Articles
<![CDATA[Uji Reliabilitas Instrumen Kualitas Hidup pada Penderita Kanker Payudara Reability Test on The Instrument of Quality of Life For Breast Cancer Patients ]]>
<![CDATA[Djuminten Siswanto Agus Wilopo Kunta Setiaji]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 27, No 3 (2011) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3401
<![CDATA[Background: Breast cancer can influence the quality of patient’s life. A measurement of quality of life (QOL) is important to evaluate the health services and the continuity of patient life. The Quality of Life Instrument (Quality of Life Breast Cancer Scale) by Ferrell, et al (1995) which has been translated into Indonesian as The Quality of Life Breast Cancer Instrument has not been tested its reliability.Objective: To know the instrument’s reliability and measuring agreement rating of breast cancer patient’s life quality between two raters.Method: This was an observational study using a cross-sectional study design. The subjects were 50 women with stage II-III of breast cancer at Sardjito Hospital selected using an accidental sampling technique. Data was collected through interviews using the QOL instrument guideline. Each subject was interviewed twice by nurse and midwife with 2-14 days difference between the interviews. The data were analyzed with Univariate, and Bivariate with Coefficient Kappa analysis, Intraclass Coefficient Correlation analysis, and alfa Cronbach Coefficient analysis.Results: The Kappa analysis to 46 items of quality of life questions done by nurse and midwife resulted in “good” and “very good” category. The lowest result was k=0.63 and the highest result was k=1.00. The lowest result of coefficient alpha analysis was r=0.63/0.63 while the highest was r=0.88/0.87. The lowest intraclass coefficient was r=0.93 while the highest was r=0.99.Conclusion: The quality of life breast cancer instrument could likely be adapted for breast cancer patients in Indonesia.Keywords: reliability, instrument, quality of life, breast cancer, Sardjito.]]>
<![CDATA[Perilaku Makan dengan Kejadian Sindrom Premenstruasi pada Remaja ]]>
<![CDATA[Nurmiaty Siswanto Agus Wilopo, Toto Sudargo]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 27, No 2 (2011) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3407
<![CDATA[Eating Behavior and the Prevalence of Premenstrual Syndrome in TeenagersBackground: Problems commonly encountered by teenagers in relation to menstruation are dysmenorrheal and premenstrual syndrome. Some recent studies reveal that micronutrients (calcium, magnesium and vitamin D) have an important role in causing disorder of mood and behavior during premenstruation. Teenagers generally consume foods with low nutrients and have a diet that causes lack of nutrient intake leading to menstrualdisorder.Objective: To identify the association between eating behavior and the prevalence of premenstrual syndrome in teenagers at District of Purworejo.Method: This was a case control study with quantitative approach. Subject of the study were students of SMKN 3 and SMAN I Purworejo. Analysis stage I was made to identify the prevalence of premenstrual syndrome (n=749). Analysis stage II was made to identify the association between eating behavior and the prevalence of premenstrual syndrome; the comparison between samples of cases and control was 1:1 (n=160).Result: The prevalence of premenstrual syndrome in teenagers was 24.6%. The test in eating behavior and premenstrual syndrome showed the result was statistically significant. When variable of stress was controlled, the risk for premenstrual syndrome was 2.3 times greater. The result of logistic regression analysis on nutrient intake showed that fat and potassium had the most dominant effect to the incidence of premenstrual syndrome with standardized coefficient value as much as 0.7982 and 0.7834 subsequently.Conclusion: Unhealthy eating behavior increased risk for premenstrual syndrome 2.3 times greater. Intake of fat and potassium most dominantly affected premenstrual syndrome.Keywords: eating behavior, premenstrual syndrome, teenagers]]>
<![CDATA[Efektivitas Pendidikan Kesehatan Melalui E-File Multimedia Materi KRR dan Tatap Muka di Kelas terhadap Peningkatan Pengetahuan Kesehatan Reproduksi Remaja ]]>
<![CDATA[Muhamad Arfan, Siswanto Agus Wilopo, Budi Wahyuni]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 26, No 3 (2010) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3462
