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Abstrak :
ABSTRAK
Nama : Wayan Indah PramantiProgram Studi : Kajian Administrasi Rumah SakitJudul : Hubungan Antara Karakteristik Individu, Motivasi DanKarakteristik Organisasi Dengan Perilaku Dokter DanPerawat Dalam Penerapan Pelayanan Berpusat Pada PasienDi RSU Ganesha, Gianyar Tahun 2018Pembimbing : Dr. Ede Surya Darmawan S.K.M., M.D.M.Pelayanan berpusat pada pasien PBP merupakan paradigma baru pelayanankesehatan di rumah sakit. Penelitian terkait penerapan PBP di Indonesia masihsangat terbatas. Penelitian ini dilatarbelakangi belum diketahuinya gambaranperilaku dokter dan perawat dalam menerapkan PBP di RSU Ganesha, Gianyar.Penelitian ini bertujuan untuk mengetahui bagaimana perilaku PBP pada dokterdan perawat serta menganalisis hubungan status kepegawaian, motivasi, dankarakteristik organisasi terhadap penerapan PBP. Penelitian ini memiliki desaincross sectional dengan menggunakan kuisioner yang disebarkan kepada seluruhdokter dan perawat. Total sampel penelitian sebanyak 141 responden. Hasilpenelitian menunjukkan sebagian besar responden 80,1 memiliki perilaku PBPyang baik. Pada komponen perilaku PBP yang diteliti yaitu komponen melibatkanpasien dan keluarga, berbagi informasi, memberi dukungan fisik, dukunganemosional, dan pelayanan yang berkelanjutan juga menunjukkan lebih banyakproporsi perilaku yang baik dengan persentase masing-masing sebanyak 68,1 ;84,4 ; 96,5 ; 94,3 ; dan 91,5 . Variabel umur, motivasi, dan karakteristikorganisasi seperti imbalan, supervise, desain pekerjaan, kepemimpinan, sertabudaya organisasi signifikan hubungannya dengan perilaku dokter dan perawatdalam menerapkan PBP nilai p

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ABSTRACT
Name Wayan Indah PramantiStudy Program Study of Hospital AdministrationTitle The Relationship Between Individual Characteristics,Motivation and Organizational Characteristics With TheBehavior of Doctors and Nurses in The Implementation ofPatient Centered Care at Ganesha General Hospital, Gianyar,2018.Counselor Dr. Ede Surya Darmawan S.K.M., M.D.M.Patient centered care PCC is a new paradigm of health care services in hospital.In Indonesia, research related to implementation of PCC is still very limited.Background of this research is there not yet known about the behavior of doctorsand nurses in implementing PCC in Ganesha General Hospital, Gianyar. The aimsof this study are to find out the PCC behavior in doctors and nurses as well asanalyze the relationship of individual, psychological, and organizationalcharacteristics to the implementation of PCC. This study has a cross sectionaldesign using a questionnaire distributed to all doctors and nurses. The total sampleis 141 respondents. The results showed that most respondents 80,1 had goodPCC behavior. In the PCC behavioral component studied, the componentsincluding the involvement of patients and families, sharing information, providingphysical support, emotional support, and sustainable health services also showed agreater proportion of poor behavior with percentage of 68.1 84.4 96.5 94.3 and 91.5 respectively. Variables of age, motivation, and organizationalcharacteristics such as rewards, supervision, job design, leadership, organizationalculture are significantly related to the behavior of doctors and nurses inimplementing PCC p

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ABSTRAK
Dokter sebagai gate keeper di fasilitas kesehatan tingkat pertama FKTP , memerlukan kompetensi pelayanan komprehensif berpusat pada pasien, sebagai komponen utama pelayanan kesehatan primer, namun kemampuan dokter dalam pelayanan berpusat pada pasien di FKTP masih rendah. Optimalisasi implementasi sistem pelayanan kesehatan berjenjang dan program rujuk balik, merupakan program Jaminan Kesehatan Nasional yang keberhasilannya ditentukan oleh dokter di FKTP, oleh karena itu diperlukan terobosan pembelajaran dengan situasi nyata di tempat kerja, serta penilaian terstandar diperlukan untuk meningkatkan kompetensi dokter dalam pelayanan komprehensif berpusat pada pasien.Penelitian ini bertujuan membuat Model pembelajaran dan penilaian berbasis tempat kerja PPBTK untuk meningkatkan kompetensi pelayanan komprehensif berpusat pada pasien bagi dokter di FKTP. Desain penelitian adalah ldquo;Penelitian Tindakan rdquo; 4 tahap yaitu ldquo;Tindakan Diagnosis rdquo; dengan metode survei. responden terdiri 96 pasien, 56 dokter, dan 64 pendidik, bertujuan mendapatkan indikator pelayanan komprehensif berpusat pada pasien, ldquo;Tindakan Perencanaan rdquo; dengan metode Delphi, responden terdiri 2 orang ahli pendidikan kedokteran, 5 orang ahli pelayanan primer, bertujuan menyusun Model Pembelajaran dan Penilaian Berbasis Tempat Kerja PPBTK yang tervalidasi dengan expert judgment, ldquo;Tindakan Implementasi rdquo; sebagai uji coba model, dengan rancangan eksperimen kuasi, terdiri 13 dokter sebagai kelompok intervensi dan 12 dokter sebagai kelompok kontrol. ldquo;Tindakan Evaluasi rdquo; dengan metode Kirkpatrick untuk membuktikan efektivitas model.Sebanyak 33 indikator dinilai relevan untuk mengukur pelayanan komprehensif berpusat pada pasien, menjadi instrumen Self Assessment dan Direct Observation. Case-based Discussion yang teruji konsistensinya, menjadi instrumen penilaian pertemuan modifikasi Balint group. Kompetensi ranah kognitif, afektif dan psikomotor sebelum dan sesudah intervensi Model PPBTK berbeda bermakna p value < 0,05 . Hasil uji SEM-PLS menunjukkan model efektif untuk meningkatkan kompetensi pelayanan komprehensif berpusat pada pasien di FKTP. Kata Kunci. pelayanan berpusat pada pasien, pelayanan komprehensif,pembelajaran berbasis tempat kerja.

