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Faktor Yang Berhubungan dengan Pasien Hipertensi Tidak Terkontrol Di Puskesmas Miftafu Darussalam; Agus Warseno
Jurnal Keperawatan Klinis dan Komunitas (Clinical and Community Nursing Journal) Vol 1, No 2 (2017)
Publisher : PSIK FKKMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.332 KB) | DOI: 10.22146/jkkk.49111

Abstract

Background: Hypertension is one of the major cardiovascular risk factors. Uncontrolled hypertension is defined as the state of systolic blood pressure ≥140 mmHg and diastolic blood pressure ≥90 mmHg based on an average of three times the measurement in hypertensive patients and with or without antihypertensive treatment. Factors that can cause uncontrolled hypertension include age, education, smoking, exercise habits, medication adherence, and recent blood pressure control habits.Objective: To identify factors related to uncontrolled hypertension patients at Puskesmas Gamping 1 Sleman Yogyakarta.Methods: The research was analytical descriptive with cross sectional design. The sampling technique of this study was consecutive sampling. There was 191 respondents in this study. The data analysis used was multiple logistic regression test.Results: The hypertension disease in Puskesmas Gamping 1 Sleman is mostly uncontrolled hypertension amounted to 143 (75%) respondents. Factors associated with uncontrolled hypertension were age (p=0,008) and blood pressure control habits (p=0,000). The multivariate analysis shows that there is only one independent variable associated with uncontrolled hypertension patient that is blood pressure control habits (aOR=5,339; 95% CI; (2,452-11,624)). Respondents who do not have regular blood pressure control habits have 5,339 times higher than other risk factors of hypertension.Conclusions: The most dominant factor associated with uncontrolled hypertension is the habit of checking blood pressure. ABSTRAKLatar Belakang: Hipertensi merupakan salah satu faktor risiko utama kardiovaskular. Seseorang dikatakan hipertensi bila memiliki tekanan darah sistolik ≥140 mmHg dan atau tekanan darah diastolik ≥90 mmHg, pada pemeriksaan yang berulang. Hipertensi tidak terkontrol didefinisikan sebagai keadaan ukuran tekanan darah sistolik ≥140 mmHg dan tekanan darah diastolik ≥90 mmHg berdasarkan rata-rata tiga kali pengukuran pada penderita hipertensi dan dengan atau tanpa pengobatan antihipertensi. Faktor-faktor yang dapat menyebabkan hipertensi tidak terkontrol antara lain umur, pendidikan, merokok, kebiasaan olah raga, kepatuhan minum obat, dan kebiasaan kontrol tekanan darah terakhir.Tujuan: Mengidentifikasi factor-faktor yang berhubungan dengan pasien hipertensi tidak terkontrol di Puskesmas Gamping 1 Sleman Yogyakarta.Metode: Desain penelitian yang digunakan adalah deskriptif analitik dengan pendekatan cross sectional. Teknik sampling penelitian ini adalah consecutive sampling, dengan jumlah sampel 191 responden. Untuk analisis menggunakan uji regresi logistik ganda.Hasil: Status hipertensi di Puskesmas Gamping 1 Sleman sebagian besar hipertensi tidak terkontrol berjumlah 143 responden (75%). Faktor yang berhubungan dengan hipertensi tidak terkontrol adalah umur (p=0,008) dan kebiasaan kontrol tekanan darah (p=0,000). Hasil akhir analisis multivariate didapatkan data bahwa hanya ada satu variabel independent yang berhubungan dengan pasien hipertensi tidak terkontrol yaitu kebiasaan kontrol tekanan darah (aOR=5,339; 95%CI; (2,452-11,624)). Jadi responden yang tidak mempunyai kebiasaan kontrol tekanan darah secara rutin mempunyai faktor risiko 5,339 kali dibanding faktor yang lain.Kesimpulan: Kebiasaan kontrol tekanan darah merupakan faktor yang paling dominan pada status hipertensi yang tidak terkontrol.
Peningkatan Kemampuan Kader Remaja Dalam Pengendalian Hipertensi Melalui Posyandu Remaja Parikesit Ratna Lestari; Miftafu Darussalam; Fajriyati Nur Azizah; Ferianto; Sriyati Sipora
The Journal of Innovation in Community Empowerment Vol 3 No 2 (2021): Journal of Innovation in Community Empowerment (JICE)
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/jice.v3i2.625

