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Abstrak :
Rasio angka kematian ibu melahirkan di Indonesia masih tinggi. Keluarga Berencana (KB) berkontribusi secara langsung terhadap penurunan rasio angka kematian ibu. Namun, kebutuhan KB yang tidak terpenuhi dan angka penggunaan kontrasepsi cara modern di Indonesia masih stagnan. Belum ada definisi dan pengukuran baku mengenai partisipasi laki-laki dalam KB. Tujuan penelitian ini untuk mengetahui tren partisipasi laki-laki dalam KB di Indonesia pada tahun 2007, 2012 dan 2017 dengan alasannya. Penelitian ini menggunakan pendekatan kuantitatif dengan desain penelitian potong lintang berdasarkan data pasangan dari Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2007, 2012 dan 2017. Subyek penelitian adalah pasangan (suami dan istri) yang berhasil diwawancarai dalam SDKI namun mereka menyatakan bahwa istrinya tidak sedang hamil dan menyatakan tidak ingin memiliki anak. Jumlah subyek penelitian sebesar 4.661 pasangan pada tahun 2007, 4.553 pasangan pada tahun 2012 dan 5.117 pasangan pada tahun 2017. Variabel bebas pada penelitian ini adalah sumber informasi KB yang diterima oleh suami baik melalui tenaga kesehatan, tenaga penyuluh KB atau media. Variabel terikat pada penelitian ini adalah partisipasi laki-laki dalam keluarga berencana yang diukur berdasarkan hasil analisis faktor dari pengetahuan suami mengenai kontrasepsi, sikap suami mengenai KB, sikap suami mengenai kontrasepsi, komunikasi pasangan mengenai KB, pengambil keputusan mengenai kontrasepsi, dan penggunaan kontrasepsi. Variabel kontrol adalah karakteristik sosial demografi pasangan. Analisis menggunakan analisis satu arah (oneway) dan analisis varians ganda (multiway Analysis of Variance-ANOVA). Dapat disimpulkan bahwa pemberian informasi secara langsung antara suami dengan tenaga kesehatan dan tenaga penyuluh KB berhubungan secara signifikan dengan partisipasi laki-laki dalam KB. Suami yang mendapat informasi KB dari tenaga penyuluh KB memiliki skor partisipasi yang baik daripada suami yang mendapat informasi dari tenaga kesehatan. Media tidak berhubungan secara signifikan dengan partisipasi laki-laki dalam KB. Disarankan tenaga penyuluh KB maupun tenaga kesehatan memberikan informasi KB secara langsung kepada suami dengan pendekatan yang sensitif jender. ......Indonesian Demographic and Health Surveys Indonesia faces huge challenges for reducing maternal mortality ratio. Family planning has direct contribution for reducing maternal mortality ratio. Nevertheless, the unmet need for family planning and contraceptive prevalence rate for modern methods remains stagnan. No universal measurement of male engagement in FP. Hence, the objective of this research is to analyze various factors associated with low male engagement in family planning in Indonesia during 2007, 2012 and 2017. This cross-sectional study utilized a quantitative approach based on couplematched data from 2007, 2012 and 2017 Indonesian Demographic and Health Surveys (IDHS). Research subjects were couples (husbands and wives) who had successfully interviewed by the IDHS but they declared that their wives were not pregnant and they were not want any child. The numbers of research subjects were 4.661 couples in 2007, 4.553 couples in 2012 and 5.117 couples in 2017. The independent variable of this study was source of family planning information received by husbands, either through health workers, family planning field workers or the media (television, radio, newspaper/magazine). This study conducted a factor analysis for reducing a set of complex variables in terms of male engagement in family planning, as the dependent variable of this study, measured by husband's knowledge on contraception, husband's attitude about family planning, husband's attitude about contraception, inter-spousal communication regarding family planning, contraceptive decision-maker, and contraceptive use. The control variable was the socio-demographic characteristics of couples. This research utilized one-way and multi-way Analysis of Variance (ANOVA). The conclusion that family planning field workers and health workers revealed significant association to male engagement into FP. Husbands who received FP information from family planning field worker had higher score of male engagement of FP than husbands who received information from health workers. Media has no correlation with male engagement into FP. Hence, it is recommended that family planning field worker and health workers provide face-to-face counselling of FP to husbands with gender sensitive approach.