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ABSTRACT
Doctors as gatekeepers at First Level Healthcare Facility FLHF require a patient-centered and comprehensive care competency. The patient-centered care competency is necessary to determine the optimization of referral program in the National Health Insurance program implementation. Thus, learning methods with real situations in the workplace and standardized assessment are also required. The study design was Action Research with 4 stages. The first stage was diagnosing action supported by survey method. This stage consisted of many respondents involving 96 patients, 56 doctors, and 64 lecturers. The determination of respondents in the first stage was aimed to obtain a patient-centered and comprehensive care indicator. Second stage namely planning action supported by Delphi method with 2 medical education experts and 5 primary care specialists as respondents. The determination of the respondents in the second stage was to develop Workplace-Based Learning and Assessment WPBLA Model validated with expert judgment. The third stage was taking action as the test model with a quasi-experimental design, consisting of 13 doctors as an intervention group and 12 doctors as a control group. The last stage was evaluating action measures with Kirkpatrick method purposed to prove the effectiveness of the model. As many as 33 indicators were assessed to be relevant for evaluating patient-centered and comprehensive care. Case-based Discussion which its consistency had been tested, functioned as instruments of Balint Group meeting modification. The cognitive, affective and psychomotor domains before and after the intervention of WPBLA Model was significantly different p value < 0.05 . The SEM-PLS test showed the WPBLA was effective in improving patient-centered and comprehensive care competency at FLHF. Keywords. comprehensive care, patient-centered care, workplace-based learning.

Abstrak :
Remaja dengan kelebihan berat badan harus diintervensi agar tidak menjadi orang dewasa dengan obesitas. Berkembangnya patient-centered care sebagai upaya pemberdayaan diri dapat menjadi pendekatan terpilih. Dibutuhkan motivasi besar dalam menjalani proses perubahan perilaku. Coaching dilakukan untuk mendampingi klien (coachee) agar mampu mengoptimalkan potensi sehingga memiliki sikap positif, mental yang kuat, dan gaya hidup yang lebih baik. Belum ada penelitian yang mengidentifikasi keberhasilan patient-centered care berbasis pemberdayaan diri dengan metode coaching pada mahasiswa obesitas. Penelitian dilakukan dengan mixed method dalam tiga tahap. Tahap 1 merupakan studi potong lintang untuk mengidentifikasi persepsi mahasiswa terhadap dampak obesitas bagi kesehatan. Kuesioner daring terdiri dari identitas, data antropometri, S-Weight, dan P-Weight. Tahap 2 dilakukan pengembangan model pelayanan dengan cara melaksanakan focus group discussion. Peserta diskusi adalah pakar di tingkat mikro, meso dan makro sistem layanan kesehatan. Tahap 3 menilai kemamputerapan dan efektivitas model layanan yang dikembangkan. Studi dilakukan pada dua kelompok mahasiswa obesitas (usia 18-24 tahun) yang dibagi dalam kelompok intervensi dan kontrol. Pada kedua kelompok diberlakukan model layanan yang sama yaitu pengukuran status antropometrik dan komposisi tubuh, pengisian kuesioner pada awal program, edukasi, dan kembali dilakukan pengukuran status antropometrik dan komposisi tubuh serta pengisian kuesioner pada akhir program. Pada kelompok intervensi ditambahkan uji coba coaching sebanyak 6 sesi setiap dua minggu. Pengukuran awal dan akhir berjarak 3 bulan. Tahap 1 diperoleh 134 mahasiswa obesitas (respons rate 14.1%). Teridentifikasi responden berada pada tahap kontemplasi (35,8%) dan aksi (35,1%) terhadap perubahan perilaku dalam proses menurunkan berat badan. Kesiapan responden bersifat positif (76,9%) pada emosi, dan bersifat negatif pada konsekuensi, dukungan, dan aksi dalam menurunkan berat badan. Tahap 2 dilaksanakan dua tahap FGD terhadap 2 kelompok @ 10 orang. Teridentifikasi bahwa program penurunan berat badan harus diinisiasi dengan membangkitkan rasa kebutuhan untuk lebih sehat dengan berat badan yang ideal. Program harus bersifat personal. Diperlukan dukungan lingkungan seperti ketersediaan makanan sehat dan sarana untuk beraktivitas. Program harus merupakan program yang menimbulkan dukungan terhadap peserta, profesional, dan tersedia di layanan kesehatan. Berdasarkan hal tersebut disusun metode coaching yang sesuai dengan patient-centered care berbasis pemberdayaan diri bagi mahasiswa obesitas dalam program penurunan berat badan. Program terdiri dari 6 sesi coaching. Setiap