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"Skizofrenia pada mulanya dianggap sebagai kondisi degeneratif yang memiliki prognosis buruk, namun sekarang mulai bergeser menuju harapan adanya pemulihan. Pemulihan secara tradisional diartikan sebagai remisi gejala positif maupun negatif. Pendekatan terbaru bergeser pada peningkatan kualitas hidup melalui peningkatan kesejahteraan emosional, sosial, serta pemulihan individu dan fungsional. Tujuan penelitian ini adalah untuk mengembangkan model pemulihan dan membuktikan efektivitasnya terhadap remisi gejala dan kemampuan fungsionalnya. Desain penelitian yang digunakan adalah mixed methods kualitatif dan kuantitatif. Penelitian terdiri dari tiga tahapan. Tahap 1 pendekatan kualitatif untuk mengeksplorasi persepsi tentang pemulihan ODS dan faktor-faktor yang memengaruhinya. Tahap 2 pengembangan model pemulihan ODS berbasis komunitas. Tahap 3 pendekatan kuantitatif untuk mengujicobakan model pemulihan yang telah dikembangkan untuk menilai efektivitasnya terhadap remisi gejala dan kemampuan fungsional. Hasil Penelitian tahap 1 dihasilkan enam tema, yaitu pengalaman keluarga dengan ODS, persepsi tentang pemulihan, faktor-faktor yang memengaruhi pemulihan, strategi mencapai pemulihan, program pemulihan ODS di komunitas, dan stigma. Model pemulihan ODS berbasis komunitas terdiri dari lima komponen, yaitu perawat, ODS, keluarga, kader, ketua RT dan RW. Model ini efektif meningkatkan remisi gejala dan kemampuan fungsional masing-masing sebesar 16,34 dan 9,61 poin lebih tinggi dibandingkan perawatan rutin puskesmas.

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Schizophrenia was initially considered a degenerative condition with a poor prognosis, but it is now shifting towards the hope of recovery. Recovery has traditionally been defined as the remission of both positive and negative symptoms. The latest approach has shifted towards improving quality of life through enhancing emotional and social well-being, as well as individual and functional recovery. The objective of this research is to develop a recovery model and demonstrate its effectiveness in symptom remission and functional ability. The research design used is a mixed methods approach, combining qualitative and quantitative methods. The research consists of three stages. Stage 1: qualitative approach to explore perceptions of ODS recovery and the factors influencing it. Stage 2: development of a community-based ODS recovery model. Stage 3: quantitative approach to test the developed recovery model to assess its effectiveness on symptom remission and functional ability. The results of Stage 1 research yielded six themes, namely family experiences with ODS, perceptions of recovery, factors influencing recovery, strategies for achieving recovery, ODS recovery programs in the community, and stigma. The community-based ODS recovery model consists of five components: nurses, ODS, families, cadres, and neighborhood heads (RT and RW). This model effectively increases symptom remission and functional ability by 16.34 and 9.61 points higher, respectively, compared to routine care at community health centers."

"Penelitian ini menganalisis pemanfaatan pelayanan rawat jalan tingkat lanjut oleh penderita skizofrenia di Indonesia, yang merupakan peserta JKN pada tahun 2023. Penelitian ini menggunakan pendekatan cross-sectional dengan menggunakan data sekunder, yaitu Data Kontekstual Kesehatan Mental Tahun 2024 yang merupakan bagian dari Data Sampel BPJS tahun 2024. Hasil penelitian menunjukkan bahwa mayoritas penderita skizofrenia (68,1%) peserta tidak rutin (>12 kali/tahun) dalam melakukan pelayanan rawat jalan. Faktor-faktor yang berhubungan dengan pemanfaatan rawat jalan tingkat lanjut diantaranya faktor usia, jenis kelamin, status pernikahan, hubungan keluarga, segmentasi peserta, hak kelas rawat, lokasi FKRTL, serta jenis kepemilikan FKRTL. Temuan ini menunjukkan bahwa perlunya penguatan kebijakan yang mendukung kemudahan akses bagi penderita skizofrenia serta peningkatan inovasi dalam program intervensi yang dilakukan kepada penderita serta keluarga penderita skizofrenia.

