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Abstrak :
ABSTRAK

Penggunaan telenursing memiliki potensi dalam menjembatani kesenjangan antara perawat dan pasien, sehingga memungkinkan pertukaran informasi dilakukan lebih cepat daripada melalui tatap muka. Tulisan ini bertujuan untuk menunjukkan implikasi telenursing melalui SMS pada klinik MTBS Puskesmas Pancoran Mas terhadap frekuensi kunjungan ulang pasien serta respon yang diberikan oleh partisipan. Penelitian ini menggunakan metode eksperimental melalui pengamatan dan pendekatan cross sectional static group comparison pada dua kelompok yang masing-masing terdiri atas 25 peserta diperlakukan secara berbeda. Hasil menunjukkan bahwa melalui uji Fisher exact ditemukan tidak ada perbedaan antara jarak tempuh ke pusat kesehatan dengan kunjungan ulang. Juga tidak ada hubungan antara telenursing dengan frekuensi jumlah kunjungan ulang kedua kelompok. Meskipun demikian, 64% partisipan intervensi merespon pesan, yang berarti membuka kemungkinan untuk proses pendidikan kesehatan untuk dilakukan dari jarak jauh. Penelitian yang bersifat kualitatif di setting yang sama untuk meninjau ulang kepuasan pasien terhadap proses telenursing ini sangat direkomendasikan

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ABSTRACT

The use of telenursing has revealed its potential benefits in bridging the gap between nurses and the patients. Thus, enabling information exchange process could be done faster than conventional face-to-face visits. This paper aims to show implications of telenursing method on a community health center pediatric clinic in Pancoran Mas Depok, Indonesia, towards its patient?s behavior to revisit as well as responses given by the patients. This research includes a set of experiment-base static group comparison method. Two groups, each consisted of 25 participants were treated differently at the same time. Using Fisher Exact technique, analysis revealed that there was no difference between distance from house to the health center and no difference between both groups in terms of repeated visits? frequency. However, it turned out that 64% participants responded the messages, opening up the possibility for health education to be undergone from distance. It is further recommended to measure patient?s satisfaction during the telenursing process in qualitative fashion

Abstrak :
Tesis ini membahas penatalaksanaan bdita sakit dengan gejala diare menunrt standar Manzgemen Terpadu Balita Sakit (MTBS) di Aceh, Jawa Tengah, Jawa Timur, Kalimautan Selatan, Nusa Tenggara Timur, Sulawesi Tenggra, dan Sumatera Utara. Hasil analisis multivariat menunjuklran tidak ada satu pun variabel bebas yang berhubrmgan secara bermakna deagan tingkat kepatuhan petugas clalarn melakukan penilaian menurut standar MTBS. Selain itu variabel pelatihan memiliki hubungan bermakna dengan lresesuaian antara klasiiikasi yang ditetaplran petugas dengan klasifilrasi menurut pengamat, dan merupalran variabel bebas yang dominan terhadap kesesuaian antara klasifikasi yang ditetapkan petugas dengan klasilikasi menunrt pengamat dengan nilai OR sebesar 27,7. Sedanglran pelatihan dan kelengkapan alat merupalum faktor dominan terhadap kesesuaian antara pengobatan yang diberikan dengan klasilikasi yang ditetapkan petugas (tanpa tablet zinc). Selain itu variabel pelatihan juga merupalran faktor dominan terhadap kesesuaian antara pengobatan yang diberilran petugas dengan pengobatan menurut pengamat. Satu hal yang rnenjadi catatan panting dalam pemberian pengobatan adalah masih nendahnya kepatuhan baik petugas maupun pengamat dalam melaksanakau pedornan yaitu memberikan tablet zinc pada anal: dengan gejala diare. Saran, peninglratan keterampilan petugas mengenai pelaksanaan MTBS dan peningkatan dukungan fasilitas di setiap pclayanan kesehatan. ......This thesis is examined the treatment of childhood illness with diarrhoea as symptom according to Integrated Management of Childhood Illness (IMCI) in Aceh, Central Java, East Java, South Kalimantan, East Nusa Tenggara, Southeast Sulawesi and North Sumatera using a Cross Sectional Design with sample size is l06. The result of multivariate analysis is indicated none of independent variables are statistically significant to the health stafPs assessment compliance in evaluation related to IMCI. Training has showed significance in statistic among classification that set up by health stat? and classification according to evaluator. It is also a dominant independent variable with OR=27.7. Training and comprehensive tools is a dominant factor to the treatment related to the classification that set up by health stai¥`(without zinc tablet). Training itself is a dominant liactor to the treatment according to the classification of the health staff and evaluator. Suggestion, skill improvement of health about [MCI implementation and facility support improvement in every health center.