tema dalam sesi coaching menggunakan langkah SMART dan diberi nama “From Fat to Fit with SMART Program”. Program dilaksanakan dalam waktu 3 bulan. Tema berturut-turut adalah healthy behavior habit, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, dan healthy behavior habit/ vision board. Kedua kelompok mendapatkan edukasi mengenai dampak obesitas bagi kesehatan, prinsip gizi seimbang, aktivitas fisik dan hidrasi yang sesuai bagi remaja dari para ahli yang terdiri dari spesialis penyakit dalam, spesialis gizi klinik, dan spesialis kedokteran olahraga yang dilakukan secara daring. Pengukuran antropometri, komposisi tubuh (menggunakan Bioelectric Impedance Analysis), pemantauan asupan makanan (menggunakan formulir food record), pemantauan aktivitas fisik (menggunakan bouchard activity record), pemberdayaan diri (menggunakan kuesioner subjective wellbeing dan skala kepuasan healthy behavior habit), dibandingkan antara dua kelompok menggunakan uji T berpasangan (jika distribusi data normal) dan uji Mann-Whitney (jika distribusi data tidak normal). Tahap 3 diawali dengan penerapan program terhadap dua kelompok @ 30 mahasiswa obesitas. Peserta dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi mendapatkan coaching dari health coach yang telah mendapatkan pelatihan sebelumnya dari coach bersertifikat Internasional. Seorang health coach mendampingi 4 mahasiswa obesitas. Health coach berjumlah 8 orang yang terdiri dari dokter spesialis kedokteran keluarga layanan primer, dokter spesialis penyakit dalam, dokter spesialis kedokteran olahraga, dokter pengelola program studi fakultas, dan coach yang berpengalaman dengan pendekatan coaching di tempat kerjanya. Sesi coaching dibagi menjadi enam pertemuan setiap dua minggu secara daring melalui media zoom meeting dengan bantuan host dari tim peneliti. Namun, meningkatnya kondisi PPKM (pemberlakuan pembatasan kegiatan masyarakat) pada tahap ini, mahasiswa yang berhasil menyelesaikan program adalah 23 mahasiswa kelompok intervensi dan 18 mahasiswa kelompok kontrol. Nilai perubahan pada kelompok intervensi secara signifikan lebih besar dibandingkan kelompok kontrol pada komponen total lemak tubuh [-0.9 (-12,9, 0,70) vs 0,0 (-6,9, 3,50), p=0,02) dan healthy behavior habit [13.5 ± 11,85 vs 7,5 ± 8,08, p=0,04]. Nilai perubahan skala kepuasan healthy behavior habit secara signifikan lebih besar dibandingkan kelompok kontrol pada aspek hobby/passion [2(-4,6) vs 1(-2,2), p=0,02], movement exercise [2,3 ± 2,11 vs 1,2 ±1,93, p=0,03], sleep rest [2(-6,5) vs 1(-3,2), p=0,01], dan spiritual [1(0,6) vs 0( -1,3), p=0,00]. ......Adolescents with excess weight should be intervened so as not to become adults with obesity. The development of patient-centred services as an effort to empower oneself could be the approach of choice. It takes great motivation in undergoing the process of behaviour change. Coaching is carried out to assist the client (coachee) to optimize their potential so that they had a positive attitude, strong mentality, and a healthier lifestyle. There has been no research that has identified the success of patient-centred care based on self-empowerment with coaching methods for obese students. Mixed method research were in three stages. Phase 1 was a cross-sectional study to identify students' perceptions of the impact of obesity on health. The online questionnaire consisted of identity, anthropometric data, S-Weight, and P-Weight. Phase 2 was developing a service model by conducting focus group discussions. Discussion participants were experts at the micro, meso, and macro levels of the health care system. Phase 3 assessed the applicability and effectiveness of the developed service model. The study was conducted on two groups of obese college students (aged 18-24 years) in the intervention group and the control group. Both groups were subjected to the same service model, namely an initial physical examination, a questionnaire at the beginning of the service, and education about how to lose weight. A final physical examination and questionnaire were carried out at the end of the program. However, the intervention group was given a coaching method. Initial and final examinations were 3 months apart. Phase 1 obtained 134 obese students (response rate of 14.1%). Respondents identified as being in the contemplation stage (35.8%) and action (35.1%) on behaviour change in the process of losing weight. Respondents' readiness was positive (76.9%) on emotions about losing weight and was negative in terms of consequences, support, and action in losing weight. Phase 2 was carried out in 2 stages of FGD with 2 groups of 10 people. It was identified that a