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This study analyzes the utilization of referral outpatient services by schizophrenia patients in Indonesia who are participants in the National Health Insurance (JKN) program in 2023. The study employs a cross-sectional approach using secondary data, specifically the 2024 Mental Health Contextual Data, which is part of the 2024 BPJS Sample Data. The results indicate that the majority of schizophrenia patients (68.1%) who are participants do not regularly (more than 12 times per year) utilize outpatient services. Factors associated with the utilization of referral outpatient services include age, gender, marital status, family relationships, participant segmentation, class of care, location of the FKRTL, and type of FKRTL ownership. These findings highlight the need for strengthened policies supporting easier access for schizophrenia patients, as well as increased innovation in intervention programs targeting both patients and their families."

"Kesehatan merupakan suatu kebutuhan dasar bagi seluruh manusia, Kesehatan masuk ke dalam The United Nation’s Sustainable Development Goals (SDGs 2017) yang memastikan pada tahun 2030 seluruh masyarakat di dunia telah mendapatkan kesehatan yang layak untuk semua di segala usia. Indonesia sendiri sudah melakukan upaya untuk memberikan pelayanan kesehatan bagi seluruh masyarakat di Indonesia seperti pembangunan fasilitas pelayanan kesehatan, seperti puskesmas. Di Indonesia permasalahan kesehatan masih menjadi permasalahan khususnya di wilayah rural, masih terjadi disparitas terhadap fasilitas kesehatan. salah satu wilayah di indonesia yang di dominasi oleh wilayah rural adalah Kabupaten Sukabumi, dengan kondisi fisik wilayah yang sangat beragam. Faktor penyebab terjadinya disparitas terhadap fasilitas kesehatan adalah ketimpangan tenaga medis dengan jumlah penduduk, jangkauan pelayanan puskesmas dan aksesibilitas. Sehingga dalam penelitian ini ingin mengetahui bagaimana jangkauan pelayanan puskesmas dan aksesibilitas masyarakat di Kabupaten Sukabumi untuk mendapatkan pelayanan kesehatan serta mencari tahu faktor yang menyebabkan perbedaan aksesibilitas permukiman terhadap puskesmas. untuk mengetahui jangkauan pelayanan puskesmas, dibuat klasifikasi dahulu untuk yang lebih dari >5 km dianggap di luar jangkauan ideal, selanjutnya memanfaatkan Network Analysis memanfaatkan tool service area, didapatkan bahwa masih banyak permukiman yang berada di luar jangkauan ideal. Sedangkan untuk aksesibilitas permukiman, memanfaatkan metode enhanced two-step floating catchment area yang mana pada perhitungannya menghasilkan indeks aksesibilitas, hasilnya aksesibilitas sangat beragam, dan perbedaan dari sebaran nilai aksesibilitas di setiap Kecamatan banyak dipengaruhi oleh faktor seperti ketersediaan jaringan jalan, kondisi fisik wilayah, serta rasio tenaga kesehatan yang berbeda-beda pada setiap Kecamatannya.

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Health is a basic need for all human beings, Health is included in The United Nation's Sustainable Development Goals (SDGs 2017) which ensures that by 2030 all people in the world have received decent health for all at all ages. Indonesia itself has made efforts to provide health services for all people in Indonesia, such as the construction of health service facilities, such as health centers. In Indonesia, health problems are still a problem, especially in rural areas, there are still disparities in health facilities. One of the areas in Indonesia that is dominated by rural areas is Sukabumi Regency, with very diverse physical conditions. Factors that cause disparity in health facilities are the gap between medical personnel and population, reach of puskesmas services area and accessibility. So, in this study, we want to find out how the puskesmas services area and community accessibility in Sukabumi Regency to get health services and find out the factors that cause differences in the accessibility of settlements to puskesmas. To find out the reach of puskesmas services, a classification was made first for those more than > 5 km considered outside the ideal range, then using Network Analysis using the service area tool, it was found that there were still many settlements that were outside the ideal range. As for the accessibility of settlements, utilizing the enhanced two-step floating catchment area method which in its calculation produces an accessibility index, the results of accessibility are very diverse, and the difference in the distribution of accessibility values ​​in each sub-district is much influenced by factors such as the availability of the road network, the physical condition of the area, and different ratios of health workers in each sub-district. "

