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Tuberculosis Treatment with DOTS Strategy on Mandiri Practice Doctor as Public Private Mix a Case Study in Kebumen Regency Arif Komedi; Hari Kusnanto J; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 2, No 1 (2019): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (35.717 KB) | DOI: 10.22146/rpcpe.44470

Abstract

Background: Tuberculosis or TB is still a public health problem that poses a global challenge. The spread of this disease through droplets of people who have been infected with tuberculosis bacilli. The incidence of TB transmission is around 5-15%. The TB Control Program in a national strategy is directed toward universal access to quality TB services, this can be achieved by involving all health-care facilities. Public-Private Mix / PPM (the collaboration between government services and private services) is the inclusion of all health service facilities in an effort to expand TB services and TB program continuity with a comprehensive approach. Uncomplicated management of pulmonary tuberculosis must be resolved by doctors who work in health centers/clinics from starting to make clinical diagnoses to managing the disease independently and thoroughly.Objectives: This research is to find out the implementation, obstacles to the implementation of DOTS strategy TB treatment at an independent practice physician in Kebumen Regency, and the form of a collaborative pattern of DOTS strategy TB treatment between independent practice doctors and health centers as a form of collaboration in Public-Private Mix.Methods: This research is a case study with a qualitative descriptive approach. Samples were taken by purposive sampling from puskesmas and health department. The total sample of 25 respondents consisted of 4 independent practice doctors, and from the puskesmas consisted of 5 puskesmas heads, 5 TB officers, 5 TB management officers, 3 Health Office officials, and 3 TB patients. Results: Most independent doctors diagnose based on clinical symptoms of TB and a small portion supported by chest X-ray. All puskesmas have implemented TB management with the DOTS strategy, but the results of TB program achievements are still low. This is because the number of suspected TBs is still low. Puskesmas need networks to find TB suspects. One solution is to form a collaboration scheme between puskesmas and independent practice doctors to improve TB management.Conclusion: The mapping of the implementation and barriers of TB DOTS and the solution to the scheme are in the form of collaboration between puskesmas and independent doctors in the form of PPM (Public Private Mix).
The Effect of Lecture and Small Group Discussion Method in Health Education Towards Dengue Haemorrhagic Fever Vector Larva Free Proportion in Gunungkidul Regency Sumitro Sumitro; Hari Kusnanto J; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 2, No 1 (2019): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (626.249 KB) | DOI: 10.22146/rpcpe.44471

Abstract

Background:Dengue Haemorrhagic Fever is community health problem in Gunungkidul Regency, Yogyakarta. In the last five years the case and its spread have been increasing. Many efforts have been conducted to overcome case increasing, the most important is community participation in Mosquito nest eradication (PSN). Health education through radio broadcast, leaflet, dan lecture are still failing in changing community behavior to conduct PSN continuously, because the number of larva free is still low and the spread keeps increasing. Previous studies said that Small Group Discussion (SGD) was more effective in changing community behavior. Therefore, further study is needed to be done to find out the effectiveness of small group discussion (SGD) method and lecture method towards community behavior in PSN, that was measured using larva free proportion in household.Objective: The objective of the study is to find out the effect of health education using Small Group Discussion (SGD) method and lecture method towards DHF vector larva free proportion in household.Method: The study was quasi experiment with control time series design. It was conducted in Wonosari district, Karangmojo district, and Playen district in Gunungkidul Regency. The subject of the study was 412 households divided into three groups, i.e. lecture intervension group, SGD intervention group and control group. Data analysis used paired sample t-test and Mann-Whitney test.Result:There was an effect in health education using SGD method towards DHF vector larva free proportion with p-value < α (0.05). There was a difference in DHF vector larva free proportion using lecture method but it was not statistically significant, p-value > α (0.05). There were differences between SGD with lecture method and control group in increasing DHF vector larva free proportion with p-value < α (0.05).Conclusion: There was an effect in health education using SGD method and lecture method towards DHF vector larva free proportion in household. Health education using SGD method is more effective than lecture method to increase DHF vector larva free proportion in household.
Prolanis Influence on Decreasing Blood Pressure of Hypertension Patients in Puskesmas Pandak II Bantul 2017 Florentina Sita Murti; Hari Kusnanto Josef; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 2, No 2 (2019): May
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (618.853 KB) | DOI: 10.22146/rpcpe.46016

