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"Kasus multidrug-resistant tuberkulosis (MDR-TB) paru di Indonesia semakin meningkat dan berdasarkan WHO Global Tuberculosis Report 2018, Indonesia merupakan satu dari 20 negara yang memiliki kasus MDR-TB terbanyak di dunia dengan tingkat keberhasilan terapi 47%. Beberapa penelitian didapatkan bahwa pada pasien TB paru terjadi peningkatan kadar malondialdehida (MDA) dan radikal bebas lainnya, selain itu juga terdapat penurunan kadar antioksidan di dalam tubuh, salah satunya adalah vitamin E. Tujuan dari penelitian ini adalah untuk mengetahui hubungan vitamin E serum dengan kualitas hidup yang dimediasi oleh MDA pada penyandang MDR-TB paru. Pada penelitian ini didapatkan 91 penyandang MDR-TB yang masih dalam terapi fase intensive dengan usia di antara18-59 tahun. Dalam penelitian ini akan dinilai kadar vitamin E dan MDA dalam serum, serta kualitas hidup dengan menggunakan kuesioner short form-36 (SF-36). Data didapatkan dari wawancara, rekam medis, pengukuran antropometri, penilaian asupan makanan (food recall 1x24jam dan FFQ semikuantitatif), dan pemeriksaan laboratorium. Analisis variabel mediasi menggunakan metode kausal step menurut Baron dan Kenny. Hasil dari penelitian ini tidak didapatkan korelasi antara kadar vitamin E dengan total skor kualitas hidup, physicall component summary (PCS), dan mental component summary (MCS). Selain itu juga MDA bukan merupakan variabel mediasi antara kadar vitamin E dengan kualitas hidup pada penyandang MDR-TB paru. Hasil lain yang didapat dalam penelitian ini adalah terdapat korelasi positif rendah signifikan antara asupan vitamin E dengan total skor kualitas hidup. Serta terdapat korelasi negatif rendah signifikan antara kadar MDA dengan total skor kualitas hidup, PCS, dan MCS.

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Pulmonary multidrug-resistant tuberculosis (MDR-TB) in Indonesia has increased and WHO Global Tuberculosis Report data in 2018 showed that Indonesia is one of 20 countries with the most common cases of MDR-TB in the world with 47% therapeutic success rate. Several studies conducted in pulmonary TB patients showed an increase in the level of malondialdehyde (MDA) and other free radicals and a decrease in the level of antioxidants in the body, including vitamin E. The purpose of this study is to find out the correlation of serum Vitamin E with quality of life mediated by MDA in pulmonary MDR-TB. This study involved ninety-one MDR-TB patients that were still in the intensive phase treatment process with age ranged from 18 to 59 years old. In this study, we examined the levels of serum vitamin E and MDA, and also quality of life using short form-36 (SF-36) questionnaire. Data were collected from interviews, medical records, anthropometric measurements, dietary assessments (24-hours food recall and semi-quantitative FFQ), and laboratory tests. The mediation variable analysis was tested using the causal step method according to Baron and Kenny. The results of this study didn't find a correlation between vitamin E levels with total quality of life scores, physicall component summary (PCS), and mental component summary (MCS). It was also found that MDA wasn't a mediation variable between vitamin E levels and quality of life in pulmonary MDR-TB patients. Another result obtained from this study was that there were a significant low positive correlation between vitamin E intake and total quality of life scores. There were also a significant low negative correlation between MDA levels and total quality of life scores, PCS and MCS."

