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Putu Ayu Swandewi Astuti
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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 310 Documents
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Workload Analysis of Doctors at Puskesmas Using Workload Indicators of Staffing Need in Denpasar Anak Agung Ngurah Gede Dharmayuda; Luh Putu Lila Wulandari; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p04

Abstract

Background and purpose: Ratio of health staff instead of workload have been used to determine quota of staff at primary health centers. There is no study assessing workload of functional medical doctors (general practitioners) at primary health centers in Bali. The objectives of this study were to describe functional medical doctors workload, the number and distribution which is needed in primary health centers in Denpasar. Methods: Descriptive cross-sectional study was conducted among functional medical doctors at 11 primary health centers across Denpasar. Data were collected by interview and participatory observation to the study participants. Data was analyzed using WISN English Version 1.1.132.0 software. Results: Among 34 study participants, majority were female (73.5%), aged 35-44 years (61.8%), working as a government employee (97.1%), with tenure of 6-10 years (55.9%) and almost all of them (95.6%) had additional duties besides providing medical care to patients. Results indicated that workload of functional medical doctors at primary health centers was high with WISN ratio 0.5-0.9 compared to the ideal ratio=1. Based on workload analysis, shortages of functional medical doctors was found in all primary health centers in Denpasar. Conclusion: When using the ratio of functional medical doctors per population, the number was sufficient. However, when using workload analysis indicated shortage.
Risk Factors of Moderate and Severe Malnutrition in Under Five Children at East Nusa Tenggara Kadek Dwi Ariesthi; Kadek Tresna Adhi; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p05

Abstract

Background and purpose: East Nusa Tenggara is the province with the prevalence of moderate and severe malnutrition second highest in Indonesia, amounting to 29.4%. The aim of this study was to identify risk factors of moderate and severe malnutrition among under five children at East Nusa Tenggara. Methods: A case control study was carried out at North Kodi Subdistrict, Southwest Sumba District, East Nusa Tenggara, consisted of 38 moderate and severe malnutrition under five children as cases and 76 healthy under five children as controls. Independent variables were maternal and child factors, feeding and health care practises and sanitation. Data were collected by conducting interviews and analysed using Stata SE 12.1. Bivariate analysis was done to calculate crude odd ratio and logistic regression was done to calculate adjusted odd ratio. Results: Bivariate analysis showed that family income, frequency of illness, mother’s knowledge, frequency of visiting health care centres, number of children , and quality of drinking water supply were risk factors of moderate and severe malnutrition among under five children. Multivariate analysis showed that significant risk factors were frequency of illness (adjusted OR=35,4; 95%CI:4,8–256,8), family income (adjusted OR=14.8; 95%CI: 2.1-100.9), mother’s knowledge (adjusted OR=9.8; 95%CI: 1.4-66.1), frequency of visiting posyandu (adjusted OR=9.0; 95%CI: 1.6-50.7) and source of drinking water (adjusted OR=7.1; 95%CI: 1.1-45.5). Conclusion: Frequency of illness, family income, mother’s knowledge, frequency of visiting posyandu and source of drinking water were predominate risk factors of moderate and severe malnutrition at North Kodi Sub-district, Southwest Sumba, East Nusa Tenggara.
The Difference of Patient Satisfaction Between ISO and Non ISO Health Centers in Denpasar A.A.A.A. Candrawati; I Ketut Suarjana; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p06