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Background: People with hypertension over age 25 years reached 40% in 2008 according to the World Health Organization and 75% occurred in developing countries. Hypertension management must be focused on first-rate health care which could reduce death-risk, disabilities, and the cost burden. Badan Pengelola Jaminan Social obliges every first-rate health care to have to apply Program Pengelolaan Penyakit Kronis (Prolanis).Objectives: This study aims to determine the difference of decreased blood pressure in Prolanis and Non-Prolanis groups in Puskesmas Pandak II.Methods: This quantitative research with cohort retrospective design used secondary data of hypertension patients who are following Prolanis compared with those who are not in Puskesmas Pandak II. Data covered characteristics of patients, blood pressure, and Body-Mass Index (BMI) over one year. The analysis used repeated measures ANOVA. Results: The comparison with the treatment group showed significant differences in blood pressure variable, diastolic pressure variable, and BMI, interaction and measureable differences during the study period in all three variables. There was an uptrend in the Non-Prolanis group and a downtrend in the Prolanis group.Conclusions: Decreased blood pressure of patients with hypertension is better in Prolanis than Non-Prolanis groups.
Understanding Cough Ethics and Changes of Behavior of Kindergarten Teachers in the Work Area of Puskesmas Sedayu I: Community-Based Health Efforts Sistia Utami; Mora Claramita; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 3, No 1 (2020): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/rpcpe.54163

Abstract

Background: Cough cases are increasing every year. The most common cause is a virus. Coughing is influenced by endurance, Cough Ethics, and Handwashing with Soap/Cuci Tangan Pakai Sabun (CTPS). Transmission occurs through droplets in the air from the patient when coughing or sneezing. We need to educate the community to minimize transmission, especially among children. Ultimately, this speeds up the healing process. Objective: This study aimed to provide an understanding of Cough Ethics and behavior change using narrative in action to kindergarten teachers. Method: This study used descriptive-analytic qualitative methods with narrative in action. The subjects of the study were a population of kindergarten teachers in the working area of the Puskesmas Sedayu 1, selected purposive snowball sampling. Retrieval of data was done through the observation stage, pre-narrative in action activities, the narrative in action, post narrative in action activities, and the final observation stage in kindergarten. Result: Observations were done at the school to find out the infrastructure. Observation before and after the demonstration showed there were improvements and concluded that all can demonstrate the Cough Ethics and CTPS. Watching the Cough Ethics video, CTPS, followed by the dialogue, motivation, education, persuasion, promotion were empowering for the teachers to change their behavior. All groups when coughing or sneezing covered their nose and mouth with a tissue, mask, or the inner side of elbow arm or expelled phlegm on the ground, lodong/special place like a jar, and toilet. Conclusion: Narrative in action activities are an alternative way of providing understanding to change behavior. Watching videos makes it easy to explain the Ethics of Cough. Practice is needed to improve the skills of narrative in action.
Effect of Terra Exercise on Increasing Quality of Life Scores for Postmenopausal Women Nawang Sukestiningsih; Denny Agustiningsih; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 3, No 1 (2020): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/rpcpe.54165

Abstract

Background: The number and proportion of the Indonesian female population aged 60 years and over from year to year have experienced a significant increase. Women who have gone through menopause and enter old age are described as having many physical and psychological changes, sometimes resulting in a crisis and psychological symptoms. Eighty percent of women report discomfort that can significantly reduce their quality of life. Terra exercise is an exercise movement that is adapted to the anatomical and physiological conditions of the elderly person’s body (low impact). Terra exercise is used to train stamina both physically and mentally. Objective: This study aimed to examine the effect of Terra exercise on the quality of life of postmenopausal women in Kemanukan Village, Bagelen District, Purworejo Regency. Method: This study used a quasi-experimental pre-test-post-test design with a control group. The samples were selected by purposive sampling with the following inclusion criteria: postmenopausal women aged 60-75 years, who did not experience kidney failure, heart disease, rheumatism, blood pressure below 160/90 mmHg, did not have a mental disorder (schizophrenia) nor violent behavior, have a level of independence in the category of sufficient or more, can communicate verbally, and willing to be respondents with a signature/thumbprint of approval to follow the study. Quality of life was measured using the Older People’s Quality of Life Questionnaire (OPQOL-35). Hypothesis testing used paired t-test and Mann-Whitney tests to see the average differences between treatment groups. Result: There was a significant change in the mean pre-test-post-test scores of quality of life of the intervention group with Terra exercise. Conclusion: Terra exercise can improve the quality of life of women after menopause.
Risk Factor Identification of Multi-Drug Resistant Tuberculosis Kurnia Fajar Chasanah; Ika Trisnawati; Wahyudi Istiono
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 5, No 1 (2022): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/rpcpe.68766