"Program Eliminasi Filariasis termasuk dalam Rencana Strategis Kementerian Kesehatan RI 2010-2014 dengan satuan lokasi berupa Kabupaten/Kota. Penelitian ini bertujuan untuk untuk mengetahui hubungan tingkat aktivitas Kader Puskesmas dalam Program Eliminasi Filariasis dengan cakupan pengobatan massal Filariasis di Kota Depok.Penelitian menggunakan desain cross sectional, dengan sampel penelitian berupa seluruh Kader Puskesmas di Kelurahan Sukmajaya dan Tirtajaya. Variabel tingkat aktivitas diukur dengan kuesioner, sedangkan data cakupan pengobatan massal Filariasis diperoleh secara sekunder dari Dinas Kesehatan Kota Depok.Hasil penelitian menunjukkan tidak ditemukan perbedaan yang bermakna antara tingkat aktivitas Kader di Kelurahan Sukmajaya dan Tirtajaya dengan cakupan pengobatan massal Filariasis (p=0,56).

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Filariasis elimination has become one of the health priorities embodied in Indonesia as manifested in the national program of infectious disease eradication. Filariasis Elimination Program is included in the Ministry of Health Strategic Plan 2010-2014, with District/City Health Department as its program executors. This study is aimed to determine the relationship of the health cadres in the community health centers specifically in the Filariasis Elimination Program with filariasis Mass Drug Administration (MDA) coverage in Depok.

The study uses cross-sectional design, with a sample of the entire health cadres in Sukmajaya and Tirtajaya village (total sampling method). The levels of activity variable measured by a questionnaire, while the data of Filariasis MDA coverage obtained secondary from Depok City Health Department.

The results showed that in general there were no significant relationship between the level of activity of health cadres in Sukmajaya and Tirtajaya village with filariasis MDA coverage, with a significance value of 0.56. Nonetheless specifically significant difference regarding several points of activities, which are steps in diagnosis, health promotion, detect and report of new cases, participate in MDA execution, and educate chronic patients and their families for treatment and how to do self-care."

