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Public Health and Preventive Medicine Archive
Published by Universitas Udayana
ISSN : 23031816     EISSN : 25032356     DOI : https://doi.org/10.53638/
Core Subject : Health,
Public Health
ublic Health and Preventive Medicine Archive (PHPMA) is an open access, peer reviewed journal published by Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University. Issues covered in the journal are as the following: Environmental and occupational health Field and Clinical Epidemiology Global health Health policy analysis Health promotion Health systems and health care management Maternal and child health Program monitoring and evaluation Public health nutrition Reproductive health, sexually transmitted infections and HIV related issues Travel health and health tourism Population and family planning Disaster management
Arjuna Subject : Kedokteran - Kesehatan Masyarakat, Kesehatan Lingkungan dan Pekerjaan
Articles 12 Documents
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Search results for , issue "Vol. 7 No. 2 (2019)" : 12 Documents clear
The roles of case managers and problems encountered in implementing patient centered care in hospitals Ni Kadek Yuliati; Ni Made Sri Nopiyani; Dyah Pradnyaparamita Duarsa
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p11

Abstract

Background and purpose: Patient centered care in hospitals has yet to be well implemented. The role of case managers is very important in the implementation of patient centered care in hospitals. Research publications on the role of case managers in patient centered care in Indonesia remain limited. This study aims to explore the roles of case managers and problems encountered in the implementation of patient centered care in hospitals. Methods: This study used a qualitative design with a case study approach conducted at Bangli District Hospital in Bali in April 2019. Data was collected through in-depth interviews with seventeen purposively selected informants consisting of ten case managers, one deputy director of medical services, two patient’s family members, two specialist doctors and two implementing nurses at Bangli District Hospital. This study uses the Patient Centered Care Framework from Greene which consists of three dimensions in patient centered care namely interpersonal, clinical and structural dimensions. Data was analyzed thematically using deductive and inductive techniques. Data validation was conducted through triangulation of data based on different sources, member checking and peer debriefing. Results: In this study, five main themes were found regarding the role of case managers in the implementation of patient centered care in hospitals, namely interpersonal, clinical and structural dimensions, support and expectations of case managers. The identified role of the case manager in the interpersonal dimension consisted of listening to patients and families actively, coordination and collaboration in problem solving, providing accurate and easy to understand information about care. Problems encountered included lack of communication between the service provider components and between the service provider with patients and their families. Roles of case manager in the clinical dimension are to hold meetings with a professional team of care givers and continuous monitoring of services to patients, while the issue encountered is the mismatch of time of service provision by specialist doctors. Roles of case managers in the structural dimension is coordination with policy holders, use of information technology and patient reporting. Problems encountered were inappropriate recruitment of case managers, lack of training of case managers, incomplete facilities, inconvenience of services and inadequate incentives. Supports from hospitals for case managers were support of facilities and legality as case managers. Expectations of case managers include case manager training, rewarding and career development opportunities. Conclusion: The roles of case managers in implementing patient centered care in Bangli District Hospital are not optimal. Efforts to address issues in the interpersonal, clinical and structural dimensions need to be carried out by the hospital management to enhance the role of case managers in the implementation of patient centered care.
Association between husband support and compliance with post-cryotherapy requirements among mothers in Tabanan District, Bali Gede Ngurah Upadana; Anak Agung Sagung Sawitri; I Nyoman Mangku Karmaya
Public Health and Preventive Medicine Archive Vol. 7 No. 2 (2019)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2019.v7.i2.p12

Abstract

Background and purpose: Cervical cancer is a major global health problem for women, with most of cases occurring in developing countries. Visual inspection with acetic acid (VIA) is one method for screening precancerous cervical lesions which can then be followed up with cryotherapy. The success of cryotherapy is influenced by many factors including maternal compliance to meet the clinical requirements after cryotherapy. This study aims to determine the association between husband’s support and mother’s compliance with post-cryotherapy requirements. Methods: A cross-sectional study was conducted on 142 mothers with positive VIA test results and had received cryotherapy in six Tabanan public health centers (PHCs) consisting of four PHCs in urban areas and two PHCs in rural areas. All mothers who underwent cryotherapy during 2017 were selected as samples. Data were collected through face-to-face interviews in each respondent’s home using a questionnaire. The information collected was four post-cryotherapy requirements consisting of sexual abstinence, on schedule follow-up examinations, compliance to the recommended antibiotic use, not using topical vaginal medication and husband’s support. Husband’s support measured by 11 questions consisted of psychological, social and environmental support. Bivariate analysis was performed with chi-square and multivariate analysis with logistic regression. Results: This study shows that only 39.4% of respondents were compliant to meet the four post cryotherapy requirements. As many as 32.4% of mothers had sex within 4 weeks after cryotherapy and 40.1% did not have the follow up examinations on schedule. Husband’s support was significantly associated with maternal compliance in the form of asking about respondent’s health condition with AOR=6.658 (95%CI: 1.794-24.702) and not asking for sex with AOR=4.151 (95%CI: 1.491-11.556). Conclusion: Mother’s compliance with the four requirements after cryotherapy remains low and the husband’s support has a role in increasing maternal compliance. Education on post cryotherapy requirements needs to be improved particularly in regards to the role of the husband.

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