani pengobatan TB MDR fase lanjutan. setelah dikontrol akses ke fasilitas layanan kesehatan. Perawat dapat meningkatkan kepatuhan pasien TB MDR dalam menjalani pengobatan fase lanjutan dengan meningkatkan efikasi diri, menurunkan stigma dan meningkatkan keterjangkauan akses ke fasilitas layanan kesehatan.Kata kunci : efikasi diri, fase lanjutan, kepatuhan pengobatan, Multidrug Resistant Tuberculosis, stigma

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ABSTRACTName Enggar PurnaningsihStudy Program Master of NursingTitle Correlation between self efficacy, stigma and patient adherence to continuation Multidrug Resistant Tuberculosis treatment phase In the continuation phase of treatment, patient adherence is one contributing factor to achieve a successful treatment in patients with Multidrug Resistant Tuberculosis MDR TB . Self efficacy and stigma have an important role in adherence to continuation MDR TB treatment phase. This study aimed to investigate the correlation between self efficacy, stigma and patient adherence to continuation MDR TB treatment phase. A cross sectional study was conducted with 80 participated patients with MDR TB. The results revealed that there was a positive significant relationship between self efficacy r 0.470 p 0.001 , stigma r 0.602 p 0.001 and patient adherence to continuation MDR TB treatment phase. Additionally, multivariate analysis showed that self efficacy and stigma were the predictor of patient adherence, in which patients were controlled to access healthcare facilities. This study results indicate that nurses can improve patient adherence to continuation MDR TB treatment phase by increasing self efficacy reducing stigma and improving access to healthcare facilities.Keywords adherence, continuation treatment phase, Multidrug Resistant Tuberculosis, self efficacy, stigma"

"Fenomena kemunculan kusta dan stigma yang menyertainya telah ada sejak berabadabad tahun lamanya. Banyak dari orang-orang dengan kusta merasakan adanya masalah psikososial yang cukup berat dan mendalam. Penelitian ini bertujuan untuk mengetahui bagaimana hubungan karakteristik dan stigma dengan harga diri orang pernah mengalami kusta pascarehabilitasi. Disain penelitian ini adalah deskriptif korelatif dengan pendekatan kuantitatif dan menggunakan teknik total sampling pada 69 penghuni UPT Rehabilitasi Sosial Eks-kusta Tuban. Instrumen yang digunakan adalah EMIC (Explanatory Model Interview Catalogue) Scale for Affected People dan ISMI (Internalized Stigma of Mental Illness) Scale untuk mengukur stigma serta Coopersmith Self-Esteem Inventory untuk mengukur harga diri. Hasil analisis menunjukkan bahwa terdapat hubungan yang signifikan antara pendidikan (p=0,029), kecacatan (p=0,004), perceived stigma, self-stigma, dan experienced stigma (p=0,000) dengan harga diri. Edukasi kesehatan dan pencegahan terjadnya kasus kecacatan pada orang yang mengalami kusta perlu dilakukan oleh perawat untuk menghilangkan stigma yang berkembang di masyarakat. Penelitian eksperimen perlu dilakukan untuk melihat akibat dari terapi aktivitas kelompok atau program pemberdayaan masyarakat pada aspek sosial-ekonomi orang yang pernah mengalami kusta sebagai upaya peningkatan harga diri mereka.

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The appearance phenomenon of leprosy and stigma related to it has existed since centuries ago. Many of leprosy people who received stigma experienced a severe and serious psychosocial problem. The study used descriptive correlative design which aimed to analyze the correlation between characteristics and stigma with self-esteem on people who have been affected by leprosy after rehabilitation. This study is a quantitative research which was using total sampling technique on 69 people who have been affected by leprosy in UPT Rehabilitasi Sosial Eks-kusta Tuban, Indonesia. The instruments using EMIC (Explanatory Model Interview Catalogue) Scale for Affected People and ISMI (Internalized Stigma of Mental Illness) Scale to identify the stigma and Coopersmith Self-Esteem Inventory (SEI) scale to identify the self-esteem. The result showed there was bound relationship between education (p=0,029), disability (p=0,004), perceived stigma, self-stigma, and experienced stigma (p=0,000) with self-esteem. Health education and prevention of deformity on people with leprosy should be performed by nurses to eradicate stigma in community towards leprosy. Experiment research needs to be done to identify the effect of group activity therapy or community empowerment program on socio-economic aspect of people who have been affected by leprosy to improve their self-esteems."

"ABSTRAKTuberkulosis masih menjadi masalah kesehatan masyarakat hingga saat ini. Salah satu masalah besar yang masih menjadi tantangan dalam penanggulangan TBC adalah kepatuhan pengobatan. Penelitian ini bertujuan mengetahui hubungan self stigma dan self efficacy dengan kepatuhan pengobatan klien dewasa Tuberculosis di kabupaten Jeneponto. Jenis penelitian crossectional study. Sampel diambil dengan teknik purposive sampling sebanyak 157 responden. Terdapat hubungan self stigma dan self efficacy dengan kepatuhan pengobatan klien dewasa TBC di kabupaten Jeneponto p value 0,001 < 0,05 . Mengetahui hubungan self stigma dan self efficacy dengan kepatuhan pengobatan menjadi dasar bagi perawat komunitas dalam memberikan intervensi yang sesuai dan pengembangan keilmuan keperawatan.

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ABSTRACT Tuberculosis is still a public health problem. One major problem that remains a challenge in TB control is medication adherence. This study aims to determine the relationship of self stigma and self efficacy with adherence treatment among adult with Tuberculosis in Jeneponto district. This is cross sectional study. The sample was taken by purposive sampling technique as many as 157 respondents. There is a relationship of self stigma and self efficacy among adult with treatment adherence in Jeneponto district p value 0,001 "

"Pengobatan tuberkulosis paru dalam jangka waktu yang lama memungkinkan penderita mengalami stress sehingga diperlukan pemberian dukungan sosial. Stigma sering melekat pada tuberkulosis paru. Penelitian dilakukan untuk mengetahui gambaran stigma masyarakat terhadap klien tuberkulosis paru tuberkulosis paru tuberkulosis paru di Pancoran Mas. Penelitian ini menggunakan desain deskriptif dengan 110 sampel berusia 20-59 tahun, diawali cluster sampling untuk menetapkan wilayah dan purposive sampling untuk responden. Hasil penelitian menunjukkan mayoritas responden memiliki stigma dengan bentuk diskriminasi. Memaksimalkan peran perkesmas serta pembentukan kelompok pemerhati tuberkulosis paru menjadi cara agar stigma tidak muncul. Penelitian selanjutnya dapat melihat gambaran stigma diri pada klien tuberkulosis paru.

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Pulmonary tuberculosis clients who get treatments in the long term experience stress that caused by stigma. This study aimed to determine description of society's stigma towards pulmonary tuberculosis clients in Pancoran Mas.

This study applied descriptive design to 110 patients with age range of 20-59 years old. Sampling recruitment consisted of cluster sampling technique and purposive technique.

The results showed that majority of respondents had stigma discrimination. Maximizing role of public health nurses and pulmonary tuberculosis support groups may become way to raise public awareness in stigma prevention. A future study may explore self stigma of pulmonary tuberculosis clients."