"Pengobatan TB MDR yang berlangsung lama menimbulkan isolasi sosial, kehilangan pekerjaan, efek sosioekonomi dan psikologis jangka panjang pada pasien. Faktor individu, sosial budaya dan lingkungan serta kemungkinan efek samping psikiatri menjadikan pasien TB MDR cenderung mengalami gejala depresi. Depresi dapat mempengaruhi kualitas hidup. Penelitian ini menilai perubahan status depresi dan hubungannya dengan kualitas hidup pasien TB MDR. MetodePenelitian ini menggunakan metode kohort observasional di Poliklinik TB MDR RSUP Persahabatan. Dua puluh sembilan subjek TB MDR dinilai status depresi dan kualitas hidupnya dengan kuesioner Beck Depression Inventory BDI dan WHOQOL BREF sebelum dan setelah 6 bulan pengobatan TB MDR. HasilProporsi pasien depresi sebelum pengobatan sebesar 75,9 22 subjek . Setelah 6 bulan pengobatan TB MDR, 13 orang skor BDInya menurun, 9 orang meningkat dan terdapat 4 orang yang sebelumnya tidak depresi mengalami depresi. Skor WHOQOL BREF mengalami peningkatan pada ranah fisis, psikologis dan peningkatan bermakna pada ranah lingkungan. Pada ranah sosial, skor kualitas hidup mengalami penurunan. Tidak didapatkan hubungan bermakna antara perubahan status depresi dan kualitas hidup. Keterkaitan antara faktor usia, jenis kelamin, tingkat pendidikan, status ekonomi, lama sakit TB dan atau TB MDR serta beratnya merokok dengan depresi tidak dapat dibuktikan pada penelitian ini. KesimpulanSebanyak 22 subjek 75,9 mengalami gejala depresi sebelum memulai pengobatan TB MDR. Setelah 6 bulan, 13 orang gejala depresinya membaik, 9 orang memburuk dan terdapat 4 orang mengalami onset baru depresi. Kualitas hidup ranah fisis, psikologis dan lingkungan mengalami kenaikan.Kata-kata kunci: tuberkulosis multidrug resistant, depresi, kualitas hidup

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IntroductionTreating drug resistant TB MDR TB which requires longer courses resulting in social isolation, loss of employment, and long-term socioeconomic and also psychological impacts for patients. Individual factors, sociocultural and environment condition also psychiatric adverse events lead the patients tend to have depression symptoms. Depression can majorly affects patients rsquo; quality of life. This study assesses the alteration of depression and its rsquo; relation with the quality of life among MDR TB patients. MethodsThis study used observational cohort methods in MDR Outpatients Clinic of Persahabatan Hospital. Twenty nine patients were diagnosed with MDR, measured depression status and the quality of life with Beck Depression Inventory BDI and WHOQOL BREF questionnaire from baseline and after 6 months therapy. ResultsPropotion of depression at baseline is 75,9 22 subjects . After 6 months treatment, the BDI score of 13 subjects were decreased, 9 subjects were increased and there were 4 subjects experienced new onset depression. The WHOQOL BREF improved in physical, psychological and significantly increased in environmental domain. In social domain, it was decreasing. This study didn rsquo;t find relation between depression status changes and the quality of life. The association between age, gender, level of education, economic status, duration of illness and smoking with depression could not be proven by this study. ConclusionsThere are 22 subjects 75,9 have already been depressed at baseline. After 6 months treatment, 13 subjects improving the symptoms, 9 subjects worsening and 4 subjects have experienced new onset depression. The quality of life in physical, psychological and environmental domain have improved. "

"Kadar TNF-α didapatkan jauh lebih tinggi pada penderita MDR-TB dibandingkandengan penderita TB sensitif obat, TNF-α dinyatakan sebagai salah satu sitokinproinflamasi yang dapat menekan selera makan. Asam lemak omega-3 diketahuimemiliki efek antiinflamasi, namun efek terhadap selera makan masihmenunjukkan hasil beragam, penelitian mengenai asupan asam lemak omega-3/omega-6 yang dapat mendukung selera makan pada penderita MDR-TB belumpernah dilakukan. Penelitian ini dilakukan untuk mengetahui hubungan antara rasioasupan asam lemak omega-3/omega-6 dengan selera makan yang dimediasi olehTNF-α pada pasien MDR-TB paru. Penelitian potong lintang ini dilakukan kepada46 subyek laki-laki dan perempuan dewasa penderita MDR-TB yang sedangmenjalani terapi fase intensif. Data dikumpulkan melalui kuesioner, food recall1x24 jam, pengukuran antropometri dan pengambilan darah vena. Analisis korelasimenggunakan uji pearson dan spearman. Rasio asupan asam lemak omega-3/omega-6 yang didapatkan adalah 0,11±0,05, nilai tengah TNF-α 7,49(1,66-447,62) pg/ml dan rerata selera makan 58,72±26,7. Hasil penelitian inimenunjukkan tidak terdapat hubungan antara rasio asupan asam lemak omega-3/omega-6 dan TNF-α (r=0,16; p=0,91), terdapat hubungan positif antara TNF-αdengan selera makan (r=0,31; p=0,04), serta tidak terdapat hubungan antara rasioasupan asam lemak omega-3/omega-6 dengan selera makan (r=-0,1; p=0,54) padapenderita MDR-TB paru.