Abstract

Background: Multi-drug resistant tuberculosis (MDR-TB) is a serious health problem with high morbidity and mortality. The identification of risk factors is needed to prevent the incidence TB-MDR. Objective: To identify the risk factors of TB-MDR in the Special Region of Yogyakarta.Method: This study used a case control design to assess the risk factors for the incidence of MDR-TB. Patients diagnosed with MDR-TB compared to non-MDR TB patients were then compared to exposure to the risk factors studied. The results of the study were analyzed by calculating the mean and proportion. Next, Chi-square tests and analysis of odds ratio (OR) with 95% confidence interval (CI) were conducted using a 2x2 dummy table as an aid with multivariate logistic regression analysis.Result: There were 53 patients with MDR-TB as the case group and 106 non-MDR TB patients as controls. There were no significant differences between the two groups regarding the characteristics of age, sex, place of residence, and type of work (p>0.05). The multivariate analysis found the risk factors associated with an increased incidence of MDR-TB were a history of previous TB treatment (p<0.001; OR 31.82; 95%CI: 9.40-107.77) and surrounding TB (p<0.01; OR 4.45; 95%CI: 1.45-13.70), while other factors that were not significantly related to the incidence of MDR-TB included body mass index, distance of home to health facilities where taking medicine, smoking, drinking alcohol, history of BCG vaccination, education, income, medication adherence, and comorbidities (p> 0.05).Conclusion: The risk factors found to be associated with an increased incidence of MDR-TB in this study were the presence of surrounding TB patients and a history of previous TB treatment.
Kepuasan Pasien Terhadap Kualitas Pelayanan di Tempat Pendaftaran Pasien Rawat Jalan Puskesmas Kretek Bantul Yogyakarta Wahyu Kuntoro; Wahyudi Istiono
Jurnal Kesehatan Vokasional Vol 2, No 1 (2017): Mei
Publisher : Sekolah Vokasi Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jkesvo.30327

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Latar Belakang: Pelayanan yang memuaskan dan berkualitas akan membentuk loyalitas pasien/pelanggan, dan kepuasan sangat erat hubungannya dengan ”word of mouth”.Efek selanjutnya akan berlanjut pada proses terbentuknya citra puskesmas yang meningkat. Hal ini dikarenakan kondisi persaingan yang sangat ketat. Maka setiap puskesmas akan berusaha untuk menempatkan dirinya sebaik mungkin dimata pasien/pelanggannya agar dapat dipercaya untuk memenuhi kebutuhannya dalam bidang kesehatan. TPP di Puskesmas Kretek Bantul Yogyakarta masih terdapat komplain pasien terhadap kecepatan pelayanan petugas. Diperlukan pengukutan terhadap tingkap kepuasan berdasarkan guna mengetahui kualitas pelayanan.Tujuan: Mengetahui distribusi kepuasan pasien berdasarkan lima dimensi kualitas jasa pelayanan, yaitu tangibles, reliability, responsiveness, assurance, emphaty; dan mengetahui perbedaan tingkat kepuasan pasien berdasarkan karakteristik.Metode: Jenis penelitian yang digunakan adalah penelitian analitik kuantitatif dengan rancangan Cross sectional dan teknik sampel yang digunakan adalah purposive accidental. Sampel yang diambil sebanyak 100 orang pasien. Teknik pengumpulan data menggunakan kuesioner dan observasi. Teknik analisa data menggunakan statistik inferensial (uji Kruskal-Wallis dan Mann-Whitney).Hasil: Berdasarkan hasil penelitian 84% menyatakan puas terhadap pelayanan di TPP. Dimensi yang perlu ditingkatkan adalah dimensi Assurance pada bagian kemampuan petugas. Berdasarkan hasil uji statistik Kruskal-Wallis dan Mann-Whitney ada perbedaan tingkat kepuasan pasien terhadap pelayanan di tempat pendaftaran pasien rawat jalan berdasarkan karakteristik pendidikan pasien, dengan nilai p (sig) sebesar 0.003.Kesimpulan: Distribusi kepuasan secara menyeluruh mayoritas pada kategori puas. Tidak ada perbedaan kepuasan berdasarkan karakteristik Jenis kelamin, Usia, dan Pekerjaan. Namun ada perbedaan kepuasan yang bermakna pada karakteristik pendidikan.
Penilaian manfaat sistem informasi manajemen rumah sakit (simrs) terhadap individu dan organisasi dengan model delone & mclean pada rsud dr.hardjono kab. Ponorogo Septa Meliana Puspitasari; Istiono Wahyudi
Jurnal Sistem Informasi Kesehatan Masyarakat Vol 4, No 1 (2019)
Publisher : Minat Sistem Informasi Manajemen Kesehatan Fakultas Kedokteran UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (341.105 KB) | DOI: 10.22146/jisph.24341