Abstrak :
Dalam siklus reproduksi, bertambah usia, jumlah anak dan kondisi kesehatan menimbulkan kebutuhan jenis alat kontrasepsi baru yang lebih rasional. Peralihan ke metode yang tidak rasional dapat berdampak pada kehamilan tidak direncanakan. Pengetahuan yang tinggi serta persepsi efektifitas dan efisiensi penggunaan alat kontrasepsi berhubungan dengan pola penggantian metode rasional. Oleh karena itu, studi ini bertujuan untuk mengevaluasi pola penggantian metode kontrasepsi, serta membuktikan perbedaan hubungan pengetahuan serta persepsi penggunaan alat kontrasepsi dengan pola penggantian metode kontrasepsi rasional antara perempuan akseptor KB di Jawa Timur dan NTB.Studi ini menggunakan pendekatan kuantitatif dengan desain studi Cross-Sectional. Subyek penelitian adalah wanita usia subur dengan jumlah 4616 perempuan di Jawa Timur dan 4819 perempuan di NTB. Perubahan jenis kontrasepsi ditinjau dari perbedaan jenis kontrasepsi saat ini dengan sebelumnya selama rentang waktu mengikuti program KB. Penilaian rasionalitas ditinjau dari kecocokan metode kontrasepsi terakhir dengan usia, jumlah anak dan motivasi KB. Pengetahuan yang diukur terkait MKJP. Sementara persepsi yang diukur terkait efektifitas efek samping dan cara pemakaian dan efisiensi biaya dan kemudahan memperoleh alat kontrasepsi. Data dianalisis dengan meggunakan multilevel analisis regresi logistik berganda untuk membuktikan hipotesis penelitian. Pola pengantian metode kontrasepsi didominasi oleh perpindahan dari non MKJP ke non MKJP lainnya. Hanya sebagian kecil perempuan berisiko tinggi yang beralih menggunakan kontrasepsi rasional baik di NTB maupun Jawa Timur. Persepsi terhadap efek samping terbukti berhubungan dengan pola penggantian rasional pada perempuan di Jawa Timur, dan persepsi terhadap cara pemakaian alat kontrasepsi terbukti berhubungan dengan pola penggantian metode kontrasepsi rasional pada perempuan di NTB. Persepsi terhadap biaya alat kontrasepsi terbukti berhubungan dengan pola penggantian metode kontrasepsi rasional pada perempuan di Jawa Timur dan NTB.Dapat disimpulkan ada perbedaan hubungan persepsi penggunaan alat kontrasepsi dengan pola penggantian metode kontrasepsi antara Jawa Timur dan NTB. Oleh karena itu, disarankan strategi KIE pada perempuan di Jawa Timur fokus pada penyelesaian masalah persepsi terkait efek samping dan pada perempuan NTB fokus pada penyelesaian masalah persepsi cara pemakaian alat kontrasepsi. Untuk menyelesaikan permasalah terkait persepsi biaya alat kontrasepsi pada perempuan di Jawa Timur dan NTB, perlu didukung keberlanjutan program penggratisan alat kontrasepsi pada masyarakat miskin dan juga masyarakat katagori lainnya melalui program BPJS. ......In the reproductive cycle, the increasing age, number of children and health conditions lead to the need for more rational types of new contraceptives. Switching contraception to irrational methods may cause unintended pregnancies. High knowledge and perceptions of the effectiveness and efficiency of contraceptive use are related to the rational switching method pattern. Therefore, this study aims to evaluate the pattern of switching contraceptive methods, and to prove the difference association of knowledge and perception of contraceptive use with the pattern of rational switching contraceptive methods among women of Family Planning FP acceptors in East Java and West Nusa Tenggara.This study used a quantitative approach with Cross Sectional study design. Research subjects were women of reproductive age with 4616 women in East Java and 4819 women in West Nusa Tenggara. Changes in types of contraceptives were reviewed from the different types of contraceptives with the previous one during the timeframe of the FP program. Assessment of rationality was reviewed from the compatibility of the last method of contraception with age, number of children and family planning motivation. Knowledge was measured related to Long Term Contraceptive Method LTCM . While, perception rsquo s measurement was related to the effectiveness side effects and mode of use and efficiency cost and ease of obtaining of contraceptives. Data were analyzed using Multilevel Multiple Logistic Regression analysis to prove the research hypothesis.The switching pattern of contraceptive methods was dominated by changing from non LTCM to other non LTCM. Only a small proportion of high risk women switched to use rational contraception both in West Nusa Tenggara and East Java. Perceptions of side effect was associated with rational patterns of switching method in women in East Java, and perceptions of the use of contraceptives had relationship with patterns of rational contraceptive methods for women in West Nusa Tenggara. Perceptions of the cost of contraceptives was foundto be related withrational switching pattern of contraceptive methods among women in East Java and West Nusa Tenggara.In conclusion, there was a difference relationship of perceptionon contraception use and switching contraceptive method between East Java and West Nusa Tenggara. Therefore, it is recommended that Communication, Information and Education CIE strategies for women in East Java should focus on solving perceptual problems related to side effect while in West Nusa Tenggara women more focus on solving perception problems about how to use contraceptives. To solve the problems related to perception of contraceptive cost among women in East Java and West Nusa Tenggara, it is necessary to support the continuity of contraceptive application program for the poor and other categories through the Social Insurance Administration Organization Badan Penyelenggara Jaminan Sosial BPJS program.