Abstract

Hipertensi dikenal dengan silent killer karena merupakan penyakit yang menyebabkan kematian tanpa disadari. Kemenkes RI (2018) melalui Riskesdas melaporkan prevalensi hipertensi di Indonesia sebesar 34,11% pada usia penduduk >18 tahun. Persentase ini mengalami peningkatan dibandingkan tahun 2013 sebesar 25,8%. Riskesdas menyebutkan penyumbang kasus tertinggi terdapat di Provinsi Kalimantan Selatan sebesar 44.13%, sedangkan Daerah Istimewa Yogyakarta menduduki peringkat ke 12 dengan jumlah prevalensi 32,86%. Berdasarkan Data Profil Kesehatan Provinsi Yogyakarta (2017) menyebutkan bahwa kasus hipertensi paling banyak terdapat di Kabupaten Sleman yaitu 12,10%. Dinkes Kabupaten Sleman (2020) melaporkan bahwa Kecamatan Kalasan merupakan penyumbang terbesar penderita hipertensi dibandingkan kecamatan lain. Hipertensi yang tidak dikelola dengan baik akan berlanjut pada penyakit kardio maupun vaskuler lainnya yang memberikan dampak pada kematian. Dibutuhkan pengendalian hipertensi melalui partisipasi aktif masyarakat atau pemberdayaan kader kesehatan. Pemberdayaan ini dilakukan dalam Upaya Kesehatan Bersumberdaya Masyarakat (UKBM) Posyandu Remaja Parikesit. Kegiatan pengabdian kepada masyarakat ini bertujuan untuk melatih kader remaja agar mempunyai pengetahuan dan keterampilan tentang hipertensi. Kegiatan pemberdayaan ini dilakukan dengan memberikan edukasi tentang hipertensi kepada kader remaja atau dikenal dengan parikesit, melatih kader menggunakan spigmometer digital agar dapat mengukur tekanan darah, dan mengajarkan cara mengisi buku raport hipertensi. Metode yang digunakan dalam pengabdian kepada masyarakat ini terdiri dari diskusi interaktif dan demonstrasi. Berdasarkan hasil evaluasi pelatihan kader didapatkan data tidak ada satupun kader remaja dengan hasil pengetahuan setelah edukasi lebih rendah daripada sebelum edukasi (0%), 3 kader remaja berpengetahuan sama/ tetap (17,7%), dan 14 kader remaja mempunyai pengetahuan yang lebih baik dari sebelum edukasi hipertensi (82,3%). Nilai p menunjukkan 0,001 yang berarti pelatihan kader remaja memiliki pengaruh terhadap peningkatan pengetahuan tentang hipertensi. Selain itu keterampilan kader remaja mengalami peningkatan setelah diberikan pelatihan sebesar 70,5% dengan nilai p 0,000.
TINGKAT PENGETAHUAN ORANG TUA TENTANG STIMULASI DAN PERKEMBANGAN MOTORIK HALUS ANAK PRASEKOLAH USIA 3-5 TAHUN Wahyu Jatmiko; Rosa Delima Ekwantini; Miftafu Darussalam
MEDIA ILMU KESEHATAN Vol 4 No 2 (2015): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