"Tolok ukur pelayanan kesehatan ibu dan anak di suatu negara dapat dilihat dari Angka Kematian Ibu (AKI) dan Angka Kematian Bayi (AKB). Semakin kecil AKI dan AKB maka menunjukan semakin baik pelayanan kesehatan ibu dan anak. AKI dan AKB di Indonesia masih tinggi yaitu 307 per 100.000 Kelahiran Hidup (KID), dan AKB 35 per 1000 KH. Lebih dari 90% penyebab kematian ibu dan bayi karena komplikasi obstetri dimana komplikasi ini tidak bisa diduga sebelumnya, Untuk itu perlu adanya sarana rujukan untuk menangani kasus kegawatdaruratan obstetri dan neonatal. Pukesmas sebagai tempat rujukan terdekat dari desa dan sebagai pembina bidan di desa, diharapkan mampu melaksanakan Pelayanan Obstetri Neonatal Emergensi Dasar (PONED).Penelitian ini dilakukan di kabupaten Indramayu, dengan metode kualitatif melalui wawancara mendalam dan fokus group diskusi yang melibatkan kepala puskesmas, tenaga pelaksana PONED, bidan di desa wilayah kerja puskesmas yang diteliti, tenaga kesehatan dari puskesmas tetangga, tokoh masyarakat yang berada diwilayah kerja puskesmas yang diteliti.Penelitian ini dilakukan untuk memperoleh gambaran sistem manajemen masukan yang meliputi sumber daya manusia, dana, sarana dan kebijakan. Selain itu, untuk memperoleh gambaran sistem manajemen proses yang meliputi sosialisasi PONED, supervisi suportif, AMP sosial untuk kinerja cakupan komplikasi maternal dan neonatal ditangani, jugs AMP Medis dan kerjasama dengan DSOG dan DSA untuk kinerja cakupan komplikasi maternal dan neonatal ditangani selamat dan dirujuk. Hasil penelitian ini diolah dengan menggunakan bentuk matriks, teknis analisisinya berupa analisis isi yaitu menganalisa sesuai dengan topik bahasan.Hasil penelitian mengenai gambaran input menunjukkan bahwa jumlah tenaga kesehatan yaitu jumlah bidan desa dan tenaga yang bertugas di PONED sudah cukup. Untuk kriteria maupun pendidikan dari tenaga kesehatan masih belum memenuhi syarat. Untuk pengetahuan tenaga kesehatan maupun camat masih kurang, begitu juga motivasi bidan desa maupun tenaga yang bertugas di PONED kurang, yaitu kepala Puskesmas Widasari belum ada kiat-kiat untuk meningkatkan motivasi, sedangkan di Puskesmas Sindang sudah ada.Tipe gaya kepemimpinan kepala Puskesmas Widasari adalah gaya misionari sedangkan gaya kepemimpinan kepala Puskesmas Sindang merupakan gaya kepemimpinan kompromis, dimana kedua tipe gaya kepemimpinan tersebut keduanya termasuk gaya kepemimpinan yang kurang efektif Dana dan sarana untuk rujukan dari Puskesmas Sindang tidak ada masalah, sedangkan untuk Puskesmas Widasari sarana rujukan masih menjadi masalah karena sopir tidak selalu slap, dan kelembagaan ambulans desa juga tidak berjalan lancar. Dana khusus untuk operasional PONED di kedua Puskesmas tidak ada, sedangkan sarana di kedua PONED sudah cukup memadai. Kebijakan pelayanan terhadap orang miskin dikedua Puskesmas walaupun tidak berjalan dijalankan secara optimal. Kebijakan penguatan sistem rujukan di Puskesmas Sindang sudah lebih baik dan Puskesmas Widasari walaupun tidak berjalan lancar, sedangkan untuk pelaksanan PONED dikedua Puskesmas belum dijalankan sebagaimana mestinya.Mengenai gambaran proses hasil penelitian ini menunjukkan, sosialisasi PONED dikedua Puskesmas belum dilaksanakan secara baik, begitu juga dengan supervisi suportif yang harus dilaksanakan oleh bidan koordinator belum dilaksanakan sebagaimana mestinya. AMP sosial, baik dari kecamatan maupun puskesmas belum ada komitmen dan kesadaran untuk melakukan AMP sosial. AMP medis ditingkat puskesmas di kedua Puskesmas tidak pernah dilaksanakan, hanya otopsi verbal masih sebatas untuk laporan, dan tidak ada kesadaran untuk membahas otopsi verbal. Kerjasama dengan DSOG dan DSA belum pernah dilaksanakan karena tidak tabu bagaimana caranya.Berdasarkan hasil penelitian ini, disarankan kepada dinas kesehatan untuk memprioritaskan pendidikan maupun pelatihan seperti APN, PPGDON, MTBM untuk bidan desa dan uelaksana PONED, pelatihan manajemen dan kepemimpinan untuk kepala puskesmas khususnya kepala Puskesmas PONED. Perlu pemberian pelatihan ESQ bagi semua jajaran kesehatan sehingga dapat meningkatkan empati dan kepeduliannya dalam pelayanan kesehatan terutama terhadap orang miskin dan juga untuk meningkatkan kembali nilai-nilai luhur, inti ajaran manajemen, inti kepemimpinan dan etika sehingga mampu bekerja dengan baik. Disarankan juga agar partograf dan MTBM dijadikan sebagai salah satu kriteria akreditasi bidan. Perlu juga adanya kesepakatan dengan rumah sakit untuk pembinaan PONED oleh DSOG dan DSA, dan pemberikan dam operasional khusus untuk PONED untuk menghindari tarif yang terlalu tinggi.

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The success on the maternal and child health services of a country can be seen at its Maternal Mortality Ratio (MMR) and Infants Mortality Rate (IMR). The less MMR and IMR they have, the better they have services on maternal and child health. The level on MMR and IMR in Indonesia is still high, namely 307/100,000 live birth for MMR and 35/1,000 live birth for IMR. It has known that 90% of the cause of the death on maternal and the infant was undetected obstetric complication. Therefore, a referral facility is needed in response to any obstetric and neonatal emergency case. Puskesmas, as the nearest referral facility in the village and tutor for midwives village, is expected to be capable on dealing with Basic Emergency Obstetric and Neonatal Services (BEONS/PONED).