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TNF-α levels were found to be much higher in MDR-TB patients compared to drugsensitiveTB patients, TNF-α is stated as one of the pro-inflammatory cytokines thatcan suppress appetite. Omega-3 fatty acid are known to have anti-inflammatoryeffects, but the effects towards appetite are still conflicting, research on the intakeof omega-3 / omega-6 fatty acid which can support appetite in patients with MDRTBhas never been done. This study was conducted to determine the relationshipbetween ratio of omega-3 / omega-6 fatty acid intake and appetite mediated byTNF-α in pulmonary MDR-TB. This cross-sectional study was conducted on 46adult male and female subjects with MDR-TB who were undergoing intensivephase therapy. Data were collected through questionnaires, 1x24 hours food recall,anthropometric measurements and venous blood collection. Correlation analysisused pearson and spearman test. The ratio of omega-3 / omega-6 fatty acid intakeis 0.11±0.05, median value of TNF-α 7.49(1.66-447.62) pg/ml and average ofappetite 58.72±26.7. In conclusion, there is no relationship between the ratio ofomega-3 / omega-6 fatty acid intake and TNF-α (r=0,16; p=0,91), there iscorrelation between TNF-α and appetite (r=0.31; p=0.04), and there is norelationship between the ratio of omega-3 / omega-6 fatty acid intake with appetite(r=-0,1; p=0,54) in patients with pulmonary MDR-TB."

"Peningkatan stres oksidatif selama penuaan, dianggap sebagai kontributor utama pada proses neuro-degenerasi dan kehilangan neuron, dan merupakan faktor utama dalam patologi penyakit Alzheimer dan penurunan kognitif terkait usia. Vitamin E merupakan antioksidan potensial yang menjadi fokus utama penelitian gangguan fungsi kognitif dan penyakit Alzheimer. Penelitian potong lintang pada populasi lansia sehat di Kelurahan Cikoko ini dilakukan pada bulan Desember 2014 untuk menilai hubungan antara kadar vitamin E serum dengan fungsi kognitif. Selain itu juga menilai asupan vitamin C dan E dengan metode FFQ. Penilaian fungsi kognitif dengan instrumen MoCA-Ina. Pemeriksaan laboratorium untuk mengetahui kadar vitamin E menggunakan metode HPLC. Data dianalisis dengan uji Mann-Whitney dan Chi-square. Sebagian besar subyek (75,9%) adalah perempuan dengan usia rata-rata 65 tahun. Sementara, kadar rata-rata vitamin E adekuat, yaitu 21,6 μmol/L. Hasil penelitian ini menunjukkan bahwa tidak ada hubungan signifikan antara kadar vitamin E serum dengan fungsi kognitif yang dinilai dengan skor MoCA-Ina. Meskipun berat badan normal hingga obes I menunjukkan hubungan signifikan dengan skor kognitif (r = 0,17 p = 0,026), tetapi tidak ada hubungan signifikan antara asupan vitamin C dengan fungsi kognitif (r = 0,19 p = 0,15) atau antara asupan vitamin E dengan fungsi kognitif (r = 0,04, p = 0.72) pada penelitian ini. Kesimpulan, tidak terdapat hubungan antara kadar vitamin E serum dengan fungsi kognitif.

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Oxidative stress increases during ageing, is considered as a major contributor to neuro-degeneration and neuronal loss, and is a primary factor in the pathology of both Alzheimer’s disease and age-related cognitive decline. Vitamin E has been the main focus of investigation in studies of cognitive impairment and alzheimer’s disease during aging as a potent antioxidant.

A cross-sectional study of an elderly population in Cikoko Regency in December 2014 was conducted to evaluate the association between serum vitamin E levels and cognitive function in elderly. Correlation between intakes of vitamin C and E as well as Body Mass Index to the MoCA-Ina scores were also investigated. Fifty four elderly were included in the study and interviewed for their vitamins intake using a Food Frequency Questionnaires (FFQ). Cognitive function was examined by Montreal Cognitive Assessment Indonesian version (MoCA-Ina). Levels of vitamin E serum were assessed by high performance liquid chromatography. Data were analyzed by using the Mann-Whitney and Chi-square test. The majority of the subjects were female (75.9%) with median age 65 years old. While, the median levels of vitamin E was 21.55 μmol/L.