weight loss program should be initiated by generating a sense of the need to be healthier with ideal body weight. Programs should be personal. Environmental support was needed such as the availability of healthy food and facilities for activities. The intervention program should be a program that creates support for participants, professional, and available in health services. Based on this, a coaching method was developed following patient-centred care based on self-empowerment for students with obesity in weight loss programs. The program consisted of 6 coaching sessions. Each session used SMART steps. Each coaching session was themed sequentially and was named “From Fat to Fit with SMART Program”. The program was implemented within 3 months. The successive themes of the coaching session were healthy behaviour habits, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, and healthy behaviour habit/ vision board. Both groups received online education about obesity, balanced diet, physical activity and hydration from experts consisting of internal medicine specialists, clinical nutrition specialists, and sports medicine specialists. Anthropometric measurements, body composition (using Bioelectric Impedance Analysis), monitoring food intake (using a food record form), monitoring physical activity (using a bouchard activity record), self-empowerment (using a subjective wellbeing questionnaire and healthy behaviour habits satisfaction scale) were compared between the two groups using paired T-test (if the data distribution was normal) and the Mann-Whitney test (if the data distribution was not normal). Phase 3 began with the application of the program to two groups of 30 obese students. Participants were divided into an intervention group and a control group. The intervention group received coaching from a health coach who had received previous training from an internationally certified coach. A health coach accompanied 4 obese students. There were 8 health coaches consisting of family medicine and primary care specialists, internal medicine specialists, sports medicine specialists, faculty study program manager doctors, and coaches who were experienced with coaching approach in the workplace. The coaching session was divided into six meetings every two weeks online via a zoom meeting with the help of a host from the research team. However, the increasing conditions of pandemic restrictions on community activities at this stage, students who completed the program were 23 students in the intervention group and 18 students in the control group. The value of change in the intervention group was significantly greater than the control group in the component of total body fat [-0.9 (-12.9, 0.70) vs 0.0 (-6.9, 3.50), p=0.02 ) and healthy behaviour habit [13.5 ± 11.85 vs. 7.5 ± 8.08, p=0.04]. The value of the change in the healthy behaviour habit satisfaction scale was significantly greater than the control group in the hobby/passion aspect [2(-4.6) vs 1(-2.2), p=0.02], move exercise [2,3 ± 2.11 vs 1.2 ±1.93, p=0.03], sleep rest [2(-6.5) vs 1(-3.2), p=0.01], and spiritual [1( 0.6) vs 0( -1.3), p=0.00]. This method has been proven to be able to be applied and is effective in reducing total body fat and significantly increasing healthy behaviour habits. This coaching method, which is following self-empowerment-based patient-centred care, has been proven to be able to be applied in the university's primary health services. However, support is needed from supportive university policies so that students participating in the program could follow it completely until all the expected output indicators are achieved properly

Abstrak :
Remaja dengan kelebihan berat badan harus diintervensi agar tidak menjadi orang dewasa dengan obesitas. Berkembangnya patient-centered care sebagai upaya pemberdayaan diri dapat menjadi pendekatan terpilih. Dibutuhkan motivasi besar dalam menjalani proses perubahan perilaku. Coaching dilakukan untuk mendampingi klien (coachee) agar mampu mengoptimalkan potensi sehingga memiliki sikap positif, mental yang kuat, dan gaya hidup yang lebih baik. Belum ada penelitian yang mengidentifikasi keberhasilan patient-centered care berbasis pemberdayaan diri dengan metode coaching pada mahasiswa obesitas. Penelitian dilakukan dengan mixed method dalam tiga tahap. Tahap 1 merupakan studi potong lintang untuk mengidentifikasi persepsi mahasiswa terhadap dampak obesitas bagi kesehatan. Kuesioner daring terdiri dari identitas, data antropometri, S-Weight, dan P-Weight. Tahap 2 dilakukan pengembangan model pelayanan dengan cara melaksanakan focus group discussion. Peserta diskusi adalah pakar di tingkat