Abstract

Background and purpose: ISO has been implemented to improve quality of care and patient satisfaction in four health centers in Denpasar. An assessment of the quality of services has been conducted, but there has been no assessment of patient satisfaction. This study determined differences of patient satisfaction between ISO and non- ISO centers and related factors. Methods: The study design was cross-sectional sample survey of 298 respondents; 149 attending ISO clinics and 149 non-ISO clinics. Data were collected using self-administered questionnaires and analyzed with chi square test and logistic regression methods as well as quadrant analysis. Results: Satisfaction was significantly higher (p=0.001) among ISO health centers (98.66%) compared to non-ISO (87.25%). Satisfaction levels were significantly higher (p=0.001) among ISO health centers specifically for sub item reliability (97.99% vs 81.21%), responsiveness (97.32% vs 82.52%), assurance (98.66% vs 84.56%), empathy (97.32% vs 77.18%) and physical appearance (97.32% vs 83.8%). Multivariate analysis indicated that factors associated with patients satisfaction were ISO status (adjusted OR=16.56; 95%CI: 3.87-70.95) and health insurance membership (adjusted OR=3.76; 95%CI: 1.38-10.23). Quadrant analysis indicated that sub item politeness, carelessness and untidiness were priority area for improvement among ISO health centers. Conclusion: Patient satisfaction was significantly higher among ISO health centers. Study findings indicated that sub-items politeness, apparent carelessness and untidiness still to be improved among ISO health centers.
Risk Factors of Attention Deficit Hyperactivity Disorder (ADHD) among Children in Denpasar I Made Sudarma Adiputra; I Made Sutarga; Gede Ngurah Indraguna Pinatih
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p07

Abstract

Background and purpose: Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder that often occurs in children characterized by low concentration and hyperactivity. Comprehensive efforts required to prevent and to understand risk factor of ADHD. Aim of this study was to understand risk factors that may increase the occurrence of ADHD among children in Denpasar. Methods: The study design was a matched case-control. Number of samples was 38 cases and 38 controls, who were matched by age, sex and residence. Cases was obtained from the Service Center of Psychology and Children with Special Needs Pradnyagama Denpasar. Controls were selected from the residence close to cases. Data analysis was performed with the McNemar test and conditional (fixed-effects) logistic regression. Results: The study found that there were two factors significantly increase risk of ADHD namely low birth weight (adjusted OR=220.9; 95%CI: 6.9-6991,3) and genetic (adjusted OR=45.5; 95% CI: 3.3-620.9). Conclusions: Low birth weight and genetic were found as risk factorsof ADHD.
Relationship between Nurse Knowledge, Attitude, Workloads with Medical Record Completion at the Emergency Unit, Sanglah Hospital, Denpasar Putri Mastini; Nyoman Tigeh Suryadhi; Alit Suryani
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p08

Abstract

Backgrounds and purpose: Accuracy and comprehensive maintenance of patient records is an integral part of nursing staff duties. Incomplete documentation could reduce the quality of care and service at the hospital. This study seeks to explore the relationship between nursing staff knowledge, attitude and workloads with accuracy of medical record maintenance at the Emergency Unit in Sanglah Hospital. Methods: Study was cross sectional with a sample of 76 nurses at Emergency Unit Sanglah Hospital. Nurses were interviewed on their knowledge, attitude and workloads. Data on accuracy and completion of medical record was obtained through direct observation. Results: Accuracy and completion of documentation had a significant relationship with knowledge and nurse attitude (p<0,05). Multivariate analysis indicated that nurse knowledge had a significant relationship in completing medical records with adjusted OR=3.7 (95%CI: 1.2- 11.5). This finding indicated that nurses with a higher knowledge on the maintaining medical records was 3.7 times more likely to complete the required documentation compared to nurses with lower knowledge. Conclusion: Accuracy and completion of patient documentation by nurses was significantly associated with their knowledge.
The Association of Individual Factors and Organization Culture and Approach with Nursing Quality of Care in Ganesha Public Hospital, Gianyar I Gusti A. Ayu Sherlyna Prihandhani; Ni Made Sri Nopiyani; Dyah Pradnyaparamita Duarsa
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p09

Abstract

Background and purpose: Satisfaction survey among patients of the inpatient unit at Ganesha Public Hospital indicated lack of caring behavior among nurses. This study aims to reveal level of quality of care and the factors associated with related behavior among inpatient ward at Ganesha Public Hospital. Methods: The study used cross-sectional survey design. Data were collected through self-administered questionnaires among 48 inpatient nurses during November-December 2014. Multivariate logistic regression was applied to determine factors associated with caring behavior of nurses. Results: The study found that 56.3% believed they provided a relatively high quality of care and 54,2% of nurses indicated a positive perception of the organization culture. Result of multivariate analysis indicated that only rewards system is independently associated with caring behavior of nurses (adjusted OR=23,39; 95%CI: 1.53-356.94; p=0,023). Conclusion: It was evident that nurses’ practice toward caring behavior is related to their attitude toward the rewards system of nurses’ performance.
Evaluation of Work Performance Two Types of Community Tuberculosis Workers in Gianyar Regency Anak Agung Gede Suputra; I Wayan Gede Artawan Eka Putra; Luh Seri Ani
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p10