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Abstract

Background: Knowledge means everything which is known or intelligence relates to something. Knowledge or cognition is an important basis to establish one's actions. Stimulation is defined as a basic ability to encourage activity of children aged 0-6 years to achieve optimum growth and development. Objective: (1) To identify the level of parents’ knowledge regarding early child stimulation; (2) to identify the development of fine motor skills of preschool children; (3) to identify correlation between parents’ knowledge and their children’s fine motor skills. Methods: A cross-sectional studi using total sampling consisted of 37 respondents from Hargotirto village in Kulonprogo district, Yogyakarta. Data were taken by using a questionnaire to identify the knowledge and the Denver Developmental Screening Test to assess the development respectively and then were analyzed by using Gamma Statistical Test. Results: The results showed that: (1) The level of parents knowledge regarding early child stimulation, mostly good (37.7%); (2) The development of fine motor skills of the children were mostly at normal range (73%); (3) There was moderate level of correlation between parents’ knowledge and their children’s fine motor skills (R=.528, p<.05) Conclusion: There is a correlation between parents’ knowledge and preschool children’s fine motor skills. Keyword: Knowledge level, stimulation, fine motor skills
PERAN AIR REBUSAN DAUN SALAM (SYZGIUM POLYANTHUM) DALAM MENURUNKAN KADAR ASAM URAT Miftafu Darussalam; Dwi Kartika Rukmi
MEDIA ILMU KESEHATAN Vol 5 No 2 (2016): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v5i2.149

Abstract

Background: Uric acid is a final product or a waste that is resulted from the metabolism of purines. A high level of uric acid (hyperuricemia) will cause several health problems, such as vascular inflammation, smooth muscle proliferation, and vascular lesion in kidneys. The syzygium polyanthum leaves contain bioactive substances that may affect the level of uric acid in blood. Objective: This study aimed to determine the influence of boiled water of syzygium polyanthum leaves to the changes of uric acid levels in the target area of Puskesmas Pandak 1 Bantul. Methods: This study employed pre- and post-test without control group design. The population consisted of all patients with hyperuricemia in the target area of Puskesmas Pandak 1 Bantul. Sample was selected with a concecutive sampling, gaining a total number of 24 respondents. Data were analyzed with the Wilcoxon test. The dose of boiled water of syzygium polyanthum leaves intake was 0.36g/ KgBW, once a day for 14 days. Result: This research showed that the boiled water of syzygium polyanthum leaves decreased hyperuricemia (uric acid levels), along with the significancy value of 0.009 (p <0.05). At the pre-test time, the average level of uric acid reached 7.279 mg/dl, and after the treatment, it decreased to 6.76 mg/dl. Conclusion: This study has established evidence that the boiled water of syzygium polyanthum leaves is able to decrease hyperuricemia (uric acid level in blood). Keywords: Syzygium polyanthum, boiled water of syzygium polyanthum leaves, hyperuricemia
PENGETAHUAN DAN SIKAP PERAWAT TENTANG MOBILISASI DINI PASIEN DI ICU RSUD PANEMBAHAN SENOPATI BANTUL YOGYAKARTA Muhamat Nofiyanto; Muhamad Munif; Miftafu Darussalam
MEDIA ILMU KESEHATAN Vol 6 No 1 (2017): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v6i1.173

Abstract

Background: Early mobilization is necessary in critically ill patients in Intensive Care Unit (ICU) to prevent hypovolemia which endangers patient’s life. The role of nurses in early mobilization is important by providing explanations and motivating patients to achieve the purpose of healing. Guidance and intensive intervention from nurses can reduce the recurrence of disease. Objective: To investigate the level of knowledge and attitude of nurses on patients early mobilization in ICU of RSUD Panembahan Senopati Bantul. Method: A descriptive, cross sectional study, was applied on 20 nurses in ICU of RSUD Panembahan Senopati Bantul. Univariate data analysis was administered to characteristics of respondents, knowledge, attitudes, and cross-tabulations. Result: Most of nurses have good level of knowledge (70%), and on attitude domain, most nurses are being supportive (75%) in terms of early mobilization to patients. Nurses whose age are 22-35 years old (10%), male (10%), have been working for 1 month up to 5 years (10%), have background of 3 years diploma in nursing (10%) fall into poor knowledge category. Similar characteristics contribute to attitude domain where nurses whose age are 22-35 years old (25%), male (15%), have been working for 1 month up to 5 years (25%), have background of 3 years diploma in nursing (35%) are placed into unsupportive category. Conclusion: The level of knowledge of nurses on patients early mobilization is in good category where the attitude is in supportive category. Keywords: Knowledge, attitude of nurses, early mobilization.
PROFIL LIPID DENGAN KEJADIAN MORTALITAS PADA PASIEN INFARK MIOKARD AKUT DI RSUD PANEMBAHAN SENOPATI BANTUL TAHUN 2015 Miftafu Darussalam; Muhamat Nofiyanto
MEDIA ILMU KESEHATAN Vol 6 No 2 (2017): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v6i2.183