Abstrak :
Berdasarkan Survei Kesehatan Rumah Tangga (SKRT), Studi Mortalitas dan Riset Kesehatan Dasar setiap tahunnya dapat diketahui bahwa penyakit masih menjadi penyebab utama kematian balita di Indonesia serta diakibatkan oleh tidak tepatnya tata laksana diare baik di rumah maupun di sarana kesehatan. Penelitian ini dilakukan terhadap Rekam medik balita yang mengalami diare yang datang ke poli Manajemen Terpadu Balita Sakit di Puskesmas Kecamatan Pasar Rebo. Penelitian ini dibagi kedalam 5 kelompok yaitu berdasarkan jenis kelamin, usia, indeks masa tubuh, penggunaan obat dan bentuk obat, dan tempat dosis. Hasil menunjukkan bahwa Pasien diare balita berjenis kelamin laki-laki memiliki kasus terbanyak yaitu 32 pasien (51.6%) dan perempuan berjumlah 30 pasien (48.4%). Jumlah usia pasien diare pada balita usia 0 tahun berjumlah 16 pasien (25.8%) dan usia 1 – 5 tahun berjumlah 46 pasien (74.2%). Kelompok indeks masa tubuh pasien diare pada balita berdasarkan standar WHO yaitu kelompok indeks masa tubuh kurang berjumlah yang diberikan 58 pasien (93.5%) dan indeks masa tubuh normal berjumlah 4 pasien (6.5%). Berdasarkan penggunaan obat dan bentuk sediaan obat diperoleh penggunaan obat pada pasien diare balita di poli MTBS lebih ke terapi supportif dengan oralit dan zinc. Pengobayan diare tepat dosis pada obat oralit dan zinc sebanyak 0 kasus (100%), dan cotrimoxazole tepat dosis sebanyak 2 kasus (66.67 %) dan terdapat 1 kasus (33.33%) tidak tepat dosis. ......Based on the Household Health Survey, Mortality Study and Basic Health Research every year it is seen that disease is still the main cause of under-five mortality in Indonesia and is caused by improper handling of diarrhea both at home and in health. Facility. This research was conducted on the medical records of toddlers who experienced diarrhea who came to the Integrated Management of Sick Toddlers at the Pasar Rebo District Health Center. This study was divided into 5 groups based on gender, age, body mass index, drug use and drug form, and place of drug administration. The results showed that male toddlers with diarrhea had the most cases, namely 32 sufferers (51.6%) and 30 female sufferers (48.4%). The number of diarrhea sufferers in toddlers aged 0 years was 16 sufferers (25.8%) and aged 1-5 years were 46 sufferers (74.2%). Based on WHO standards, the body mass index group for diarrhea sufferers was less than 58 patients (93.5%) and 4 patients (6.5%) had normal body mass index. Based on the use of drugs and drug dosage forms, it was found that the use of drugs in children with diarrhea under five at the MTBS poly was more supportive of therapy with ORS and zinc. Treatment of diarrhea with ORS and zinc was dosed correctly in 0 cases (100%), and co-trimoxazole was dosed correctly in 2 cases (66.67%) and there was 1 case (33.33%) wrong dose.