mikro, meso dan makro sistem layanan kesehatan. Tahap 3 menilai kemamputerapan dan efektivitas model layanan yang dikembangkan. Studi dilakukan pada dua kelompok mahasiswa obesitas (usia 18-24 tahun) yang dibagi dalam kelompok intervensi dan kontrol. Pada kedua kelompok diberlakukan model layanan yang sama yaitu pengukuran status antropometrik dan komposisi tubuh, pengisian kuesioner pada awal program, edukasi, dan kembali dilakukan pengukuran status antropometrik dan komposisi tubuh serta pengisian kuesioner pada akhir program. Pada kelompok intervensi ditambahkan uji coba coaching sebanyak 6 sesi setiap dua minggu. Pengukuran awal dan akhir berjarak 3 bulan. Tahap 1 diperoleh 134 mahasiswa obesitas (respons rate 14.1%). Teridentifikasi responden berada pada tahap kontemplasi (35,8%) dan aksi (35,1%) terhadap perubahan perilaku dalam proses menurunkan berat badan. Kesiapan responden bersifat positif (76,9%) pada emosi, dan bersifat negatif pada konsekuensi, dukungan, dan aksi dalam menurunkan berat badan. Tahap 2 dilaksanakan dua tahap FGD terhadap 2 kelompok @ 10 orang. Teridentifikasi bahwa program penurunan berat badan harus diinisiasi dengan membangkitkan rasa kebutuhan untuk lebih sehat dengan berat badan yang ideal. Program harus bersifat personal. Diperlukan dukungan lingkungan seperti ketersediaan makanan sehat dan sarana untuk beraktivitas. Program harus merupakan program yang menimbulkan dukungan terhadap peserta, profesional, dan tersedia di layanan kesehatan. Berdasarkan hal tersebut disusun metode coaching yang sesuai dengan patient-centered care berbasis pemberdayaan diri bagi mahasiswa obesitas dalam program penurunan berat badan. Program terdiri dari 6 sesi coaching. Setiap tema dalam sesi coaching menggunakan langkah SMART dan diberi nama “From Fat to Fit with SMART Program”. Program dilaksanakan dalam waktu 3 bulan. Tema berturut-turut adalah healthy behavior habit, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, dan healthy behavior habit/ vision board. Kedua kelompok mendapatkan edukasi mengenai dampak obesitas bagi kesehatan, prinsip gizi seimbang, aktivitas fisik dan hidrasi yang sesuai bagi remaja dari para ahli yang terdiri dari spesialis penyakit dalam, spesialis gizi klinik, dan spesialis kedokteran olahraga yang dilakukan secara daring. Pengukuran antropometri, komposisi tubuh (menggunakan Bioelectric Impedance Analysis), pemantauan asupan makanan (menggunakan formulir food record), pemantauan aktivitas fisik (menggunakan bouchard activity record), pemberdayaan diri (menggunakan kuesioner subjective wellbeing dan skala kepuasan healthy behavior habit), dibandingkan antara dua kelompok menggunakan uji T berpasangan (jika distribusi data normal) dan uji Mann-Whitney (jika distribusi data tidak normal). Tahap 3 diawali dengan penerapan program terhadap dua kelompok @ 30 mahasiswa obesitas. Peserta dibagi menjadi kelompok intervensi dan kelompok kontrol. Kelompok intervensi mendapatkan coaching dari health coach yang telah mendapatkan pelatihan sebelumnya dari coach bersertifikat Internasional. Seorang health coach mendampingi 4 mahasiswa obesitas. Health coach berjumlah 8 orang yang terdiri dari dokter spesialis kedokteran keluarga layanan primer, dokter spesialis penyakit dalam, dokter spesialis kedokteran olahraga, dokter pengelola program studi fakultas, dan coach yang berpengalaman dengan pendekatan coaching di tempat kerjanya. Sesi coaching dibagi menjadi enam pertemuan setiap dua minggu secara daring melalui media zoom meeting dengan bantuan host dari tim peneliti. Namun, meningkatnya kondisi PPKM (pemberlakuan pembatasan kegiatan masyarakat) pada tahap ini, mahasiswa yang berhasil menyelesaikan program adalah 23 mahasiswa kelompok intervensi dan 18 mahasiswa kelompok kontrol. Nilai perubahan pada kelompok intervensi secara signifikan lebih besar dibandingkan kelompok kontrol pada komponen total lemak tubuh [-0.9 (-12,9, 0,70) vs 0,0 (-6,9, 3,50), p=0,02) dan healthy behavior habit [13.5 ± 11,85 vs 7,5 ± 8,08, p=0,04]. Nilai perubahan skala kepuasan healthy behavior habit secara signifikan lebih besar dibandingkan kelompok kontrol pada aspek hobby/passion [2(-4,6) vs 1(-2,2), p=0,02], movement exercise [2,3 ± 2,11 vs 1,2 ±1,93, p=0,03], sleep rest [2(-6,5) vs 1(-3,2), p=0,01], dan spiritual [1(0,6) vs 0( -1,3), p=0,00]. ......Adolescents with excess weight should be intervened so as not to become adults with obesity. The development of patient-centred services as an effort to empower oneself could be the approach of choice. It takes great motivation in undergoing the process of behaviour change. Coaching is carried out to assist the client (coachee) to optimize