Studi Kasus Ketidakpatuhan Orang Kontak Serumah terhadap Anjuran Pemeriksaan Tuberkulosis - Herawati H; Rovina Ruslami; Ahmad Yamin (Jurnal Keperawatan Padjadjaran, 2013)
Ketidakpatuhan orang kontak serumah terhadap anjuran pemeriksaan Tuberkulosis (TB) merupakan fenomena kompleks, dinamis dari faktor yang berkaitan dengan perilaku. Penelitian ini bertujuan untuk menggali perilaku ketidakpatuhan orang kontak serumah terhadap anjuran pemeriksaan TB dengan menggunakan Health Belief Model(HBM). Penelitian ini adalah studi kasus yang dilakukan di Kelurahan Pajajaran Kota Bandung. Subjek penelitian adalah sembilan orang kontak serumah dan enam orang perawat Puskesmas Pasirkaliki. Pengumpulan data dilakukan dengan studi dokumentasi, observasi pasif tidak berstruktur, wawancara mendalam, dan diskusi kelompok terarah. Data dianalisis dengan menggunakan model Miles dan Huberman, yaitu reduksi data, penyajian data, dan penarikan kesimpulan. Hasil penelitian meliputi persepsi kerentanan, persepsi keseriusan, persepsi manfaat pemeriksaan orang kontak serumah, dan isyarat untuk melakukan tindakan berdasarkan HBM. Persepsi orang kontak serumah tentang kerentanan TB meliputi adanya perasaan takut tertular, melakukan pemisahan, dan menerima takdir. Persepsi orang kontak serumah mengenai keseriusan penyakit TB yaitu kematian, perasaan malu atau minder. Persepsi orang kontak serumah tentang manfaat skrining yaitu akan diketahui apakah orang kontak serumah terkena TB atau tidak. Isyarat untuk melakukan tindakan pemeriksaan TB menurut orang kontak serumah yaitu apabila mereka sudah sakit atau muncul gejala-gejala TB. Hasil penelitian dari perawat menunjukkan bahwa perawat mengetahui bahwa salah satu standar program penanggulangan TB (P2TB) adalah pemeriksaan TB pada orang kontak serumah penderita TB paru terutama yang basil tahan asam (BTA) positif dan anak dengan TB. Pemeriksaan TB tersebut dilakukan dengan pemeriksaan dahak sewaktu-pagi-sewaktu (SPS). Persepsi perawat mengenai hambatan dalam menjalankan peran dan fungsinya yaitu adanya keterbatasan jumlah tenaga di puskesmas, pendidikan perawat masih rendah, dan perawat mendapat tugas limpahan di klinik. Kata kunci:Ketidakpatuhan, kontak serumah, pemeriksaan TB, studi kualitatif. AbstractNon-adherence of household contacts to undergo screening for Tuberculosis (TB) is a dynamic and complex phenomenon of the various factors related to behaviour. The objective of this study was to explore the behaviours related to non-adherence of household contacts to undergo screening for TB. This study is a descriptive case study that was conducted at the Pajajaran village, Bandung city. Participant were 9 household contacts of smear positive TB patients and 6 nurses who is working in the Pasirkaliki Community Health Center (CHC). Data collection was performed with the study documentation, non-structured passive observation, in-depth interview, and focus group discussion (FGD). Data analysis was according to Miles and Huberman model, which consist of data reduction, data display and drawing conclusions. The result includes perception of vulnerability of TB, perceptions of seriousness of TB, perceptions of benefits of TB screening, and cues to action for the TB patients household contact. The result showed that perceptions of the household contact of TB vulnerability were: fear of infection, make the separation and accept fate. Perceptions of the seriousness of TB were that TB could cause death and feelings of shame or inferiority. As for the perception of benefits was by doing screening,it will be known whether household contacts are exposed to TB or not. While the cues to action for household contact to perform screening for TB was if they are sick or have emerging symptoms of TB. The nurses knew that according to P2TB (TB management program) standards, the household contacts of TB patients should undergo screening for TB, especially for smear-positive pulmonary TB patients and paediatric TB. They knew that TB screening was done through sputum smear microscopy. Nurses’ perceptions about the barriers in carrying out their role and function were limited number of human resources in CHC, lack of education, and the presence of abundance tasks at the clinic. . Key words:Household contact, non-adherence, qualitative study, TB screening.