Abstrak :
Keberhasilan suatu program berhubungan dengan kinerja petugasnya. Penelitian ini bertujuan untuk mengetahui kinerja petugas Manajemen Terpadu Balita Sakit (MTBS) dan hubungan antara variabel indepeden yang terdiri dari faktor individu (umur, masa kerja, pengetahuan dan motivasi), dan faktor organisasi (pelatihan, fasilitas, kepemimpinan) dengan variabel dependen yaitu kinerja petugas MTBS. Jenis penelitian yang digunakan adalah kuantitatif dengan rancangan penelitian cross sectional. Jumlah sampel 50 responden petugas MTBS.Pengumpulan data dilakukan dengan pengisisan kuesioner dan wawancara serta observasi.Pengolahan data dengan menggunakan perangkat lunak computer, analisis data dengan univariat, bivariat dengan uji statistik chi-square dan multivariat dengan uji statistik multipel regresi logistik. Hasil penelitian menunjukkan bahwa 62% petugas MTBS mempunyai kinerja baik. Terdapat hubungan antara umur, masa kerja, pengetahuan, motivasi, fasilitas dan kepemimpinan dengan kinerja petugas MTBS. Faktor dominan yang mempengaruhi kinerja petugas MTBS adalah masa kerja dan kepemimpinan. ......The success of a program related to the performance of its officers This study aims to determine the performance of Integrated Management of Childhood Illness (IMCI) officers and determine the relationship between the independent variables consisting of individual factors (age,length of work, knowledge and motivation) and organizational factors (training, facilities, leadership) with the dependent variable which is the performance of IMCI officer. This type of research is quantitative with cross sectional study design. The sample of 50 respondents IMCI officer.Collecting data by filling the questionnaire and interviewing and observation.Processing data using computer software, data analysis with univariate, bivariate statistical test chi-square and multivariate multiple logistic regression statistical test. The results of this study showed that 62% good performance of IMCI officer. There was correlation between age, length of work,knowledge, motivation, training and leadership with performance of IMCI officer. The dominant factor affecting performance is the IMCI officers working life and leadership.

Abstrak :
Sejak tahun 1997, Departemen Kesehatan bekerjasama dengan WHO telah mengembangkan suatu pendekatan dalam tatalaksana balita sakit di tingkat pelayanan kesehatan dasar yang selanjutnya disebut sebagai Manajemen Terpadu Balita Sakit (MTBS). Kabupaten Sidoarjo Jawa Timur dengan dana bantuan WHO pada tahun 1997 pula telah mulai menerapkan pendekatan MTBS di 6 puskesmas. Tujuan penelitian ini adalah untuk memperoleh gambaran tingkat kepatuhan petugas pelaksana MTBS dan kepuasan ibu balita yang mendapat pelayanan dengan menggunakan tatalaksana MTBS di Kabupaten Sidoarjo. Penelitian ini menggunakan disain cross sectional dengan pendekatan kuantitatif dan kualitatif dengan jumlah sample sebanyak 12 petugas pelaksana MTBS dan 120 ibu balita. Pengumpulan data dilakukan dengan pengamatan secara langsung pada saat petugas memeriksa balita sakit dengan menggunakan daftar tilik dan wawancara terhadap ibu balita setelah selesai pelayanan dengan menggunakan kuesioner, kemudian dilakukan wawancara mendalam kepada petugas dan diskusi kelompok terarah dengan ibu balita. Hasil penelitian memperlihatkan bahwa pada tingkat kepatuhan petugas dengan menggunakan cut off point 90 dalam niiai kisaran kepatuhan tertinggi 100 dan terendah 83,32 maka sebanyak 65,80% petugas patuh dalam melakukan penilaian dan klasifikasi, 9I,70% petugas patuh dalam menentukan tindakan dan 66,70% petugas patuh dalam memberikan konseling. Untuk tingkat kepuasan ibu balita, dengan cut off point 29 dari total score 40, maka secara umum ibu balita menyatakan puas mendapat pelayanan dengan tatalaksana MTBS, tetapi masih ada 8,34% ibu balita yang tidak puas dalam hal keinginannya untuk kembali. Dengan uji statistik, pada p~,43 terdapat hubungan yang bermakna antara kepatuhan petugas dalam penilaian dan klasifikasi penyakit dengan kepuasan ibu balita dalam hal keinginannya untuk kembali membawa anaknya berobat ke puskesmas. Kesimpulan secara umum, tingkat kepatuhan petugas daIam tatalaksana MTBS sudah cukup baik, demikian pula kepuasan ibu balita terhadap pelayanan kesehatan dengan menggunakan tatalaksana sudah cukup tinggi. Maka disarankan kepada Dinas Kesehatan Kabupaten Sidoarjo untuk tetap mempertahankan kualitas bimbingan dan supervisinya agar kelangsungan pendekatan ini tetap terjaga. Bagi puskesmas perlunya memberikan penghargaan tertentu bagi petugas yang patuh untuk mempertahankan tingkat kepatuhan petugas , dan untuk meningkatkan kepuasan ibu perlu dilakukan sosialisasi tentang MTBS. Bagi Departemen Kesehatan perlu mempertimbangkan cut off point tingkat kepatuhan, disesuaikan dengan telah berapa lama puskesmas menerapkan MTBS. ......Relationship on the Compliance Rate of Health Workers and the Satisfaction Rate of Mothers on the Integrated Management of Childhood Illness at Distric Sidoarjo East Java year 2002Since 1997, the Ministry of Health Republic of Indonesia in collaboration with the World Health Organization has developed an approach in managing sick child underfive at the primary health services known as Integrated Management of Childhood Illness (LMCI). District of Sidoarjo, using WHO budget has started socializing the IMCI in 6 health centers on 1997. The objective of this study is to have a description of health worker's compliance and mother's satisfaction towards IMCI implementation in district Sidoarjo. The study will use cross sectional design with quantitative and qualitative approach with sum of sample to 12 IMCI-implement health workers and 120 mothers. Data collection is conducted by direct observation to health workers during sick child examination using a checklist and exit interviews to mothers using questionnaires then followed by an indepth interview to the health workers and focus group discussion to the mothers. The study showed that means of staff compliance score on IMCI procedures are 92,18; 96,56; 93,06 and 95,45 respectivety for patient assessment & classificatioiu; determine treatment; giving counseling; and average total compliance using cut-off 90, it is showed that compliance on treatment determination is highest with 91,70% respondent midwifes. Followed by giving counseling (66,70%) and assessment & classification (65,50%). Furthermore, this study showed level of satisfaction for IMCI service on high (by using cut-off score of 29 of total score 40), except that there are 8,30% of mothers who expreseed will not return for the IMCI services at the health center. Furthermore, using Chi Square statistic with exact p-value approach, it is showed that there is a significant relationship between compliance in assessment & classification and satisfaction in intention to return for the same services (p~,03). In conclusion, the compliance rate of health workers towards the IMCI achieve a higher level than Ministry of Health suggestion (80% comply)) similar results are shown for the mother satisfaction in health treatment. This study suggest the District Health Office of Sidoarjo to maintain its quality of IMCI services with adequate supervision and monitoring evaluation. Furthermore, Puskesmas manager should identify staff with excellent compliance and reward them adequately. For other staff, the manager may promote continuously the IMCI services. At last but not least, this study suggest the Ministry of Health recruits level of compliance based local experience on applying IMCI services.

