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Abstrak :
Sejak Indonesia ikut dilanda krisis ekonomi, kompetisi antara rumah sakit sebagai pemberi jasa pelayanan kesehatan makin ketat, dimana rumah sakit saling bertahan untuk tetap hidup sementara daya beli masyarakat yang makin rendah dan biaya hidup yang makin meningkat. Oleh karena itu rumah sakit dituntut untuk meningkatkan mutu pelayanannya, dan salah satu ukuran mutu rumah sakit adalah survey kepuasan pasien atas layanan keperawatan.
Walaupun kepuasan pasien atas layanan keperawatan bukan satu-satunya pertimbangan, namun merupakan hal yang penting mengingat kedudukan perawat yang sangat erat dalam berhubungan dengan pasien, yang oleh penulis disebut sebagai "The Major Caring Profession" (Krowinski W. & Steiber S., 1996)
Hasil beberapa penelitian juga menyatakan lebih dari 40 % kepuasan pasien terhadap rawat inap rumah sakit ditentukan oleh keperawatan.
Pada penelitian ini ingin diketahui tingkat kepuasan umum pasien atas layanan keperawatan rawat inap yang meliputi faktor-faktor yang diuji yaitu :
1. Ketrampilan perawat
2. Komunikasi perawat
3. Kepedulian perawat
4. Ketanggapan perawat terhadap masalah pasien
5. Respon perawat terhadap panggilan pasien
Analisa bivariat 1 Student `t' test dan multivariat 1 regresi logistik yang digunakan untuk uji rata-rata skor kepuasan pada faktor layanan keperawatan dan analisa Chi-square digunakan untuk bentuk katagorik. Hasil penelitian ini ternyata persepsi pasien atas layanan umum keperawatan rawat inap mempunyai hubungan yang bermakna dengan semua faktor layanan keperawatan yang diuji dan hanya jenis kelamin dari karakteristik pasien yang berhubungan dengan tingkat kepuasan umum atas layanan keperawatan. Kelas perawatan dimana pasien dirawat tidak berhubungan dengan tingkat kepuasan umum pasien atas layanan keperawatan.
Diantara faktor layanan keperawatan rawat inap ternyata respon terhadap panggilan merupakan faktor yang paling berperan dalam menentukan tingkat kepuasan umum pasien atas layanan keperawatan (Wald = 8,9705).
Sesuai dengan hipotesa peneliti, bahwa faktor respon terhadap panggilan merupakan faktor yang paling berperan karena di Indonesia masih kurang tenaga perawat yang profesional dalam arti pekerjaan mendatangi panggilan dapat dikerjakan oleh siapa saja, perawat dengan latar belakang pendidikan apa saja, sebab tindakan ini dapat dilakukan tanpa pemikiran mendalam.
Kepada RSUD Bekasi disarankan untuk meningkatkan ketrampilan dan kepedulian perawatnya sehingga perawat RSUD Bekasi akan menjadi lebih profesional dan memenuhi kaidah pelayanan keperawatan yang bertendensi : bio-psiko-social-kultural-spiritual.
Daftar bacaan : 40 (1959 - 1997)

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Perception of Inpatient Satisfaction on Nursing Care at Bekasi Public Hospital 2000
Since Indonesia has been crashed in economic crisis, competition among hospitals as provider of health services become more tied. Every hospital struggle to be survive, while ability to pay from the people are decreasing and the cost of living is increasing.
Therefore, demand to increase the quality of services challenges every hospital. One of the measurements of hospital's quality is survey about patient satisfaction on nursing services.
Although patient satisfaction on nursing services is not the only one judgment but it is an important matter. It is due to the position of nurses which has a close relation mention by the writer as "the major caring profession".
Some research findings state more than 40 % of patient satisfaction to the hospital services contributes by nursing care (Krowinski W. & Steiber S., 1996).
The purpose of this study is to obtain level of inpatient's satisfaction on nursing care which includes the following factors to be tested statistically, as follows :
1. Skills of nursing staff assigned
2. Communication skills with patient
3. Care and concern shown by nurses
4. Nurse's responses to patients need
5. Nurse response to on-call request
The analysis of bivariate I student `t' test and multivariate 1 logistic regression will be used to examine the difference between means score of satisfaction on factor of nursing services and the analysis of Chi-square are used for categoric scates. The result is patient's perception on nursing care has significant correlation with all the factors of the nursing care. On the other hand, only sex variable of the characteristic of patient. has significant correlation. Patient's class has no correlation with inpatients satisfaction of the nursing care (Wald = 8.9705).
Among factors of nursing care, response to patient's call as the most significant factors to the level of inpatient's satisfaction on nursing care. According to hypothesis of this study, it is due to the Iack of professional nurse in Indonesia; in the other word, the activity to come to the patient's call is simple, this activity can be addressed by all nurses regardless back ground of study.
To Bekasi Public Hospital, it is recommended to increase the skill and carry of the nurses so that this hospital may become more professional and fulfill the philosophy of the nursing care to serve holistically : bio-psycho-social-cultural and spiritual.

