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All Journal International Journal of Evaluation and Research in Education (IJERE) Jurnal Keperawatan Indonesia Jurnal Kebijakan Kesehatan Indonesia Journal of Dentistry Indonesia Insisiva Dental Journal : Majalah Kedokteran Gigi Insisiva Public Health of Indonesia Media Medika Muda Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education JURNAL MEDIA KESEHATAN Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Berita Kedokteran Masyarakat

Mora Claramita

Departemen Pendidikan Kedokteran Dan Bioetika, Fakultas Kedokteran Kesehatan Masyarakat Dan Keperawatan Universitas Gadjah Mada- INDONESIA

Author-ID : 517876

Dentistry Education Health Professions Medicine & Pharmacology Nursing Public Health

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Developmental Trial of Maternity Education Control Cards Adolfina Nilasari; Mora Claramita; Shinta Prawitasari; Lisa Soldat
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 1, No 1 (2018): January
Publisher : Faculty of Medicine, Public Health, and Nursing

Background: The behavior of a pregnant woman in maintaining her health during pregnancy is influenced by her knowledge of pregnancy. The greater the knowledge of pregnant women about pregnancy, the better the attitude of pregnant women in maintaining their pregnancy. Consequently, a primary care physician who is a health manager of pregnant women needs to pay attention to this knowledge aspect. Primary care physicians should be able to quickly identify the level of knowledge of pregnant women about pregnancy and determine whether that knowledge is sufficient. For that purpose, primary care physicians need to have the right measurement instruments.Objectives: This study aimed to develop, validate and test the instruments that primary care physicians can use to identify and add to pregnant women’s level of knowledge about pregnancy.Methods: This study involved research and development of a validated instrument that consisted of several stages, namely development, validation and testing. Validation was done through two stages, specifically content validation by experts and face validation by 7 doctors. The experimental phase was a quasi-experimental research with 35 pregnant women who presented for antenatal examination at the Puskesmas Banguntapan I (Community and Primary Health Care Center). T-tests were used to determine whether there was a significant difference between the knowledge of pregnant women before and after using the Maternity Education Control Cards.Results: The validated instrument called the Maternity Education Control Card developed by primary care physicians can be used to identify and increase the level of knowledge of pregnant women about pregnancy. The Maternity Education Control Card was validated by several experts, including communication experts, obstetricians and the Maternal and Child Health Program Coordinator at Bantul Regency. Layout, style, accessibility, and feasibility were assessed by a team of validators at the Puskesmas Banguntapan I (7 doctors and 1 midwife coordinator). The data analysis showed that there was a significant difference between pre-test and post-test scores (p = 0.000). This value was not influenced by age variables, educational level, number of pregnancies nor previous antenatal care frequency, but the level of education did affect the post-test value. The duration required for education was between 9 - 20 minutes, with an average of 14.63 minutes (± 2.61). The duration required for education related to the delta of pre and post-test values. The greater the delta, the longer time required for education.Conclusions: Maternity Education Control Card has been successfully established, validated and proven to significantly increase pregnant women’s knowledge about pregnancy.

Making and Validating a Promotive and Preventive Effort Model for Stages 1-5 of Chronic Kidney Disease in Primary Care Services Anita Rahman Hajam; Bambang Djarwoto; Mora Claramita
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.33866

Background: The prevalence of Chronic Kidney Disease (CKD) is continuously increasing worldwide, including in Indonesia and has become a global public health problem. With the increased number of patients with CKD and the limited number of nephrologists, primary care physicians and specialists should play an important role in providing quality sustainable prevention and treatment by improving promotive and preventive efforts in primary care. Most patients with CKD can be managed by doctors in primary care in collaboration with specialist doctors in secondary and tertiary care. However, clinical practice guidelines for promoting and preventing CKD in primary care apparently have not been optimally implemented.Objective: This research aimed to make a promotive and preventive model for stages 1-5 of CKD in primary care.Methods: This research employed a research and development strategy with the following stages: (1) Preliminary study stage (literature review), (2) Development stage (initial draft of the model) and (3) Resources validation stage (in-depth interviews).Results: Five primary care physicians, two internists and one nephrologist participated in the validation stage for the initial draft of the model. The three stages of this research obtained the pattern of doctor's practice for CKD and the feedback related to the model to be adjusted according to the condition of primary care in Indonesia.Conclusion: There is a lack of understanding and awareness of primary care physicians about prevention and treatment of CKD, and a lack of supporting examination facilities for serum creatinine and albuminuria in primary care for screening of the risk factors of CKD. A promotional and preventative model of stages 1-5 for CKD in primary care was successfully made and validated.