Abstrak :
Kondisi kesehatan yang memadai sangat dibutuhkan oleh jemaah haji karena prosesibadah haji melibatkan aktivitas fisik yang sangat berat. Jemaah haji yang bugar adalahjemaah haji yang memenuhi istifa'ah kesehatan. Untuk menjadi bugar dan istifa'ah,jemaah haji harus diberdayakan dan diberi pembinaan, sehingga memiliki kemampuan diri melakukan latihan fisik secara teratur. Partisipasi jemaah haji dalam program peningkatan kebugaran, baik secara perorangan maupun kelompok, dapat diupayakan melalui pembinaan latihan fisik dengan melibatkan peran kader kesehatan olahraga (kesorga). Studi ini bertujuan untuk mengetahui: (i) peran kader kesorga dalam mendukungkeberhasilan latihan fisik jemaah haji di Kabupaten Lumajang, Provinsi Jawa Timur; (ii) hubungan variabel komposisional level individu dengan latihan fisik; (iii) diketahuinya hubungan variabel kontekstual level desa dan level Puskesmas dengan latihan fisik. Penelitian ini menggunakan mixed method yaitu metode kuantitatif dan kualitatif, dengan desain studi potong lintang cross sectional. Variabel yang diukur ada 3 level yaitu: (i) level individu meliputi karakteristik demografik dan penerapan konsep HBM pada 178 jemaah haji; (ii) level desa terdiri atas karakteristik demografik kader, motivasi dan keaktifan 61 kader serta dukungan 61 kepala desa; (iii) level Puskesmas mencakupdukungan 22 Puskesmas dan 19 KUA. Analisis data menggunakan uji statistik multilevel regresi logistik berganda untuk membuktikan hipotesis penelitian. Hasil penelitian menunjukkan bahwa penerapan konsep HBM terbukti memilikihubungan yang signifikan dengan partisipasi jemaah haji dalam melakukan latihan fisik.Fakta ini menerangkan bahwa berolahraga secara teratur bukanlah hambatan bagi jemaahhaji. Selanjutnya jemaah haji juga meyakini mampu melakukan latihan fisik secara teraturdan cenderung menjadikannya sebagai kebiasaan hidup. Ditemukan pula bahwa kaderkesorga terbukti berperan dan memiliki hubungan yang signifikan dengan tingkat latihanfisik jemaah haji. Studi ini menemukan ada variasi atau perbedaan peran kader kesorga menurut penerapaan konsep HBM dalam kaitannya dengan tingkat latihan fisik jemaah haji. Disarankan agar setiap Puskesmas dapat mengembangkan pola alternatif pembinaaan kader kesorga dan calon jemaah haji dengan melibatkan klub olahraga, kelompok jemaah haji, kepala desa dan KBIH. Program latihan fisik jemaah haji dengan melibatkan peran kader kesorga perlu diadopsi oleh Kementerian Kesehatan RI dan selanjutnya direplikasikan ke daerah lain.