their potential so that they had a positive attitude, strong mentality, and a healthier lifestyle. There has been no research that has identified the success of patient-centred care based on self-empowerment with coaching methods for obese students. Mixed method research were in three stages. Phase 1 was a cross-sectional study to identify students' perceptions of the impact of obesity on health. The online questionnaire consisted of identity, anthropometric data, S-Weight, and P-Weight. Phase 2 was developing a service model by conducting focus group discussions. Discussion participants were experts at the micro, meso, and macro levels of the health care system. Phase 3 assessed the applicability and effectiveness of the developed service model. The study was conducted on two groups of obese college students (aged 18-24 years) in the intervention group and the control group. Both groups were subjected to the same service model, namely an initial physical examination, a questionnaire at the beginning of the service, and education about how to lose weight. A final physical examination and questionnaire were carried out at the end of the program. However, the intervention group was given a coaching method. Initial and final examinations were 3 months apart. Phase 1 obtained 134 obese students (response rate of 14.1%). Respondents identified as being in the contemplation stage (35.8%) and action (35.1%) on behaviour change in the process of losing weight. Respondents' readiness was positive (76.9%) on emotions about losing weight and was negative in terms of consequences, support, and action in losing weight. Phase 2 was carried out in 2 stages of FGD with 2 groups of 10 people. It was identified that a weight loss program should be initiated by generating a sense of the need to be healthier with ideal body weight. Programs should be personal. Environmental support was needed such as the availability of healthy food and facilities for activities. The intervention program should be a program that creates support for participants, professional, and available in health services. Based on this, a coaching method was developed following patient-centred care based on self-empowerment for students with obesity in weight loss programs. The program consisted of 6 coaching sessions. Each session used SMART steps. Each coaching session was themed sequentially and was named “From Fat to Fit with SMART Program”. The program was implemented within 3 months. The successive themes of the coaching session were healthy behaviour habits, vision strategy, body self-image, timeline perspective/ state line exercise, happiness model, and healthy behaviour habit/ vision board. Both groups received online education about obesity, balanced diet, physical activity and hydration from experts consisting of internal medicine specialists, clinical nutrition specialists, and sports medicine specialists. Anthropometric measurements, body composition (using Bioelectric Impedance Analysis), monitoring food intake (using a food record form), monitoring physical activity (using a bouchard activity record), self-empowerment (using a subjective wellbeing questionnaire and healthy behaviour habits satisfaction scale) were compared between the two groups using paired T-test (if the data distribution was normal) and the Mann-Whitney test (if the data distribution was not normal). Phase 3 began with the application of the program to two groups of 30 obese students. Participants were divided into an intervention group and a control group. The intervention group received coaching from a health coach who had received previous training from an internationally certified coach. A health coach accompanied 4 obese students. There were 8 health coaches consisting of family medicine and primary care specialists, internal medicine specialists, sports medicine specialists, faculty study program manager doctors, and coaches who were experienced with coaching approach in the workplace. The coaching session was divided into six meetings every two weeks online via a zoom meeting with the help of a host from the research team. However, the increasing conditions of pandemic restrictions on community activities at this stage, students who completed the program were 23 students in the intervention group and 18 students in the control group. The value of change in the intervention group was significantly greater than the control group in the component of total body fat [-0.9 (-12.9, 0.70) vs 0.0 (-6.9, 3.50), p=0.02 ) and healthy behaviour habit [13.5 ± 11.85 vs. 7.5 ± 8.08, p=0.04]. The value of the change in the healthy behaviour habit satisfaction scale