Abstract

Latar belakang: RSUD dr. Hardjono Kab. Ponorogo telah mengimplementasikan SIMRS untuk meningkatkan kinerja rumah sakit khususnya di dalam penyediaan dan pengelolaan data sejak tahun 2011. Pembangunan sistem informasi di rumah sakit bekerjasama dengan pihak ketiga, kontrak kerjasama tersebut berakhir pada akhir tahun 2016. Kerjasama meliputi pemeliharaan sistem setiap bulan. Kendala yang dihadapi selama proses implementasi adalah pengguna sering mengeluhkan data output sistem informasi yang tidak sesuai dengan kebutuhan mereka.Tujuan :  Penelitian ini bertujuan untuk mengetahui manfaat SIMRS di RSUD dr. Hardjono Kab. Ponorogo terhadap individu serta organisasi dengan mengukur pengaruh 4 variabel yaitu kualitas informasi, kualitas sistem, kualitas layanan dan kepuasan pengguna.Metode : Penelitian ini merupakan penelitian kuantitatif dengan metode survey dan bersifat cross sectional. Jumlah sampel sebanyak 89 buah, kuisioner yang layak diolah adalah 67 kuisioner sisanya 22 tidak memenuhi persyaratan untuk diolah. Analisa data dilakukan menggunakan metode structure equation model (SEM) dengan aplikasi. WarpPLS. Analisa dilakukan dengan 3 tahapan yaitu pengujian outer model, pengujian inner model dan pengujian hipotesis.Hasil: Hasil pengujian outer model didapatkan bahwa indikator pembentuk konstruk telah memenuhi  validitas dan reliabilitas data, sedangkan dari pengujian inner model didapatkan model pengujian memenuhi syarat model fit. Dari hasil pengujian hipotesis didapatkan nilai path koeffisien dan p-value sebagai dasar pengambilan kesimpulan. Hasil analisa didapatkan hipotesis yang tidak berpengaruh terhadap kepuasan pengguna yaitu variabel kualitas informasi. Sedangkan untuk variabel kualitas informasi dan kualitas layanan berpengaruh terhadap kepuasan pengguna. Variabel kepuasan pengguna berpengaruh terhadap net benefit berupa dampak organisasi dan dampak individu.Kesimpulan: Penelitian ini membuktikan bahwa tidak semua hipotesis yang diajukan terbukti secara empiris. Sistem informasi terbukti bermanfaat bagi individu maupun organisasi namun demikian kualitas informasi yang dihasilkan masih dirasa tidak sesuai dengan kebutuhan dan kurang meyakinkan bagi pengguna sistem dan tidak berpengaruh bagi kepuasan pengguna.
Studi Komparasi Perilaku Masyarakat dalam Upaya Pencegahan Demam Berdarah Dengue terhadap Keberadaan Nyamuk sebagai Vektor Briliana Nur Rohima, Sutami Budi Fitriawan, Puti Neila Kharisma Abbas,; Kusuma Dewi, Hanif, Karttegayen,Nabilah, Rizka Aries Putranti,Laxmiprita Pusparani Rahardjo,; Ayu Wikan Sayekti Agung Prasetyo Wicaksono Wahyudi Istiono
Berita Kedokteran Masyarakat (BKM) Vol 27, No 4 (2011)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (213.403 KB) | DOI: 10.22146/bkm.3397