Bibliography : 40 (1959 - 1997)

Abstrak :
[ABSTRAK
Pendahuluan: Di Indonesia belum ada penelitian tentang injeksi silikon dan komplikasinya, walaupun kasusnya banyak. Patogenesis granuloma silikon masih belum jelas. Beberapa penelitian mengemukakan peran sel T dan sitokin, namun belum ada yang meneliti tentang toleransi imun. Metode: Penelitian ini merupakan penelitian deskriptif analitik meliputi rancangan potong lintang membandingkan 3 kelompok, yaitu 31 jaringan granuloma dan 31 kulit submental pasien dengan suntikan silikon di dagu (kasus) dan 37 kulit normal (kontrol), terhadap gambaran klinis, histopatologis, dan respons imun melalui ekspresi sitokin TNF-a, IFN-g, IL-10, enzim IDO, serta sel Treg (CD4+CD25+); Penelitian eksperimental membiakkan darah penuh kasus dan orang normal, pada RPMI, dan RPMI yang distimulasi PHA, dan silikon. Dilanjutkan dengan mengukur kadar sitokin TNF-a, IFN-g, IL-10 dan IDO supernatan biakan darah. Penelitian dilakukan di klinik spesialis JMB, FMIPA, FKUI, FKUNAIR, dan lembaga Eijkman, tahun 2012 - 2014. Hasil Penelitian: Sebanyak 31 pasien granuloma akibat suntikan silikon di dagu umumnya datang berobat 12,5 tahun setelah penyuntikan, perubahan bentuk dagu terjadi pada tahun ke-4, perubahan warna pada tahun ke-5. Kadar sitokin proinflamasi di supernatan biakan darah lebih tinggi pada pasien granuloma daripada normal. Terdapat korelasi bermakna antara TNF-a di supernatan biakan darah dengan ekspresi TNF-a di jaringan granuloma. Enzim IDO, Treg, IL-10 di kulit submental berkorelasi bermakna dengan sitokin di granuloma. Sitokin anti inflamasi berperan pada kulit submental. Rasio TNF-a/IL-10 di supernatan biakan darah berkorelasi terbalik dengan ekspresi sel Treg di granuloma, membuktikan fungsi Treg sebagai toleransi imun, bekerja melalui IL-10. Enzim IDO di granuloma berkolerasi bermakna dengan rasio TNF-a/IL-10 di supernatan biakan darah dan Treg kulit submental. Simpulan: Enzim IDO bekerja sama dengan fungsi sel Treg dalam toleransi imun pada granuloma akibat suntikan silikon. TNF-a di supernatan biakan darah dan sitokin anti inflamasi di kulit submental dapat dijadikan prediktor untuk menilai respons imun yang terjadi akibat suntikan silikon.;

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ABSTRACT
Background: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance. Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014. Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin. Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection. ;Background: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance. Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014. Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin. Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection. , Background: There is no study on silicone injections and its complications in Indonesia, yet, although the number of cases increased. The pathogenesis of silicone granulomas is still unclear. A few studies have been made to investigate the role of T cells and cytokines, however, none investigates the role of immune tolerance. Method: An analytical descriptive study encompassing cross sectional research was designed to compare 3 groups of 31 granuloma tissue and 31 submental skin of the patients with silicone injection in the chin (case) and 37 normal skin (control) on the clinical pictures, histopathological features and immune response through the expression of TNF-a, IFN-g, IL-10 cytokines, IDO enzyme, and Treg cells (CD4+CD25+). The experimental study cultured whole blood of the case and control patients and measured the level of TNF-a, IFN-g, IL-10 cytokines and IDO enzyme. The study was conducted in JMB specialist clinics, FMIPA, FKUI, FKUA, and Eijkman foundation from the year 2012 to 2014. Result: Thirty one patients with granuloma caused by silicone injection in the chin commonly seek medical advice 12.5 years after the injection, the chin shape changed on the fourth year and the skin color changed on the fifth year. Patients with granuloma had higher level of proinflammatory cytokines in their blood cultured supernatant. There was a significant correlation between TNF-a in blood cultured supernatant with the expression of TNF-a in the granuloma tissue. IDO enzyme, Treg cells, IL-10 in the submental skin significantly correlated with the cytokines in the granulomas. Anti inflammatory cytokines played a role on the submental skin. The ratio of TNF-a/IL-10 in blood cultured supernatant reversely correlated with the expression of Treg cells in the granuloma, demonstrating the function of Treg cells as an immune tolerance working through IL-10. IDO enzyme in the granulomas significantly correlated with the ratio of TNF-a/IL-10 in blood cultured supernatant and Treg in the submental skin. Conclusion: IDO enzyme collaborates with Treg cells in the immune tolerance caused by silicone injection. TNF-a in blood cultured supernatant and anti inflammatory cytokines in the submental skin can be utilized as predictors to assess the resulting immune response due to silicone injection. ]