<![CDATA[Background: Reproductive health has not been fully incorporated into health education in the formal school system due to limited time allocation and teachers. Since media have become an inseparable part of adolescents’ life as more than just their peer, therefore, one alternative in educating adolescents on reproductive health is by using the E-file multimedia of ”The Information, Education and Communication Materials on Adolescent Reproductive Health”.Objective: To examine the effectiveness of adolescent reproductive health E-file multimedia as a method of health education in improving adolescents’ knowledge on reproductive health.Methods: The study was an experimental study designed using quasi experiment. Samples were selected by purposive sampling. Samples were 77 junior high school students. Data were analyzed using t test by applying multiple linear regressions in order to examine the difference in the average scores of adolescents’ knowledge on reproductive health.Results: The average score of health education on reproductive health using multimedia electronic file was 4.31 at deviation standard 1.32 whereas using face to face method in the classroom was 2.5 with deviation standard 1.39. Average difference in both methods was 1.8 at 95% CI (1.19 – 2.42) and p=0.00 or p<0.05.Conclusion: There was no difference between multimedia electronic file method and face to face method in improving knowledge of teenagers about reproductive health.Keywords: health education, knowledge E-file, multimedia, adolescent reproductive health.]]>
<![CDATA[Hubungan Antara Akses KB dengan Pemilihan Kontrasepsi Hormonal dan Non Hormonal di Kabupaten Purworejo ]]>
<![CDATA[Sri Panuntun, Siswanto Agus Wilopo, Lina Kurniawati]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 25, No 2 (2009) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3569
<![CDATA[Background: The report of 2002-2003 Indonesia’s Demographic and Health Survey (IDHS) suggests that the prevalence of family planning in Indonesia reach 60 percent with the hormonal contraceptive increase by 16 percent and the non hormonal contraceptive decrease by 7 percent. Generally, the choice of contraceptives is based on clear reasons to regulate the birth spacing or to limit births. Factors determining the choice of non hormonal contraceptives include physical access (distance), economy (cost), administration (service resource) and cognitive accesses (knowledge).Objective: To investigate the relationship between contraceptive accesses and the choice of hormonal and non hormonal contraceptives in Purworejo District.Method: This was an observational study with a case control study design.Subject: Samples were married women 20-35 years of age that became the new acceptors with the choice of non hormonal contraceptives (IUD) as the case (133 women) and of hormonal contraceptives (pill and injectable) as the control (133 women) from 1 January 2004 to 31 December 2004.Data analysis: The qualitative data analyses used were univariable, bivariable and multivariable. Statistical test used chi-square and logistic regression.Results: The bivariable and multivariable analyses showed that there was a relationship between family planning demand and the choice of non hormonal contraceptives. Respondent residing far from family planning services tended to choose non hormonal contraceptives with a chance of 1.9 times higher (OR=9.5;CI95%=1.16-3.19). The variable that had the greatest chance to influence respondents to choose non hormonal contraceptives was cost that was 7.5 times (OR=7.5; CI 95% = 2.60-21.87). The respondents that utilized private facilities tended to choose non hormonal contraceptives.Conclusion: Respondents with family planning demand to limit births were likely to choose non hormonal contraceptives. Other factors affecting the choice of non hormonal contraceptives were income.Keywords: family planning accesses, family planning demand, choice of hormonal and non hormonalcontraceptives, case control]]>
<![CDATA[Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Multivariabel data Survailan Demografi dan Kesehatan di Kabupaten Purworejo ]]>
<![CDATA[Siswanto Agus Wilopo]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 25, No 1 (2009) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3574
<![CDATA[Background: Recent controversial reports suggest that recipients of one dose of DTP vaccines had higher mortality than children who had received no DTP vaccine. We reanalyzed data on vaccination and child survival collected from demographic and health surveillance to challenge previous findings.Objectives: To estimate specific and non-specific effects of DTP vaccination on child mortality age 1-24 months under routine vaccination program in Indonesia.Methods: A longitudinal surveillance data provided information on 5647 children below 24 months of age who received DTP and other vaccinations. The main outcome measure was all-cause mortality. Background factors associated with mortality were collected, such as: sex, birth order, dead sibling, mother’s education and family size. We assessed DTP vaccinations as an independent factor with other variables in Cox’s regression models with time dependent covariates.Results: There is no sex differential of mortality among children in Purworejo even after considering other factors using Cox regression analysis. Mortality was lower in the group vaccinated with DTP vaccine compared with those not vaccinated, the relative risk of mortality (RR) being 0.56 with 95% confidence interval (CI) is 0.453–0.690. After controlling for the background factors, recipient of DPT vaccines continued to have a lower mortality with RR=0.74 (95% CI: 0.586–0.925). BCG and measles vaccines have stronger non-specific effects compared to effects of DTP vaccines.Conclusion: Through specific effect against targeted diseases and a non-specific benefit against others illnesses, the study showed reduced mortality among children who received DTP vaccine. There is no reason to change current vaccination policy because DTP was not associated with any harmful effect among girls.Keywords: non-specific effects, DTP Vaccine, child survival, Cox’s Regression]]>