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Background: Dengue Hemorrhagic Fever (DHF) is one of the main public health problems in Indonesia. It canaffect all age groups and may lead to death especially in children. The data shows that DHF cases in KecamatanMantrijeron between January-June 2010 have reached the highest number of cases in past seven years, about94 cases. Kecamatan Mantrijeron has an increasing trend of DHF which make it possible for the occurrence ofan outbreak of DHF when no preventions are done. RW 17 Kelurahan Suryodiningratan and RW 02 KelurahanGedongkiwo are areas with highest prevalence. There are 8 and 9 cases in each area respectively.Objective: To compare community behavior in preventing the existence of mosquitoes that is a DHF vector in theenvironment of Kelurahan Suryodiningratan and Gedongkiwo, Kecamatan Mantrijeron.Method: This research was a descriptive observational study, with cross-sectional retrospective study designin July-August 2010 in RW 17 Kelurahan Suryodiningratan and RW 02 Gedongkiwo, Kecamatan Mantrijeron,Kotamadya Yogyakarta. The research target population was 379 head of family (HF) from RW 17 KelurahanSuryodiningratan and 360 HF from RW 02 Kelurahan Gedongkiwo. Samples used was 60 HF from RW 17Kelurahan Suryodiningratan and 66 HF from RW 02 Kelurahan Gedongkiwo (minimal sampling with P=0.5 were58 HF for RW 17 and 57 HF for RW 02). Sampling was done by random sampling with milestone technique, thebehavior questionnaire, and observational checklist of mosquito existence as the instrument. Independentvariables were six behavioral criteria; dependent variable was the existence of mosquitoes. Data analysis wasdone with bivariate analysis using relative risk (RR) and odds-ratio (OR).Results: Analysis result of correlation between behavior to existence of mosquitoes in RW 17 with RR andOR>1 are: 1. Not routinely inspecting larvae in water reservoir (RR=1.38 and OR=1.89) and 2. Not cleaning thebathtub once a week (RR=1.32 and OR=1.74). Analysis result of correlation between behavior to existence ofmosquitoes in RW 02 with RR and OR>1 are: 1. Not getting rid of bottles and cans (RR=1.66 and OR=3.89); 2. Notclosing all water reservoir (RR=3.21 and OR=17.55); 3. Not routinely inspecting larvae in water reservoir(RR=2.36 and OR=-); 4. The behavior of not cleaning the bathtub once a week (RR=2.07 and OR=-); 5. Thebehavior of not draining-up the bath tub when cleaning (RR=2.03 and OR=-); 6. The behavior of not brushingwater reservoir when cleaning (RR=1.94 and OR=-). The difference between both districts is the characteristicof RW 17 Kelurahan Suryodingratan that is abundant in trees as the rest area for mosquitoes and the riverbanksof RW 02 Kelurahan Gedungkiwo are filled with household wastes.Conclusion: There are differences in behavior in preventing mosquito existence in both RW 17 KelurahanSuryodiningratan and RW 02 Kelurahan Gedongkiwo. The population of Kelurahan Gedongkiwo regularly disposesbottles and cans, drains the bath tub when cleaning, brushes water reservoir when cleaning, closes all waterreservoir, inspects larvae in water reservoir and cleans the bathtub once a week to prevent mosquitoes. Thepopulation of Kelurahan Suryodiningratan inspects larvae in water reservoir and cleans the bathtub once aweek to prevent mosquitoes.Keywords: Dengue Hemorrhagic Fever, behavior, RW 17 Kelurahan Suryodiningratan and RW 02 KelurahanGedongkiwo, Kecamatan Mantrijeron
Analisis Faktor-Faktor yang Mempengaruhi Status Gizi Balita Wahyudi Wahyudi Istiono, Heni Suryadi, Muhammad Haris, Irnizarifka, Andre Damardana Tahi
Berita Kedokteran Masyarakat (BKM) Vol 25, No 3 (2009)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.733 KB) | DOI: 10.22146/bkm.3562

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Background: The first two years in life are critical period in which rapid growth and development occured. Nutritional status of children under five years old is influenced by several factors, such as social, economic, cultural, health, environmental, and demographic factor. The World Health Organization reported that protein- energy malnutrition (PEM) prevalence in Indonesia was high. It was estimated that 27.5% of children under five years old were experienced from moderate malnutrition, while 8.5% of them were severely malnourished.Objective: This study is aimed to determine nutritional status of children under five years old as well as to identify the correlation between risk factors and the nutritional status on the area of Dukuh Madigondo, Sidoharjo Village, Samigaluh Subdistrict, and the District of Kulonprogo.Methods: The design of this study was observational with cross sectional study to identify 15 risk factors associated with nutritional status in children under five years old. Subjects were 48 children under five years old which assessed with research questionnaires. Correlation among variables was then analyzed using Kruskal Walis One Way Anova and Pearson Chi Square Test.Result: The nutritional status of fourty four children under five years old were good, while two of the children were below standard and the remaining two were bad in nutritional status. Pearson Chi Square analysis has showed no significant correlation between nutritional status and sickness frequency, familial characteristics, expenditure, environmental hygiene sanitation, health care access, mother act, mother behavior, along with mother knowledge factor.Conclusion: There was no significant correlation found among 15 risk factors towards nutritional status of children under five years old in Dukuh Madigondo, Sidoharjo Village, Samigaluh Subdistrict, District of Kulonprogo.Keywords: nutritional status, children under five years old, sex, sickness frequency, familial characteristics, expenditure level, environmental hygiene sanitation, health care access, mother act, mother behavior, mother knowledge