The result of this study showed that there was no association between vitamin E level and MoCA-Ina scores. Although normal weight to obese I was significantly associated with cognitive scores (r = 0,17 p = 0.026), no significant correlation between vitamin C intake and cognitive function scores (r = 0.19 p = 0.15) or between vitamin E intake and MoCA-Ina scores were found in this study (r = 0.04, p = 0.72). In conclusion, there is no association between vitamin E serum and cognitive function."

"Penyakit paru obstruksi kronis PPOK merupakan penyebab kematian ketiga di dunia dengan prevalensi 5,6 di Indonesia. Penderita PPOK berisiko mengalami eksaserbasi yang dicetuskan oleh inflamasi dan/atau stres oksidatif. Stres oksidatif akan mempengaruhi status antioksidan di dalam tubuh termasuk vitamin E. Penelitian ini bertujuan mengetahui korelasi antara kadar vitamin E serum dan kekerapan eksaserbasi pada penderita PPOK. Penelitian potong lintang ini dilakukan di Rumah Sakit Umum Pusat Persahabatan pada bulan April-Agustus 2016, melibatkan 47 penderita PPOK. Asupan vitamin E dinilai dengan food frequency questionnaire FFQ semikuantitatif, kekerapan eksaserbasi didapatkan dari wawancara dan/atau rekam medis, kadar vitamin E serum ditentukan mengunakan high performance liquid chromatography HPLC . Rerata asupan vitamin E subjek adalah 5,8 2,9 mg/hari, di bawah Angka Kecukupan Gizi. Nilai median kadar vitamin E serum 10,8 3,0 ? 14,8 ?mol/L, dan kekerapan eksaserbasi 2 0 ? 9 kali/tahun. Tidak didapatkan korelasi bermakna antara kadar vitamin E serum dan kekerapan eksaserbasi.

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Chronic obstructive pulmonary disease COPD is the third leading cause of death in the world with a prevalence of 5.6 in Indonesia. COPD patients were at risk of exacerbations which may be triggered by inflammation and or oxidative stress. Oxidative stress will affect the antioxidant status, including vitamin E. The aim of this study was to investigate a correlation between serum vitamin E concentration and exacerbation frequency of COPD. This cross sectional study was conducted at Persahabatan General Hospital from April to August 2016, involving 47 COPD patients. Vitamin E intake was assessed using semi quantitative food frequency questionnaire FFQ , exacerbation frequency was obtained by interview and or medical records, serum vitamin E concentration was determined using high performance liquid chromatography HPLC . Subjects rsquo mean vitamin E intake was 5.8 2.9 mg day, which did not meet Recommended Dietary Allowance. Median serum vitamin E concentration was 10.8 3.0 14.8 mol L, and exacerbation frequency was 2 0 9 times year. There was no significant correlation between serum vitamin E concentration and exacerbation frequency. "

"[ABSTRAKLatar Belakang: Pengobatan TB MDR memiliki hasil yang buruk dengan keberhasilan hanya 48% di dunia. Salah satu indikator keberhasilan pengobatan adalah konversi dini. Identifikasi faktor yang mempengaruhi konversi merupakan hal yang penting. Metode: Penelitian ini dilakukan secara kohort retrospektif dengan menggunakan rekam medik pasien TB MDR di RSUP Persahabatan Jakarta yang berobat selama bulan Agustus 2009 - Desember 2013.Hasil: Dari 436 pasien terdapat 248 pasien laki-laki (56.6%). Sebanyak 256 pasien (58,7%) mengalami konversi biakan dalam dua bulan pengobatan. Nilai tengah waktu konversi adalah 44 hari. Faktor yang memperlambat lama konversi adalah jenis kelamin perempuan (aHR 0,808; [95%CI 0,659-0,991]), IMT pasien kurang (0,792; [0,637-0,983]), ditemukan gambaran kavitas pada foto toraks (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), riwayat pengobatan OAT sebelumnya dengan lini kedua (0,597;[0,415-0,858]), jumlah resisten obat > 2 OAT (0,614;[0,429-0,879]), kelompok pasien Pre XDR dan TB XDR (0,486;[0,305-0,776]), dan jumlah limfosit rendah (0,681;[0,524-0,885]).Kesimpulan: Jenis kelamin perempuan, IMT kurang, gambaran kavitas pada foto toraks, tingginya bacterial load, riwayat pengobatan OAT sebelumnya dengan lini kedua, jumlah resisten obat > 2 OAT, kelompok pasien Pre XDR dan TB XDR serta limpositopenia berhubungan dengan lamanya konversi pada pasien TB MDR.