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Adequate health condition urgently required by pilgrims because the process ofpilgrimage involves a very heavy physical activity. Hajj pilgrims with good physical fitnessclassified as pilgrims who fulfill health isti'ah. In order to become fit and isti'ah,pilgrims should be empowered and provided such a coaching, so they will have the abilityto execute physical exercise in a regular basis. Participation of pilgrims in a fitness improvement program, either individually or in groups, could be pursued through physical exercise coaching by involving the role of sport health cadres. The main purpose of this study was to find out: (i) the role of sport health cadres inorder to support the success of pilgrims physical exercise in Lumajang District, East Java Province; (ii) examine the association of compositional variables individual level with physical exercise; (iii) examine the association of contextual variables village and Puskesmas levels with physical exercise. This research was conducted using a mixed method quantitative and qualitative methods with cross sectional study design. The measured variables consisted of 3 levels: (i) individual level included demographic data and the application of HBM concept to 178 pilgrims; (ii) village level consisted of cadre demographic characteristics, cadres motivationand cadres; activeness of 61 cadres and the support of 61 village heads; iii Puskesmaslevel included the support of 22 Puskesmas and 19 KUAs. Data analysis was performedusing multilevel statistical test of multiple logistic regression to prove a research hypothesis. The application of the HBM concept proved to have a significant relationship withparticipation of pilgrims in physical exercise. The findings of the study explain that regularphysical exercise is not an obstacle for pilgrims. Furthermore, pilgrims also convince thatthey are able to maintain physical exercise regularly and tend to make it as a habit of life. Another result of study indicates the cadres proved to have a significant relationship withthe level of pilgrims; physical exercise. Finally, in conclusion this study found that there was a variation or differencebetween the application of the HBM concept and the role of cadres with the level ofpilgrims; physical exercise. It was suggested that each Puskesmas should develop variousalternative coaching patterns for cadres and pilgrims by involving sports clubs, hajj groups, village heads and KBIH. Hajj pilgrims; physical exercise program involving the role ofcadres required to be adopted into the Ministry of Health program and then replicated toother provinces.

Abstrak :
Peningkatan prevalensi diabetes menjadi tantangan bagi tenaga profesional kesehatan dalam meningkatkan kualitas hidupnya. Tujuan penelitian ini adalah mengembangkan model coaching dan menilai efikasinya terhadap kualitas hidup pasien diabetes. Desain penelitian ini adalah penelitian dan pengembangan. Tahapan penelitian terdiri dari pengembangan model coaching dilakukan dengan studi literatur, validitas konten dan ujicoba, sedangkan menilai efikasi dengan randomized control trial pada 134 pasien diabetes yang dibagi ke dalam dua kelompok, yaitu kelompok yang mendapat coaching dan edukasi. Intervensi diberikan empat kali, satu kali face to face dan tiga melalui telepon yang dilakukan selama 12 minggu. Outcome yang diukur adalah perubahan rerata skor kualitas hidup, literasi kesehatan, HbA1c dan kepatuhan.  Analisis yang dilakukan adalah differences in differences. Dihasilkan model coaching ICARE yaitu introduksi, cek outcome, asesmen faktor yang berpengaruh, rencanakan tindakan dan eksplorasi tanggungjawab. Hasil uji efikasi  menunjukkan adanya perbedaan perubahan rerata skor antara kelompok intervensi dan kontrol, perbedaan perubahan skor literasi kesehatan   2,52 (1,18 – 3,65),  kepatuhan  7,02 (5,58 – 8,85), HbA1c  -0,34 (-0,47 -- 0,18) dan kualitas hidup  2,9 (2,01-3,72). Coaching menjadi perubah  signifikan pada dimensi kemampuan menerapkan informasi kesehatan yang diterima. Coaching  model ICARE dapat meningkatkan kualitas hidup pada pasien diabetes melalui perubahan dimensi literasi kesehatan dan kepatuhan.  ......The increasing prevalence of diabetes was a challenge for health professionals to improving quality of life. The purpose of this study was to develop a coaching model and assess its efficacy on the quality of life of diabetic patients. The design of this research is research and development. The reseach stages consist of developing a coaching model with literature studies, content validity and testing. while assessing efficacy with a randomized controlled trial on 134 diabetic patients who were divided into two groups, namely the group that received coaching as intervention and standard care as a control. The intervention was given four times, once time face to face and three times by telephone which was carried out for 12 weeks. The outcomes measured were changes in the mean quality of life scores, health literacy, HbA1c and adherence scores. The analysis carried out is differences in differences. ICARE's coaching model was generated, namely introduction, check for outcome, assessment of influencing factors, rearrange the action plan and exploration of responsibilities. The results of the efficacy test showed that there were differences in changes in the mean scores between the intervention and control groups, differences in changes in health literacy scores 2.52 (1.18 – 3.65), adherence 7.02 (5.58 – 8.85), HbA1c -0.34 (-0.47 - -0.18) and quality of life 2.9 (2.01 – 3.72). Coaching is a significant change in the dimension of the ability to apply health information received. Coaching ICARE application model can improve the quality of life in diabetic patients through changes in the dimensions of health literacy and compliance.