Abstract

BACKGROUND: Lipid profile is important as supporting data on heart patients. Lipid profile is a state of fat seen in the levels of total cholesterol, LDL, HDL, and triglycerides. Disorders of lipid metabolism characterized by an increase or decrease in blood plasma is called dyslipidemia. Dyslipidemia has a close relationship with the occurrence of atherosclerosis and Acute Myocardial Infarction (AMI) as one of the leading causes of death in industrialized countries and emerging economies. OBJECTIVE: To determine the relationship lipid profile with the incidence of mortality in patients with acute myocardial infarction in hospitals Panembahan Senopati Bantul in 2015. METHODS: This study used a descriptive exploratory design with data retrieval medical record in 2015 with a total of respondents 106 was done in Panembahan Senopati Bantul District Hospital. To analyze the data, the researchers used the Lamda test. RESULT: The results obtained were an association of mortality with total cholesterol by P: 0006 and the level of closeness strong (0647), LDL with P: 0009 and the level of closeness strong (0647), HDL with P: 0017 and the level of closeness is strong enough (0529), triglycerides P: 0003 and the level of closeness strong (0765) CONCLUSION: Mortality of AMI was statistically significant associated with total cholesterol, HDL, LDL, and triglycerides. Keywords: Acute Myocardial Infarction (AMI), lipid profile, mortality of AMI
ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN KETERBUKAAN STATUS HIV SEROPOSITIF WANITA PENDERITA HIV/AIDS TERHADAP PASANGAN SEKSUAL DI LSM VICTORY YOGYAKARTA Dwi Kartika Rukmi; Miftafu Darussalam
MEDIA ILMU KESEHATAN Vol 7 No 2 (2018): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v7i2.230

Abstract

Background: The disclosure of women’s HIV status toward their sexual partners is an important issue that should be regarded as one of the efforts to prevent and control the spread of HIV. Research on the disclosure of seropositive HIV status as well as women-related factors in Indonesia, especially Yogyakarta is only a few. Objective: The purpose of this study is to analyse a factor related to the growth of HIV-positive female HIV/AIDS to sexual partners in LSM Victory Yogyakarta Methods: This is a correlational descriptive research along with its cross-sectional approach on 329 women with HIV/AIDS at the Victory Plus NGO from June to July 2016. This research used a purposive sampling method and a questionnaire as the data collection technique. The bivariate analysis test was undertaken by using a chi square and multivariate test along with a logistic regression. Result: The multivariate analysis and logistic regression show five independent variables related to the disclosure of seropositive HIV status of women with HIV/AIDS toward their sexual partners, namely ethnicity (aOR = 36,859; 95% CI; (6,544-207,616)) religion (aOR =0,255; 95%CI; (0,075-0,868)), discussion with partners prior to the HIV test (aOR =0,069; 95%CI; (0,065-0,438)) , types of sexual partners (aOR = 0.191; 95% CI; (0.082-0,445)) and knowledge on the partners’ HIV status (aOR = 0.036; 95% CI; (0.008-0.160)). The highest level of reason for seropositive HIV women not to be open about their partners’ status is the fear of being rejected by their partners and the environmental stigma of HIV AIDS disease. Conclusion: The disclosure of seropositive HIV status in women with HIV/AIDS in the Victory Plus NGO of Yogyakarta was 79.4% or classified as a high category with some related factors such as ethnicity, religion, discussion with partners prior to the HIV test, types of partners and knowledge on the partners’ HIV status. Keywords: Women, HIV, Disclosure, Sexual Partner.
PELATIHAN COMPRESSION ONLY-CPR EFEKTIF MENINGKATKAN KETEPATAN KOMPRESI DADA PADA ORANG AWAM Muhamat Nofiyanto; Miftafu Darussalam; Arif Adi Setiawan
MEDIA ILMU KESEHATAN Vol 8 No 1 (2019): Media Ilmu Kesehatan
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/mik.v8i1.250