The Practice of Home-based Direct Observer Treatment of Patients with Positive Pulmonary Tuberculosis (DOT – TB) at Kebumen District of Indonesia Timbul Pranoto; Mora Claramita; I Dewa Putu Pramantara
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 1, No 2 (2018): May
Publisher : Faculty of Medicine, Public Health, and Nursing

Background: Tuberculosis (TB) is a major global health problem, even though TB can be prevented and treated. The WHO Global Tuberculosis Report 2015 reported 1.5 million deaths from TB, of which 1.1 million were TB with HIV-negative and 0.4 million were HIV-positive tuberculosis. As many as 25% of deaths from TB were in productive ages between 15 to 54 years. Low adherence is a major cause of treatment failure, drop-out and the rising number of cases of MDR (Multi Drugs Resistance). Adherence is also a key to improve the cure rate of treatment of TB patients. Home-based Direct Observer Treatment of patients with positive pulmonary Tuberculosis (DOT–TB) or in Bahasa Indonesia also known as Pengawas Minum Obat (PMO) may improve adherence and increase the TB cure rate and success rate. The DOT-TB has tasks to oversee, remind, motivate and assist TB patients who are undergoing the treatment process. Background of DOT–TB in improving adherence needs to be explored by examining their experiences, which can be expressed by using a phenomenological qualitative study to explore the meaning and significance of their experiences. Objectives: This study aimed to explore the efforts of DOT–TB in performing their duties, the constraints arising from these efforts, benefits, and expectations of the DOT–TB position.Methods: This study applied a qualitative approach with descriptive phenomenological methodology. The number of informants were 21 people divided into groups of DOT–TB whose patients were perfectly recovered (7 people), groups of DOT–TB whose patients were drop-out or failed (7 people) and a group of 7 TB programmers. Each group participated in the Focus Group Discussion (FGD) for 90-120 minutes.Results: The results of the study indicate that the presence of DOT–TB is very important and necessary in the management of TB. The biggest challenge of DOT–TBs in performing their duties are communication barriers due to differences in hierarchy and social status in the society. Their sense of hesitancy was a major challenge of DOT–TB in charge. According to respondents, the ideal DOT–TB is someone close to the patients, has patience, compassion, enough knowledge about TB and good communication skills.Conclusions: In order to perform their duties well, DOT–TBs require training concerning tuberculosis and communication.

Training Detection of Preeclampsia Risk Factors for Physicians in Primary Care with Experience-Based Learning Methods: A Quasi Experimental Study Brantas Prayoga; Shinta Prawitasari; Mora Claramita
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 1, No 2 (2018): May
Publisher : Faculty of Medicine, Public Health, and Nursing

Background: Training for primary care physicians in the management of pregnant women often combines detection of the risk of bleeding, risk of infection and the risk of preeclampsia. Meanwhile, preeclampsia contributes to the world's largest maternal mortality rate, including in Indonesia. Primary care physicians’ knowledge about the risk factors and the early detection of preeclampsia is still very limited. It is therefore necessary to detect preeclampsia risk factors as early as possible and perform proper, fast and effective therapeutic diagnosis to prevent the onset of preeclampsia and to make efforts to safeguard maternal health and the survival and wellness of her baby. Experiential learning was selected in this training as it allows for sustainable learning.Methods: Quasi experimental study was conducted with 30 physicians of Community and Primary Health Care Center (Puskesmas) who were randomly divided into 2 groups, i.e. treatment group and control group each with 15 people. The treatment group was given training by 2 cycles of experiential learning, then both groups rated knowledge with vignette questionnaires from international sources that have been validated by experts in obstetrics, with 1-week interval time between the post-test and pre-test.Results: There was an increase of knowledge in primary care physicians after receiving training for both the treatment group (p = 0.034) or the control group (p = 0.000). The increase of knowledge in the treatment group after training was higher than the control group with the mean difference of 5.733. This result shows that the use of experiential learning methods proved effective.Conclusion: The detection training of risk factors for preeclampsia increases the physician's knowledge in managing preeclampsia in primary care.