Abstrak :
Insiden cedera tertusuk jarum suntik CJS pada mahasiswa keperawatan masih tinggi. Penelitian ini bertujuan menghasilkan Model Pembelajaran berbasis Keselamatan MPbK untuk membentuk perilaku mencegah CJS mahasiswa keperawatan di wahana praktik. Desain penelitian ini adalah quasi experimental pre and post-test with control group. Penelitian terdiri dari dua tahapan yaitu penyusunan dan pengujian MPbK. Penyusunan MPbK dilakukan berdasarkan hasil systematic review dan focus group discussion pada 10 pembimbing klinik. Pengujian MPbK dilakukan pada 165 mahasiswa praktik profesi keperawatan dengan membandingkan perubahan pengetahuan, sikap, dan intensi perilaku. Responden dikelompokkan dalam 4 kelompok yaitu 26 mahasiswa mendapatkan MPbK 1 intervensi individu reedukasi pengingat harian, intervensi kelompok, dan organisasi ; 72 mahasiswa mendapat MPbK 2 intervensi individu reedukasi dan organisasi , 31 mahasiswa mendapat MPbK 3 intervensi kelompok dan organisasi , dan 36 mahasiswa tanpa intervensi. Intervensi individu meliputi reedukasi dan pengingat harian pencegahan CJS melalui pesan singkat teks dan video. Intervensi kelompok meliputi pengingat dan contoh peran dari pembimbing klinik yang telah dilatih pencegahan CJS. Intervensi organisasi meliputi kontrak program keselamatan dan penyediaan fasilitas penunjang pencegahan CJS. Penelitian tahap 1 menghasilkan MPbK yang diuji pada penelitian tahap 2. Hasil uji GLM-RM pada penelitian tahap 2 didapatkan bahwa pengetahuan dan sikap mencegah CJS dapat ditingkatkan secara signifikan menggunakan MPbK 1, 2, dan 3 p

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Needle Stick Injury NSI incident in nursing student is constantly high. This research aimed to develop Safety based Learning Models MPbK in Indonesia to shape preventive behaviors of NSI among nursing students during clinical practices. Quasi experimental pre and post test design with control group was employed in this study. The study comprised two stages MPbK development and testing stages. The during the first stage, systematic reviews and a focus group discussion with 10 clinical instructors were conducted to generate MPbK. While, the testing stage was performed to measure the changes in students rsquo knowledge, attitudes, and intention before and after the implementation of MPbK. A sample of 165 nursing professional program students was selected for the second stage, dividing into 4 main groups 26 students participated in MPbK1 individual, group, and organizational interventions , 72 students participated in MPbK2 individual and organizational interventions , 31 students participated in MPbK3 group and organizational interventions , and 36 students received no interventions. Individual interventions comprised re education and daily reminders through short message and video. Group interventions included role model clinical instructors whereas organizational interventions were safety programs contract between the university and hospitals, along with the provision of appropriate infrastructure and facilities to promote safety. Results of GLM RM analysis demonstrated the use of MPbK1, 2, and 3 significantly increased the knowledge and atitudes of students p 0,001 , the intention of student behavior to prevent NSI can be increased, but not yet significan p 0,110 0,993 . NSI incidents can be reduced using MPbK1 zero incident . The study suggested nursing educational institutions, hospitals and nursing professional organizations to use MPbK as a reference to develop policies of NSI prevention.