Abstract

Background: Many studies show a low rate of immediate chest compression in OHCA cases. One of the factors that inhibits is the lack of knowledge of lay people who witness cases of cardiac arrest. Objective: To determine the effect of providing compression-only CPR training on chest compression skills in lay people Methods: This research used pre-experiment with one group pre-post test design, with a total of 28 respondents, using simple random sampling technique. Respondents measured chest compression skills before training, then provided training for 120 minutes.Wilcoxon test was used to analyze data sets. Results: There were almost the same number between male and female respondents, and most have never received CPR training. Only 5 respondents had received previous training, with details of 3 years, 6 years, 8 years, 9 years and 11 years ago. There was a difference in the accumulation of the accuracy of chest compression before and after training with a p-value of 0,000. Conclusion: Compression only-CPR training can improve chest compression skills, especially aspects of accuracy of compression. Broader training and intensification of training programs are needed to realize emergency preparedness in the campus community. Keywords: Cardiac arrest, CPR, training
Upaya Peningkatan Kualitas Hidup Pasien Post Stroke Pada Fase Rehabilitasi : Literature Review Miftafu Darussalam; Sri Achadi Nugraheni
Jurnal Ilmu Keperawatan Jiwa Vol. 4 No. 4 (2021): November 2021
Publisher : Persatuan Perawat Nasional Indonesia (PPNI) Jawa Tengah

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Abstract

Rehabilitasi dini penderita stroke dalam perawatan akut sangat penting untuk mengoptimalkan potensi pemulihan dalam mencegah berbagai komplikasi sekunder dari gejala sisa stroke. Rehabilitasi stroke yang tepat akan meningkatkan kualitas hidup penderita stroke. Tujuan studi literatur ini untuk mengetahui bagaimana upaya peningkatan kualitas hidup penderita stroke pada fase rehabilitasi. Ada enam tahap dalam literatur ini yaitu identifikasi tujuan, menemukan literatur-literatur yang relevan dengan menggunakan empat databased yaitu JSTOR, Science direct, Proquest, dan Cambridge Core dengan menggunakan kata kunci (stroke survivor) AND (rehabilitation program) AND (quality of life), seleksi literatur dengan menggunakan diagram Prisma, pemetaan data dengan melakukan critical appraisal berdasarkan check list penelitian RCT menggunakan check list dari  Joanna Briggs Institute, merangkum serta melaporkan hasil, dan konsultasi ahli. Literatur didapatkan 11285 artikel diperoleh 7 artikel yang sesuai dengan kriteria.  Kelompok intervensi pada artikel yang dibahas menunjukkan peningkatan kualitas hidup dibanding dengan kelompok kontrol. Akses terhadap pelayanan rehabilitasi oleh tenaga kesehatan, khususnya rehabilitasi berbasis rumah, dan kurangnya sumber daya manusia dan sarana prasarana dalam melakukan rehabilitasi stroke merupakan masalah sistemik yang harus diatasi dan direkomendasikan untuk fokus dalam meningkatkan kualitas hidup penderita stroke.
Cegah Komplikasi Gangguan Muskuloskeletal Dengan Balut Bidai Melalui Posyandu Remaja Parikesit Miftafu Darussalam; Ratna Lestari; Ferianto; Dini Threes Harjanti
The Journal of Innovation in Community Empowerment Vol 4 No 2 (2022): Journal of Innovation in Community Empowerment (JICE)
Publisher : Universitas Jenderal Achmad Yani Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30989/jice.v4i2.731