Patients’ and families’ experiences in Lung Tuberculosis treatment in Kebumen District, Central Java Province: A phenomenology study of ‘Drop Out’ and ‘Uninterrupted’ groups Pratama Adi Prabawa; Mora Claramita; I Dewa Putu Pramantara
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 1, No 3 (2018): September
Publisher : Faculty of Medicine, Public Health, and Nursing

ABSTRACTBackground: Tuberculosis (TB) is still a worldwide health problem based on the impact of the disease, difficulties in the eradication and drop out tendency in treatment. One of the problems of TB in Indonesia is the high incidence of drop out treatment. Discontinuation of treatment leads to treatment failure, a source of transmission and drug resistance.Objectives: This study aimed to examine the process of meaning-making for the patients and their families’ as well as their PMO (Pengawas Minum Obat) / DOT-TB (Direct Obverser Treatment of Patients with Positive Pulmonary Tuberculosis) experience in pulmonary tuberculosis treatment of ‘Uninterrupted’ and ‘Drop Out’ groups.Methodology: A qualitative phenomenological approach was used with a purposive sampling strategy to select the participants. The data were collected by a psychologist with an in-depth interview with 7 patients and their families who continued the treatment until fully recovered (‘Uninterrupted’) and 7 patients and their families who dropped out the TB treatment (‘Drop out’) with the total subjects are 28 people. The location of research was in the Kebumen District which includes a Puskesmas (Community Health Center), Hospital and UP3 (Pulmonary Disease Treatment Unit). The Colaizzi method was used to analyze the data.Results: Patients' and their family's knowledge about TB of both groups were insufficient. However, the ‘Uninterrupted’ group were found to be self-motivated and received all possible psychological, and physical supports from their family while encouraging treatment adherence as factors that support the sustainability of pulmonary TB treatment. Whereas, these factors were not found in the ‘Drop out’ group.Conclusions: Self-motivation and family support / PMO for pulmonary TB patients is the key to the sustainability of pulmonary tuberculosis treatment until fully recovered. Education and counseling for pulmonary TB patients and their families / PMOs are absolutely necessary in Indonesia.

Study of Acceptance and Application of Calgary Cambridge Communication Guideline for Doctor-Patient Communication in Primary Health Care Widyastuti Widyastuti; Mora Claramita; Retna Siwi Padmawati
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) Vol 1, No 3 (2018): September
Publisher : Faculty of Medicine, Public Health, and Nursing

ABSTRACTBackground: Communication is a basic skill that must be acquired by every doctor just like all other clinical skills. One of communication guidelines for doctor-patient that is the most widely used in many countries is the Calgary-Cambridge Communication Guideline (CCCG). However, since CCCG is based on the Western style of communications, a further study is necessary to determine whether CCCG is acceptable and applicable in Indonesia.Methods: This research was an analytic descriptive study with a cross-sectional design. The research was conducted from December 2016 until January 2017 in Yogyakarta with 58 primary care doctors. The data was collected using the CCCG-based questionnaire method with a cross-cultural adaptation.Results: The CCCG is well accepted although its application is not optimum. The acceptance rate was 4.03 (indicating highly acceptable), while the application rate was 3.74 (indicating occasionally implemented). There was a significant difference between the acceptance and application rates (p<0.01). There were no significant differences between the acceptance rates of Puskesmas (Community and Primary Health Care Center) and non-Puskesmas (p = 0.115) facilities while the application was significantly different (p = 0.001). The application levels of the Puskesmas were lower than those in non-Puskesmas. Additionally, there was no difference in the acceptance or application of CCCG for doctors who have and who have not attended communication training.Conclusion: There was no difference in the acceptance of CCCG, but there was a difference in its application. The application rate at Puskesmas was lower than non-Puskesmas facilities. The experience in communication training did not affect the acceptance and the application rates of CCCG.