The study is carried out at the district of Indramayu. The research method used with qualitative approach through in-depth interview and focused group discussion (FGD) towards the head of Puskesmas, personnel who Implement the PONED, village midwives of the working area of Puskemas Widasari and Sindang, health providers from neighborhood's puskesmas, and community leaders at the working area of Puskesmas Widasari and Sindang.

The purpose of the study is to find out the description of the input and process management system of the PONED. The input management system is consisting of the human resources, budgeting, facility, and policy. And the process management system will look at its PONED socialization, supportive supervision, the social audit maternal and perinatal (AMP) of the performance on the coverage of maternal and neonatal complication that has managed the medical AMP and the collaboration with obgyn and pediatrician for the performance on the coverage of maternal and neonatal complication that has managed, rescued and referred.

The result of the study is analyzed by using matrices, and the technique analysis is using content analysis which analyzes on each topics of subject study. The result study on input management system found that the number of health personnel, i.e. number of village midwives and PONED personnel is adequate. But for the criterion for health personnel's education is still have not reach the standard. The level of knowledge for health personnel and the head of sub-district are still low. The reason for work or motivation to work as village midwives and PONED personnel are minor. From two puskesmas studied, the head of Widasari Puskesmas is still have no attempt on elevating the motivation on his staffs, but the head of Sindang Puskesmas is having it. The leadership style of Widasari is missionary style, while Sindang is a compromise leadership style. Both of those leadership styles above are known as less effective leadership style. For Sindang Puskesmas, there are no difficulties found on budgeting and facility for referral, but for Widasari Puskesmas, a problem found in regard to facility for referral, as the ambulance driver is not always ready to work and the ambulance institution body is also found unmanageable. There is no special budget for PONED operational duty in both puskesmas, but both of them has reached the adequacy for PONED facilities. Policy on services for poor people in both puskesmas is still not run in optimal way. Although it's not run so well, the policy on referral system enhancement on Sindang is better than Widasari. However, the implementation on PONE') in both puskesmas is far from the expectation.

For process management system, the study found that the socialization on PONED in both puskesmas is still not well implemented. Supportive supervision by coordinator midwife is also not employed as it should be. Of social AMP, there is no commitment or awareness on doing social AMP in both from sub-district office or puskesmas. Medical APM in both puskesmas is also never carried out Verbal autopsy is only the activity that implemented in both of puskesmas, and it's solely for the reporting and has no awareness to discuss the verbal autopsy findings. The collaboration between obgyn and pediatrician is never carried out because they do not know how to do collaboration.

Suggestion addressed to the head of health authority office that he has to prioritize the education or trainings on medical techniques for village midwives and PONED personnel. A management and leadership training for the head of puskesmas, especially for PONED Puskesmas. There is a need on ESQ training for all health personnel in order to raise the empathy and awareness on addressing health services to poor people, and also to increase the noble values, management principals, leadership principals and ethic cores for having a better work environment. Partograph fulfillment and MTBM is a criterion for midwives accreditation. Establish an agreement with hospital for obgyn and pediatrician guidance and training for PONED personnel. Lastly, to have a special budget for PONED operational in order to avoid a very high expenses for having PONED."

"Conceived of as an empowering alternative to inpatient treatment and traditional community programs, mental health consumer-run organizations--CROs--offer consumers a hands-on stake in their own recovery. A growing evidence base suggests that CROs are a particularly effective form of self-help, with randomized trials demonstrating CRO participants experience improvements in personal empowerment, social integration, and well-being. Consumer-Run Mental Health explains their methods and analyzes their efficacy.A robust theoretical framework synthesizes diverse perspectives to illuminate behavioral processes that contribute to recovery and the dynamics of CROs in creating environments that promote recovery. Data from the author's studies of CRO participation highlight consumer perceptions of the benefits of their involvement. An in-depth ethnographic study examines participant’s lives inside and outside the organization. And in a set of remarkable narratives, consumers describe dealing with both mental illness and the tasks of running a non-profit organization, for a fuller understanding of the impact of CRO participation on their lives."