was significantly greater than the control group in the hobby/passion aspect [2(-4.6) vs 1(-2.2), p=0.02], move exercise [2,3 ± 2.11 vs 1.2 ±1.93, p=0.03], sleep rest [2(-6.5) vs 1(-3.2), p=0.01], and spiritual [1( 0.6) vs 0( -1.3), p=0.00]. This method has been proven to be able to be applied and is effective in reducing total body fat and significantly increasing healthy behaviour habits. This coaching method, which is following self-empowerment-based patient-centred care, has been proven to be able to be applied in the university's primary health services. However, support is needed from supportive university policies so that students participating in the program could follow it completely until all the expected output indicators are achieved properly

Abstrak :
Latar Belakang Patient-centered care (PCC) dalam pelayanan kesehatan merupakan pendekatan terbaik dengan luaran pasien lebih optimal. Di Indonesia sendiri, PCC belum banyak diketahui penerapannya di fasilitas pelayanan kesehatan. Persepsi pasien dapat menjadi indikator yang baik dalam mengevaluasi penerapan layanan kesehatan. Persepsi pasien dapat berkaitan dengan berbagai faktor, salah satunya adalah faktor sosio demografis. Oleh karena itu, dilakukan studi bertujuan untuk mempelajari hubungan antara faktor sosio demografis dan persepsi pasien tentang PCC, khususnya di fasilitas kesehatan wahana pendidikan Universitas Indonesia. Metode Studi ini menggunakan data sekunder dengan desain cross-sectional pada subjek pasien yang berkunjung ke rumah sakit dan klinik wahana pendidikan Universitas Indonesia pada Januari - Februari 2023. Subjek disesuaikan dengan kriteria inklusi dan eksklusi untuk selanjutnya diberikan kuesioner terkait interaksi dokter-pasien yang sudah diterima. Jawaban subjek kemudian dianalisis menggunakan uji Chi-square dan uji Fisher untuk melihat sebaran karakteristik faktor sosio demografis dan dilihat hubungannya dengan persepsi mereka tentang pelayanan berorientasi pasien yang dilakukan oleh dokter. Hasil Dari 240 responden diperoleh sebaran karakteristik dengan faktor sosio demografis dimana lebih banyak pasien yang dewasa, berjenis kelamin laki-laki, berpendidikan maksimal lulusan SMA, tidak bekerja, dan belum menikah. Dari hasil kuesioner, diperoleh bahwa pasien yang berusia anak-anak dimana informannya adalah orang tua, berjenis kelamin laki-laki, merupakan maksimal lulusan SMA, tidak bekerja, dan belum menikah merasa pelayanan yang mereka terima dari dokter sudah sesuai dengan prinsip pelayanan berpusat pada pasien. Kesimpulan Ditemukan terdapat perbedaan proporsi faktor sosio demografis dengan persepsi pasien tentang pelayanan berorientasi pasien di rumah sakit dan klinik wahana pendidikan Universitas Indonesia. ......Introduction Patient-centered care (PCC) in healthcare is the best approach with optimal patient outcomes. In Indonesia, PCC has not been widely recognized in health care facilities. Patient perception can be a good indicator in evaluating the implementation of health services. Patient perception can be related to various factors, one of which is sociodemographic factors. Therefore, a study was conducted to study the relationship between sociodemographic factors and patients' perceptions of PCC, specifically in the educational health facility of Universitas Indonesia. Method This study used secondary data with a cross-sectional design on patient subjects who visited the Universitas Indonesia teaching hospital and clinic in January - February 2023. Subjects were adjusted according to the inclusion and exclusion criteria and then given questionnaires related to doctor-patient interactions that had been received. Subjects' answers were then analyzed using the Chi-square test and Fisher test to see the distribution of sociodemographic factor characteristics and their association with their perceptions of patient-oriented services performed by doctors. Results Of the 240 respondents, the distribution of characteristics with sociodemographic factors was obtained where more patients were adults, male, had a maximum education of high school graduates, were not working, and were not married. From the results of the questionnaire, it was found that patients who are children where the informants are the parents, male, are a maximum of high school graduates, not working, and not married feel that the services they receive from doctors are in accordance with the principles of patientcentred care. Conclusion It was found that there was a difference in the proportion of socio-demographic factors with patients' perceptions of patient-centred care at the University of Indonesia's teaching hospitals and clinics.