Abstract

ABSTRAK Fraktur merupakan terputusnya kontuinitas tulang yang dapat menimbulkan gejala yang umum seperti nyeri atau rasa sakit, pembengkakan dan kelainan bentuk tubuh. Fraktur atau patah tulang harus ditangani dengan cepat, tepat dan harus sesuai dengan prosedur pelaksanaan. Menurut WHO 70% kecelakaan lalu lintas dialami oleh pelajar atau remaja. Berdasarkan Survei Kesehatan Nasional melaporkan bahwa kasus fraktur pada tahun 2017 secara Nasional mengalami peningkatan sebesar 27,7%. Kecelakaan pada sistem musculoskeletal harus ditangani dengan cepat dan tepat. Apabila tidak dilakukan akan menimbulkan cidera yang semakin parah dan dapat memicu terjadinya perdarahan. Dampak lain yang terjadi dapat mengakibatkan kelainan bentuk tulang, kecacatan dan sampai kematian. Untuk mencegah terjadinya cidera pada sistem muskuloskeletal dibutuhkan pertolongan balut bidai. Balut bidai merupakan tindakan memfiksasi atau mengimobilisasi bagian tubuh yang mengalami cidera yang menggunakan benda yang bersifat kaku maupun fleksibel sebagai fiksator. Pertolongan balut bidai dapat dilakukan oleh semua orang awam yang terlatih. Salah satu orang awam yang terlatih disekolah yaitu siswa yang telah mendapatkan pendidikan dasar kegawatdaruratan melalui kegiatan ekstrakurikuler Palang Merah Remaja (PMR), dan seharusnya pendidikan dasar kegawatdaruratan tidak hanya diberikan kepada anggota PMR tetapi juga semua siswa disekolah atau remaja di lingkungan desa. Pengabdian masyarakat yang dilakukan di Kelurahan Tamanmartani ini diikuti oleh 21 kader remaja Parikesit. Metode yang digunakan dengan pemberian materi secara online pada hari pertama dan praktik secara langsung di hari kedua. Pengetahuan kader remaja sebelum dan setelah edukasi pembalutan dan pembidaian ada peningkatan pengetahuan dengan mean nilai pretest adalah 62,38 dan mean nilai posttest adalah 95,24. Jadi ada peningkatan sebesar 32,86. Kader sebelum pelatihan yang tidak terampil menjadi terampil sebanyak 12 (57%) kader, sedangkan 4 (19%) kader masih belum terampil. Dibutuhkan pendampingan dari pihak puskesmas Kalasan agar kader remaja Parikesit dapat mengaplikasi ilmu yang telah didapatkan untuk pencegahan komplikasi akibat gangguan fraktur. KATA KUNCI: Posyandu Remaja; Fraktur; Kader Remaja ABSTRACT A fracture is a break in the continuity of the bone that can cause general symptoms such as pain or tenderness, swelling and deformity of the body. Fractures or fractures must be treated quickly, accurately and follow the implementation procedure. According to WHO 70% of traffic accidents are experienced by students or teenagers. Based on the National Health Survey reports, fracture cases in 2017 increased by 27.7% nationally. Accidents to the musculoskeletal system must be treated quickly and appropriately. Failure to do so will result in more severe injury and lead to bleeding. Other impacts can result in bone deformities, disability and even death. To prevent injury to the musculoskeletal system, splints are needed. A splint is an act of fixing or immobilizing the injured body part using a rigid or flexible object as a fixator. Splint dressing can be performed by all trained laypeople. One of the laypeople who are trained in school is a student who has received basic emergency education through extracurricular activities of the Palang Merah Remaja (PMR), and basic emergency education should not only be given to PMR members but also all students in schools or youth in the village environment. The community service carried out in Tamanmartani Village was attended by 21 Parikesit youth cadres. The method used is giving the material online on the first day and hands-on practice on the second day. There was an increase in knowledge of adolescent cadres before and after education on bandages and splints, with the mean pretest value being 62.38 and the posttest mean value being 95.24. So there is an increase of 32.86. There were 12 (57%) cadres before training who were unskilled, while 4 (19%) cadres were still unskilled. Assistance is needed from the Kalasan Public Health Center so that the Parikesit youth cadres can apply the knowledge obtained to prevent complications due to fracture disorders. KEYWORDS: Posyandu Remaja; Fracture; Youth Cadre