Benefits of Diabetes Support Group in Chronic Disease Management Program (Prolanis) in Puskesmas Jetis II, Bantul District: a Case Study Yulia Dewi Irawati; Adi Heru Sutomo; Mora Claramita
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

Background: Type 2 diabetes mellitus is a chronic disease and has the potential for complications that affect the entire body so that it requires a comprehensive approach. This means that the management of DMT2 must involve various parties, both medical, paramedic, patient, family and community. One strategy for managing DMT2 is Prolanis (Chronic Disease Management Program) which is a diabetes support group at Jetis II Health Center. To find out the success of Prolanis implementation, an evaluation of the benefits of the diabetes support group is needed.Objective: To find out the benefits obtained from participating in the diabetes support group in Prolanis at the Jetis II Bantul Health Center.Method: A qualitative descriptive study with a case study approach. Data were obtained from patients with DMT2 members of Prolanis (Chronic Disease Management Program) and officers of the Jetis II health center in Bantul Regency. Retrieval of data in patients with focus group discussions on 30 resource persons divided into 3 groups. Other data is by conducting independent interviews with 6 informants of the puskesmas staff involved in the diabetes support group activities of Prolanis.Results: The benefits obtained from the diabetes support group are grouped into 3 categories namely biopsychosocial support, information, and individual empowerment. Most patients benefit from obtaining biopsychosocial support from the Prolanis group. Benefits for DMT2 patients Prolanis members get information in the second place and the last is individual empowerment at least the benefits are felt.Conclusion: The benefits of a diabetes support group for DMT2 patients in Prolanis members are to get biopsychosocial support, information, and individual empowerment.

Evaluation of Community Based Disaster Preparedness Training for UGM Health Study Program Students in 2016 Istianto Kuntjoro; Mora Claramita; 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

Background: Disasters are events that destroy infrastructure, take casualties, disrupt life and systems, damage social order, health, and security, and occur on a global scale. Various places in the world began to include disaster management in their doctors' education curricula, including Indonesia, which is geologically located in areas with high potential for disasters, which have the potential to be continually harmed by disasters that always occur.Objective: To see whether the disaster management training in UGM semester 7 study program students have properly increased the students' knowledge and attitude towards disaster.Method: Quantitative research design and using Quasi-experimental method, without control, with pre-test and post-test instruments. The population of this study was students of medical education study programs, nutrition study program students, and nursing study students, with a sample of 175 students. The independent variable measured is community-based disaster management training. Collecting research data using an instrument in the form of a questionnaire after that was analyzed by a paired T-test.Results: There was an increase in the score of knowledge and attitudes about disaster after receiving training, but the achievement of the mean value of each question was still close to the median. The highest increase in scores achieved in each study program is a value of 6.Conclusion: There was an increase in knowledge about disasters and disaster preparedness attitudes in 2016 health study program students who attended Disaster Preparedness training.

The Consumption of Traditional Medicine by Type 2 Diabetes Mellitus Patients at the Public Health Center of Panjatan in the Regency of Kulon Progo as a Case Study Enuk Endah Sunarto; Mora Claramita; M Robikhul Ikhsan
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

Background: The consumption of traditional medicine is very much done in the society including by type 2 diabetes mellitus patients.Purpose: This study is purposed to understand the reasons of type 2 diabetes mellitus patients at the Public Health Center of Panjatan in the Regency of Kulon Progo in consuming traditional medicine and their knowledge about type 2 diabetes mellitus.Method: This study is a qualitative research with case study approach. The data is obtained through focus group discussion involved 56 type 2 diabetes mellitus patients. The data is analyzed by qualitative analysis techniques from Miles and Huberman.Results: The reasons of type 2 diabetes mellitus patients in consuming traditional medicine, i.e. (1) they are following friends or relatives who has consumed traditional medicine that is considered successful, or (2) they are not believing in the medical doctor's treatment. The economic and distance factors are not their consideration. The type 2 diabetes mellitus patients who have consumed traditional medicine but have now stopped have the following reasons: (1) they are asked to stop in consuming traditional medicine by medical doctors; (2) they said that it is not practical how to mix traditional medicine so that they become lazy to consume traditional medicine; or (3) the mixing of traditional medicine is easily depleted. In addition, from this study also known that some type 2 diabetes mellitus patients understand very well about type 2 diabetes mellitus disease suffered, some others do not have enough knowledge about type 2 diabetes mellitus.Conclusion: The type 2 diabetes mellitus patients in consuming traditional medicine are due to various factors, i.e. the trust of medical doctors, following friends or relatives as well as sufficient knowledge about the effects of traditional medicine. This study also founded that generally all type 2 diabetes mellitus patients understand the disease they suffered well.