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ABSTRACTIntroduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.;Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients., Introduction: Treatment for MDR-TB has a poor outcomes, success rate was only 48% worldwide. One indicator of treatment success is early culture conversion. Identification of potential factors associated with culture conversion are important.Methods: A cohort rectrospective study using medical records of MDR-TB patients of Persahabatan Hospital during August 2009 until December 2013. Data were analyzed using multivariate analysis.Results : Of a total 436 patients, there are 248 patients (56.6%) were males. Two hundred fifty six patients (58,7%) had sputum culture conversion at two months. The median time to culture conversion was 44 days. The factors for longer sputum culture conversion were female (aHR 0,808; [95%CI 0,659-0,991]), underweight patients (0,792; [0,637-0,983]), cavitaty on chest radiograph (0,781;[0,634-0,961]), bacterial load 2+ (0,617;[0,439-0,869]), bacterial load 3+ (0,701;[0,501-0,979]), previous TB treatment with second line drugs (0,597;[0,415-0,858]), resistance to more 2 TB drugs (0,614;[0,429-0,879]), pre XDR and XDR-TB (0,486;[0,305-0,776]), and lower lymphocites count (0,681;[0,524-0,885]).Conclusion: Female, underweight patients, cavitaty, high bacterial load, previous TB treatment with second line drugs, resistance to more 2 TB drugs, resistance to rifampicine, isoniazid and other second line drugs, and lower lymphocites count were associated with longer time culture conversion in MDR-TB patients.]"

"ABSTRAK Tujuan. Mengetahui proporsi depresi pada pasien TB paru tidak resisten obat di RS Cipto Mangunkusumo serta mengetahui faktor-faktor apa saja yang berhubungan dengan kejadian depresi pada pasien TB paru. Metode. Studi dengan desain potong lintang terhadap 122 pasien TB paru tidak resisten obat yang berobat jalan di poliklinik paru RS Cipto Mangunkusumo dari bulan Agustus hingga Oktober 2018. Diagnosis depresi ditegakkan dengan wawancara menurut kriteria diagnosis dari Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) dan derajat depresi ditentukan menggunakan kuesioner Beck Depression Inventory-II (BDI-II). Analisa bivariat dan multivariat dengan uji regresi logistik dilakukan dengan menggunakan SPSS. Hasil. Dari 122 pasien dengan TB paru tidak resisten obat yang menjadi subyek penelitian, didapatkan proporsi depresi sebesar 48,4%. Terdapat dua faktor yang berhubungan dengan kejadian depresi pada pasien TB paru tidak resisten obat yaitu adanya efek samping obat anti TB (p < 0,001; OR 7,13; IK 95% 2,67 - 19,03), dan adanya komorbiditas penyakit kronik (p < 0,001; OR 12,90; IK 95% 4,01 - 41,50). Simpulan. Proporsi depresi pada pasien TB paru tidak resisten obat di RS Cipto Mangunkusumo sebesar 48,4%. Adanya efek samping obat anti TB dan komorbiditas penyakit kronik berhubungan dengan kejadian depresi pada pasien TB paru tidak resisten obat.

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ABSTRACT

Aim. To determine the proportion of depression in non multidrug-resistant pulmonary TB patients at Cipto Mangunkusumo General Hospital and also its related factors. Method. A cross-sectional study of 122 non multidrug-resistant pulmonary TB patients was done at outpatient department of Cipto Mangunkusumo General Hospital from August to October 2018. The diagnosis of depression was made by interview according to Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) criteria, and severity of depression is determined using Beck Depression Inventory-II (BDI-II). Bivariate and multivariate analysis using the logistic regression test was done using SPSS. Results. From 122 patients with non multidrug-resistant pulmonary TB, the proportion of depression is 48,4%. There are 2 factors related to depression in non multi-drug resistant pulmonary TB patients, which are the occurrence of side effects from TB treatment (p < 0,001; OR 7,13; 95% CI 2,67 - 19,03), and the presence of other chronic disease (p < 0,001; OR 12,90; 95% CI 3,87 - 4,01 - 41,50). Conclusion. The proportion of depression in non multidrug-resistant pulmonary TB patients at Cipto Mangunkusumo General Hospital is 48,4%. The occurrence of TB treatment side effects, and the presence of chronic disease comorbidities are related to depression in non multidrug-resistant pulmonary TB patients."