Abstrak :
Latar Belakang Pelayanan berorientasi pasien dianggap memiliki lebih banyak manfaat yang ditandai dengan hasil kesehatan yang lebih baik, kepuasan pasien yang lebih besar, serta pengurangan biaya kesehatan. Walaupun memiliki manfaat yang sangat besar dengan berbagai alasan, pendekatan ini belum banyak diterapkan pada negara berkembang salah satunya di Indonesia. Oleh karena itu, perlu dilakukannya evaluasi pada fasilitas kesehatan di Indonesia untuk melihat apakah pelayanan berorientasi pasien telah diterapkan atau belum, salah satunya dengan melihat dari persepsi pasien. Oleh karena itu, dalam penelitian ini akan mengeksplorasi karakteristik pendekatan pelayanan berorientasi pasien pada sistem pelayanan kesehatan di Indonesia, terkhusus pada fasilitas kesehatan Universitas Indonesia. Metode Studi ini akan menggunakan data sekunder hasil kuesioner dengan desain penelitian cross-sectional pada pasien di Rumah Sakit dan Klinik Wahana Pendidikan Universitas Indonesia yang berkunjung periode Januari - Februari 2023 sesuai dengan kriteria inklusi dan eksklusinya. Lalu akan dilakukan uji chi square dan fisher (jika tidak memenuhi syarat) untuk melihat hubungan antara faktor pelayanan kesehatan dengan persepsi pasien mengenai pelayanan berorientasi pasien. Hasil Penelitian ini melibatkan 240 responden dengan pasien yang melakukan kunjungan ke Klinik Makara, merupakan kunjungan pertama, kunjungan pertama, pelayanan ke dokter umum, serta mengunjungi poli umum secara signifikan lebih merasa bahwa mendapatkan pelayanan yang sesuai dengan pelayanan berorientasi pasien atau merasa lebih terbantu dan mendapatkan pelayanan yang baik dari dokter. Kesimpulan Terdapat hubungan bermakna antara faktor pelayanan kesehatan terhadap persepsi pasien tentang pelayanan berorientasi pasien di rumah sakit dan klinik wahana pendidikan Universitas Indonesia. ......Introduction Patient-oriented services are considered to have more benefits, characterized by better health outcomes, greater patient satisfaction, and reduced health costs. Even though it has enormous benefits for various reasons, this approach has not been widely applied in developing countries, one of which is Indonesia. Therefore, it is necessary to evaluate health facilities in Indonesia to see whether patient-oriented services have been implemented or not, one of which is by looking at patient perceptions. Therefore, this research will explore the characteristics of a patient-oriented service approach in the health service system in Indonesia, especially at the X University health facilities. Method This study will use secondary data from questionnaires with a cross-sectional research design on patients at the Wahana Pendidikan Hospital and Clinic, University of X who visited the period January - February 2023 in accordance with the inclusion and exclusion criteria. Then chi square and Fisher tests will be carried out (if they do not meet the requirements) to see the relationship between health service factors and patient perceptions regarding patient-oriented services. Results This research involved 240 respondents with patients who visited the clinic, namely the first visit, first visit, service to a general practitioner, and visited a general polyclinic who were significantly more likely to feel that they received services that were in line with patient-oriented services or felt more helped and received better services. good from the doctor. Conclusion There is a significant relationship between health service factors and patient perceptions of patient-oriented services at hospitals and educational clinics at University X.

Abstrak :
ABSTRAK
Tingginya kasus diabetes Melitus telah menempatkan Indonesia pada urutan ketiga yang memiliki kasus DM terbanyak se-Asia. Diperlukan suatu bentuk pendekatan interaksi antara tenaga kesehatan dengan pasien guna meningkatkan kualitas layanan dan keberhasilan penatalaksanaan pasien DM tipe 2. Penelitian kuantitatif cross sectional ini bertujuan mempelajari hubungan patient centered care terhadap DM outcome dan kemampuan self care pasien DM tipe 2. Data dikumpulkan dari 70 pasien DM tipe 2 yang berusia lebih dari 20 tahun dan rutin berobat di unit rawat jalan RS Premier Bintaro. Hasil penelitian menunjukkan bahwa sebagian besar 51,4 responden memperoleh pendekatan interaksi pelayanan patient centered care, dan 48,6 responden memperoleh pendekatan interaksi pelayanan non patient centered. Secara statistik tidak terdapat hubungan jenis pendekatan interaksi patient centered care dengan DM outcome. Namun terbukti terdapat hubungan jenis pendekatan interaksi patient centered care dengan kemampuan selfcare pasien DM tipe 2. Kesimpulannya adalah bahwa pendekatan interaksi patient centered care seharusnya berfokus pada peningkatan kemandirian pasien dalam melakukan penatalaksaanaan DM tipe 2, sehingga diabetes outcomes tercapai.

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ABSTRACT
High incidence of diabetes mellitus has put Indonesia in the third country with the most diabetes cases in Asia. Therefore, it is required a interaction approach applied between health professionals with the patients in order to improve service quality and successfulness of the type 2 diabetes management. This study aims to identify the effectiveness of patient centered approach to DM outcomes, and the ability of self care in patients with type 2 DM. This study employed a cross sectional with an analytic descriptive desing study.The data in this study were collected from 70 patients with type 2 diabetes over the age of 20 years and regularly visit the outpatient unit. The results of this study showed that the majority 51.4 of respondents obtained patient centered care approach in their interaction and 48.6 with of non patient centered. Statistically, there was no correlation between the type of patient centered care approach with DM outcome p 0,393 . But in other parts, this study proved that there was a relationship between patient centered care approach with the ability of self care in type 2 diabetes. To conclude, the Patient Centered Care approach should focus more on enhancing patients ability to patients self care in order to improve diabetes outcomes.