<![CDATA[Estimasi Pengaruh Vaksin DPT pada Kematian Anak: Analisis Diskritif Data Surveilan Demografi dan Kesehatan di Kabupaten Purworejo ]]>
<![CDATA[Siswanto Agus Wilopo]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 24, No 3 (2008) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3591
<![CDATA[Background: Recent controversial reports suggest that recipients of one dose of DTP vaccine have higher mortality than children who have received no DTP vaccine. Those reports were mainly derived from African countries where mortality and malnutrion were higher than Indonesia.Objectives: To describe specific and non-specific effects of DTP vaccination on child mortality age 1-24 months under routine vaccination program in Indonesia.Methods: During period of January 1 1995 to August 31, 2001 our longitudinal surveillance data at Purworejo district provided information on 5647 children below 24 months of age who received DTP and other vaccinations. The main outcome measure was all-cause mortality. Vaccination status on DTP, BCG, and measles were collected every 90 days and recorded its time at vaccination. Confounding factors associated with mortality were also collected. This first report used descriptive analysis and a survival curve (Kaplan-Meier) to examine the differential of mortality according to sex of the children and among vaccinated and non-vaccinated children with DTP, BCG, and measles vaccines. The second report will use survival analysis to estimate specific and non-sprecific effects of DTP by considering time at vaccination and other counfounding factors.Results: There is no sex differential of mortality among children in Purworejo. A probability of dying was lower in the children vaccinated with DTP vaccine compared with those not vaccinated DTP. Simmilarly, vaccinated children with BCG and measles have lower mortality compared to unvaccinated children. There is strong indication that BCG and measles have stronger protected effects to risk of dying than DTP.Conclusion: The study showed lower mortality among children who received DTP, BCG, and measles vaccines compared those unvaccinated. There were not enough evidences to change current vaccination policy because DTP was not associated with any harmful effect among girls.Keywords: non-specific effects, DTP vaccine–child survival- Kaplan Meier’s Curve]]>
<![CDATA[Studi Validasi Autopsi Verbal Kematian Bayi ]]>
<![CDATA[Ernaningsih Siswanto Agus Wilopo, Djauhar Ismail]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 24, No 1 (2008) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3604
<![CDATA[Background: Infant mortality is a tragedy which cannot be easily forgotten by mothers and their family. Data on mortality from hospital or hospital-based cause of death was not representative. Community-based cause of death with verbal autopsy approach is a way to provide statistical data on mortality. Personnel of verbal autopsy are medical staff or skilled non-medical staff. Limited number of medical staff and midwifes has made all verbal autopsy processes impossible to be carried out by medical staff. Therefore a method of verbal autopsy needs to be developed by non medical staff. This method should be validated prior to its implementation.Objectives: The objective of the study was to identify verbal autopsy validity viewed from measurement process conducted by different measurement staff to reach final diagnose agreement on cause of infant mortality between medical and non medical staff compared to doctor’s diagnose as gold standard.Methods: The study used a diagnostic test with retrospective cohort research design. Numbers of samples were 110 cases and length of study was 3 months. Cases were taken from infant mortality which occurred in hospitals during the last 3 years with their medical records. Training was given for 1 / day to midwives and statistic officers on how to execute verbal autopsy. Questionnaires used were adapted from World Health Organization which had been translated and tested in on settings. Staff conducted measurement or interview with statistic officers and a week later with midwives.Results: Analysis result of Kappa statistical test showed that value of agreement between doctor’s diagnose and verbal autopsy by statistic officers was 0.57 with p=0.00. This meant that there was good agreement. Result of Kappa statistical test between midwifes and statistic officers was 0.63 with p=0.000. This also showed good agreement between midwife verbal autopsy and statistic officer verbal autopsy. Statistic officers could conduct verbal autopsy.Conclusion: Agreement reached between statistic officers and doctors diagnose was quite good. Statistic officers could conduct verbal autopsy.Keywords: verbal autopsy, validation, infant mortality]]>
<![CDATA[Perilaku Ibu Memanfaatkan Pelayanan Kesehatan Selama Hamil dan Penggunaan Kontrasepsi Selama Menyusui ]]>