Why does she suffer prolonged status asthmaticus? Mora Claramita; Nur Afrainin Syah
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

A mother (Y) aged 55 years, was hospitalized with ‘Status Asthmaticus’, for 4 days in a hospital, with admission through an Emergency Department Service. The case history was ‘Intermittent Asthma’ with corticosteroid inhaler treatment for the past three years and ‘Diabetes Mellitus’ (DM) Type 2, controlled by the treatment of Metformin and Acarbose. The results of the history, physical examination, and laboratory lead to the main diagnosis ‘Status Asthmaticus’. Blood glucose before and when at the hospital was within normal limits (with treatment). Asthma attack was absent during the last 2 years, relapsed 2 years ago because of 'Bronchopneumonia'.

Co-Authors ., Widyandana Abu Bakar Achmad Yarziq Mubarak Salis Salamy Adi Heru Sutomo Adi Heru Sutomo Adolfina Nilasari Anita Rahman Hajam Aras Utami Arif, Luthfi Saiful Armyn Nurdin Astrid Pratidina Susilo Bambang Djarwoto Brantas Prayoga Bulan Kakanita Hermasari Cicih Bhakti Purnamasari Cornelia Wahyu Danawati Dhanasari Vidiawati Diah Prasetyorini Dina Qurratu Ainin Elsa Pudji Setiawati Enuk Endah Sunarto Fatmala, Galuh Dyah Fauziah, Siti Rizki Febria, Nyka Dwi Fino Susanto Fitriana Murriya Ekawati Gandes Retno Rahayu Handayani, Fani T. Hari Kusnanto Hari Kusnanto Josef Hikmawati Nurrokhmanti Hikmawati Nurrokhmanti, I Dewa Putu Pramantara I Dewa Putu Pramantara I Dewa Putu Pramantara Ibrahim Amnur Ira Paramastri Irawati, Yulia Dewi Istianto Kuntjoro IZZAH, NURUL Josef, Hari Kusnanto Lisa Soldat Lisma Evareny, Mohammad Hakimi, Retna Siwi Padmawati M Robikhul Ikhsan Mahmudah, Noor Afif Mariatul Fadilah Michael Andreas Leman Michael Andreas Leman Miko Ferine Mohammad Hakimi Mumtihana muchlis Murti Mandawati Nababan, Adelina Novita Nadia Greviana Ngang, Inggong Noor Afif Mahmudah Nugraha, Ryan Rachmad Nunik Sulistyaningsih Nur Afrainin Syah Nurrokhmanti, Hikmawati Nurul Fauziah Nurul Qomariyah Nurul Qomariyah Ova Emilia Pratama Adi Prabawa Prattama Santoso Utomo Putri Hidayati Rachmadya Nur Hidayah Rahayu, Gandes R. Rahmi Surayya Rilani Riskiyana Riri Indriyanti Ronanarasafa, Ronanarasafa Rosaria Indah Rusetiyanti, Nurwestu Sari, Silvia Mustika Savirani, Rifda Shinta Prawitasari Sintak Gunawan Sistia Utami Siti Solekah Slamet, R Sunarko Soenarto Sastrowijoto, Soenarto Sri Handayani Surya Akbar Syarhan Syarhan Sylvia Mustika Sari Tezar Samekto Darungan Timbul Pranoto Titi Savitri Tri Nur Kristina Tridjoko Hadianto Umi Farida Hidayati Utomo, Prattama Santoso Wahyudi Istiono Widyandana Widyandana Widyastuti Widyastuti Wiwik Salistyaningsih Theresia Puspitawati Dwi Kurniawan Nugroho Yanti Yanti Yayi Suryo Prabandari Yogi Fitriadi Yogi Fitriadi Yoyo Suhoyo Yulia Dewi Irawati Yulita Hendrartini

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