"Penyakit tuberkulosis paru dapat menimbulkan penurunan terhadap aspek kualitas hidup pasien TB Paru. Beberapa faktor yang mempengaruhi kondisi tersebut adanya depresi dan stigma negatif terhadap penyakit. Tujuan penelitian ini untuk mengetahui hubungan depresi dan stigma dengan kualitas hidup pasien tuberkulosis paru yang menjalani pengobatan OAT. Penelitian ini merupakan penelitian kuantitatif dengan menggunakan desain cross sectional dan teknik yang digunakan adalah concecutive sampling. Populasi target dalam penelitian ini adalah pasien tuberkulosis paru yang menjalani pengobatan OAT di poli paru RSUP Persahabatan yang berjumlah 96 responden. Data dianalisis dengan uji analisa univariat dan bivariat, hasil uji bivariat menggunakan pearson menunjukan hasil p = 0,000 p < 0,05. Berdasarkan hasil tersebut menunjukan adanya hubungan antara depresi dan kualitas hidup serta stigma dan kualitas hidup pasien tuberkulosis paru. Diharapkan hasil penelitian ini dapat menunjukan perlunya deteksi dini depresi dan stigma dilakukan oleh perawat pada saat merawat pasien TB paru.

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Treatment pulmonary tuberculosis disease may lead to a decrease in the quality of life of patients with pulmonary tuberculosis. Several factors that affect the existence of depression and negative stigma against the disease.The study aimed to identify relation of depression and stigma and quality of life of patients with tuberculosis who were undergoing anti tuberculosis regimen.

This quantitative study used cross sectional approach and used consecutive sampling technic. Target population of this study was patients with tuberculosis who have undertaking anti tuberculosis medication in polyclinic of pulmonary of RSUP Persahabatan with total sample of 96 respondents."

"Penyakit tuberkulosis masih menjadi masalah kesehatan masyarakat yang utama di Indonesia baik dalam hal prevalensinya maupun masalah-masalah lainnya yang ditimbulkannya. Upaya dalam penanggulangan penyakit tuberkulosis masih terus dilakukan. Namun dalam perjalanannya banyak hambatan dalam upaya tersebut, salah satunya adalah adanya fenomena tuberkulosis multidrug resistant (TB-MDR). Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap kejadian TB-MDR. Desain penelitian yang digunakan adalah kasus-kontrol dengan populasinya pasien TB di RSUP Persahabatan tahun 2013. Penelitian ini menghasilkan bahwa faktor-faktor yang berpengaruh terhadap kejadian TB-MDR di RSUP Persahabatan adalah umur (OR 1,7; 95%CI 0,7-4,1), konsumsi alkohol (OR 1,5; 95%CI 0,5-4,5), riwayat kontak TB (OR 2,1; 95%CI 0,8-5,2), kepatuhan minum obat (OR 10,8; 95%CI 4,4-26,8), status gizi (OR 3,3; 95%CI 1,4-7,8) dan diabetes mellitus (OR 2,1; 0,7-5,8). Penelitian tersebut menunjukkan bahwa untuk mendukung pelaksanaan program DOTS, penderita TB harus terus dimonitoring dan dikontrol selama pengobatannya terutama dalam hal kepatuhan dalam minum obat.

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Tuberculosis remains a major problem of public health in Indonesia, both in terms of prevalence and other problems it causes. An attempt of the tuberculosis prevention is still underway. But along the way there are a lot of obstacles in it, one of which is a phenomenon of multidrug-resistant tuberculosis (MDR-TB). This study intended to find the factors that affecting the MDR-TB. The design study is a case-controland the population is patients with TB at RSUP Persahabatan in 2013.

This study found that affected is the factors in MDR-TB at RSUP Persahabatan are the age (OR 1.7; 95%CI 0.7-4.1), alcohol consumption (OR 1.5; 95%CI 0.5-4.5), history of TB contact (OR 2.1; 95%CI 0.8-5.2), medication compliance (OR 10.8; 95%CI 4.4-26.8), nutritional status (OR 3.3; 95%CI 1.4-7.8) and diabetes mellitus (OR 2.1; 95%CI 0.7-5.8). The study showed that to support the implementation of DOTS program, TB patients should be closely monitored and controlled during treatment, especially in terms of medication compliance. "

"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"