Abstrak :
Analysis on the Compliance Rate of Health Personnel towards the Integrated Management of Childhood Illness at DKI Jakarta Health Center Year 2001The Ministry of Health Republic of Indonesia in collaboration with the World Health Organization, since 1997, has developed an approach in managing sick child under-five at the primary health services known as Integrated Management of Childhood Illness (IMCI). Today, IMCI has been implemented in 26 provinces (of 30 provinces present) covering 128 districts/municipalities in Indonesia. The province of DKI Jakarta, using regional budget 2000, has started socializing the IMCI to 14 health centers in 5 regions of Jakarta. How is the compliance of health worker in implementing the IMCI has never been studied. The objective of this study is to have a outline information on factors related to the health worker's compliance towards IMCI implementation at HC in Jakarta. The study will use "cross-sectional" design with quantitative and qualitative approach and total sample of 23 IMCI-implement health workers. Data collection is conducted by direct observation to the health workers during sick child examination using a checklist. After the observation, the health workers will fill in a questionnaire. Some secondary data will also be collected using the checklist for Monitoring IMCI record and checklist for supporting facilities. The result of the study shows that of 23 IMCI-implement health workers in DKI Jakarta 21.72% comply with interval value 58.61% - 90.28%, with cut off point value 80. The Internal factors is proven to have significant correlation with health worker's compliance with p = 0.04. While the external factors is proven to have significant correlation with human resources/MMCI facilities with p = 0.02 and leader's commitment with p = 0.009. In conclusion, the compliance rate of HC personnel in DKI Jakarta towards IMCI has not adequate. It is suggested to the Provincial Health Services DKI Jakarta to provide a health policy in managing sick child under-five using IMCI approach and at the same time improving quality of its monitoring and supervision. Health Center needs to have a clear task description for each of their personnel and a continued monitoring/supervision. A reward system should also be considered. The Ministry of Health needs to review the IMCI Monitoring and Supervision Checklist also considers Cut of Point of IMCI compliance rate and finalizing the Essential Drug for IMCI.