<![CDATA[Indarwati Siswanto Agus Wilopo, Djauhar Ismail]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 23, No 4 (2007) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3613
<![CDATA[Background: The 2002-2003 Indonesian Demographic and Health Survey (IDHS) data indicated an increase up to 41% in the number of children not breastfed until two years old. Previously, according to 1997 IDHS data, there were only 34% babies who were weaning before they had reached two years. This increase was in line with the increasing number of pregnant mothers utilizing health care and hormonal contraceptives.Objective: to explore the correlation between the length of breastfeeding and the behaviors of Indonesian pregnant mothers utilizing health care and hormonal contraceptives.Methodology: Using the cohort retrospective approach, the research was conducted upon 5940 mothers, who were 15 years to 49 years old. Each had at least one under-five-years-old child. The proportional Odds Model was employed to analyze the ordinal out come of the study. The life table served to show the continuity of breastfeeding. The variables taken were the length of breastfeeding. ANC visits, contraceptive usage, ownership assets, educational level, working status, parity, residence, prelactal liquid and milk from bottles.Findings; The probability of breastfeeding up two years old between mothers with ANC visits and without ANC visits were notdifferent. The probability of breastfeeding until two years old between mothers using non-hormonal contraception was higher compared to hormonal ones. The risk of weaning before two years in mothers using hormonal contraception was higher (1.5 times) compared to those using non-hormonal contraception.Conclusion: Factors significantly correlated with breastfeeding period were women's behaviors and characteristic as well as the family's economic status, the declining median of breastfeeding period of Indonesian mothers had strong correlation with hormonal contraceptive usage and bottles milk.Keywords: breastfeeding, antenatal care, contraceptives, demography]]>
<![CDATA[Determinan Penggunaan Metode Kontrasepsi IUD di Indonesia Analisis Data SDKI 2002-2003 ]]>
<![CDATA[Rosyati Pastuti, Siswanto Agus Wilopo]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 23, No 2 (2007) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3627
<![CDATA[Background: Report of Indonesian Health and Demographic Survey (IHDS) 2002-2003 showed an increase of contraceptive use from 57% (1997) to 60% (2002-2003) among married women in Indonesia. The use of Injection method had the highest increase while Intra Uterine Device was decrease. Contraceptive method usually was used based on the reasons for controlling birth and birth spacing. The choice of contraceptive method was influenced by motivation, access and cost.Objective: The goal was to explore the determinant of IUD method use in Indonesia.Method: Data of IHDS 2002-2003 was analyzed using cross-sectional study design. Sample was married women aged 15-49 years old who use IUD method. Data was analyzed statistically using chi-square test and logistic regression at 95% significant level.Result: Logistic regression analysis showed a significant relationship between the demand of contraceptive use and IUD method use. Respondent with birth control reason had a probability of 2.8 times to use IUD (OR=2.8; CI 95%=2.45-3.13). Health service place and cost of service were also had a significant relationship with contraceptive use demand. Respondent who used government’s health facility had a probability to use IUD OR=1.9; CI 95%=1.67-2.06).Conclusion: Respondent with birth control reason tends to use IUD. Those who use government’s health facility and those who paid more than Rp200.000,00 were also tend to use IUD. Another factors influence IUD method use was age, parity, education level, economic status and residence status.Keywords: IUD, family planning, birth spacing]]>
<![CDATA[Keefektivan metode simulasi dan metode brainstorming untuk meningkatkan pengetahuan kesehatan reproduksi remaja ]]>
<![CDATA[Wiwik NorMa , Ova Emllla, Siswanto Agus Wilopo]]>
<![CDATA[ Berita Kedokteran Masyarakat (BKM) Vol 21, No 3 (2005) ]]>
Publisher : <![CDATA[Fakultas Kedokteran Universitas Gadjah Mada ]]>
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DOI: 10.22146/bkm.3673
<![CDATA[Background: Early education on reproductive health helps teenagers to have responsible attitude and behavior. Integrating reproductive health education in the school curricula is a very important strategy. Methods of education which can improve effectiveness of knowledge dissemination on reproductive health needs to be identified, Objective: To understand the effectiveness of simulation and brainstorming methods to Increase teenagers knowledge on reproductive health. Method: This was a quasi experimental study which used pre test-post test control group design. Samples were divided into two groups simulation and brainstorming. There were 160 respondents age 10-12 years old. Samples were purposively selected considering their basic characteristics. Data analysis used paired t-test, independent Hest and double linear regression analysis with significance 95%]]>