"Tesis ini membahas tentang kinerja Puskesmas Pahandut sebagai organisasi publik dengan menggunakan metode Balance Scorecard. Tujuan penelitian ini untuk menganalisis kinerja Puskesmas Pahandut ditinjau dari aspek-aspek Balance Scorecard, yang meliputi perspektif pelanggan, keuangan, pertumbuhan dan pembelajaran dan proses internal organisasi. Metode penelitian menggunakan kuantitatif deskripsi.Hasil penelitian untuk prespektif pelanggan dinilai memuaskan untuk pelayanan yang diterima dengan yang diharapkan, perspektif keuangan masih dinilai kurang efektif karena anggaran habis untuk belanja pegawai dan setiap tahun anggaran untuk Puskesmas Pahandut menurun, perspektif pertumbuhan dan pembelajaran dinilai cukup memuaskan karena pegawai banyak yang merasa kurang menjiwai pekerjaan yang ada dan prespektif proses internal organisasi dinilai cukup memuaskan karena kurangnya fasilitas sarana dan prasana yang mendukung.

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This thesis discussed about the achievement of the Pahandut Community Health Centre as the organisation of the public by using the aspect-aspectBalance Scorecard method. The aim of this research of analyse the achievement of the Pahandut Community Health Centre was considered from the Balance Scorecard approach, that covered the perspective of the customer, finance, the growth and learning and the internal process of the organisation. The research method used quantitative the description.Results of the research to prespective the customer was judged satisfactory for the service that was accepted with that was hoped for, the perspective of finance was still being it was thought more ineffective because the budget completely for the official's expenses and every year the budget for the Pahandut Community Health Centre descended, the perspective of the growth and learning was considered quite satisfactory because of the official many that felt not all that inspired the available work and prespective the internal process of the organisation was considered quite satisfactory because of the shortage of means facilities that supported."

"Keperawatan Kesehatan Jiwa Komunitas / CMHN adalah pelayanan keperawatan yang komprehensif, holistik dan paripurna berfokus pada masyarakat yang sehat jiwa, rentan terhadap stress dan dalam tahap pemulihan serta pencegahan kekambuhan. Perawat bekerja sama dengan klien, keluarga dan tim kesehatan lain dalam melakukan tindakan. Tujuan penelitian untuk mengetahui mengetahui faktor - faktor yang berhubungan dengan keberhasilan pelaksanaan kegiatan CMHN di Kabupaten Aceh Besar dan Kota Banda Aceh. Desain penelitian Cross Sectional. Penelitian dilakukan pada 30 orang perawat CMHN dan 48 orang stakeholder, dilakukan secara total sampling berjumlah 78 orang.Hasil penelitian menunjukkan bahwa terdapat hubungan bermakna (p - value α ≤ 0,05) antara persepsi perawat CMHN dan stakeholder tentang faktor dukungan politik, stabilitas dana, partnership, kapasitas organisasi, evaluasi program, program adaptasi, komunikasi, rencana strategis dan sosial dengan keberhasilan pelaksanaan kegiatan CMHN. Rekomendasi hasil penelitian adalah perlunya evaluasi faktor - faktor yang berhubungan dengan keberhasilan pelaksanaan kegiatan CMHN secara periodik, penyegaran dan pelatihan CMHN yang terus menerus dan terstruktur.

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Community Mental Health Nursing (CMHN) is comprehensive nursing care, holistic and adequate, focus in community whose healthy in mentally, far from stressing vulnerability and in the recovery phase also in avoiding to having a relapse. Nurse work together with client, family and other medical team in effort to doing practice. This research aim to know the factors which related with successful implementation of program CMHN in County Aceh Besar and Banda Aceh city. Research design using cross sectional study. Respondents consist of 30 nurse who execute CMHN who work in Central of Community (Puskesmas) and 48 stakeholder, soo its done with total sampling 78 person.Result of this research show that there is significant correlation (p ? value α ≤ 0,05) on perception of nurse CMHN and stakeholder about politic support, budget stability, partnership, organization capacity, programs evaluation, adaptation programs, communication, strategic plan and social to successful implementation of program CMHN . Recommendation based on this research result among other : its need to periodically evaluating factors that related to successful of implementation CMHN, continuously updating and training CMHN."