Abstract

Background and purpose: One of the strategies adopted to improve coverage of TB patients (BTA+) in Gianyar Regency is to involve the pakraman (desa adat) TB cadres and the regular (PPTI) TB cadres with four tasks in order to help health care workers to trace and find tuberculosis suspect patients. The purpose of this study was to evaluate work performance between two types of community TB cadres in Gianyar Regency. Methods: This study was an observational research using secondary data of cadres work reports and interview to study participants to understand cadres characteristics and health workers supervision. Numbers of participants were all village TB cadres namely 29 pakraman and 88 regular TB cadres located in Gianyar Regency. Data collection was carried out using questionnaires and observation sheets. Univariate, bivariate and multivariate analysis was conducted. Results: The result shown that work performance of pakraman TB cadres was statistically better than regular TB cadres (adjusted RP=6.1; 95%CI: 3.3-11.2). Better work performance of pakraman TB cadres was found in all four tasks of cadres namely helping education (adjusted RP=7.8; 95%CI: 4.2-14.2), finding tuberculosis suspects (adjusted RP=7.4; 95%CI: 1.7-33.1), tracing of defaulters TB suspects (adjusted RP=17.1; 95%CI: 1.8-166.4) and tracing loss of follow up TB patients (adjusted RP=3.8x108; 95%CI: (1.6-8.9)x108). Conclusion: Work performance of pakraman TB cadres was better than regular TB cadres in all four tasks.
Risk of in House Cigarette Smoke Exposure to the Premature Birth in Denpasar City Ni Ketut Noriani; I Wayan Gede Artawan Eka Putra; I Nyoman Mangku Karmaya
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p11

Abstract

Background and purpose: Indonesia is ranked fifth in the world in term of premature birth prevalence, which is estimated 10-20%. This study aimed to find out risk of in house cigarette smoke exposure to premature birth in Denpasar. Methods: This study is a case control. Case is a mother experienced premature delivery, while the control is mothers who been registered in the same period with mature delivery. Samples either case or control were selected using systematic random sampling, which preceded by listing premature and mature birth in each puskesmas in 2013. Data analysed bivariate and multivariate using chi-square test and logistic regression. Results: Bivariate analysis showed no significant different of characteristic (age, education, occupation and parity status) between case and control group. However, significant different of ANC behavior and average of arm circumference were found between case and control. Multivariate analysis showed that the adjusted OR of tobacco smoke exposure at home after being controlled by ANC and upper arm circumference was 3.647 (95%CI: 1.683-9.903). Conclusion: In house cigarette smoke exposure increases significantly the risk of premature birth in Denpasar.
Barriers to Integrating Antiretroviral Therapy Services Into Community Health Centre: A Qualitative Study in Badung Regency Made Sugiana; I Nyoman Sutarsa; Dyah Pradnyaparamita Duarsa
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p12

Abstract

Background and purpose: Increasing of HIV+ cases resulted in the increasing demand for antiretroviral (ARV) and access to ART services. This study aims to explore barriers of integrating ART services into primary health centres in Badung District. Methods: Explorative interviews were conducted with CST officers at Badung District Hospital, puskesmas (health centres), NGOs, policy makers, community leaders and PLWHA. Data were collected by conducting indepth interviews, focus group discussion and observation. Data were thematically analysed. Results: The study found that there were variations in internal barriers across different puskesmas in Badung District to be a satellite site. The main internal barriers perceived by health officers particularly in relation to issues around the availability of human resources, lack of competencies and increase of workload. Internal capacity of puskesmas which also perceived as barriers including the availability of laboratory facilities, absent of operational procedures, limited information system and source of funds that predominantly still from donor agencies. External barriers perceived by respondent were stigma and discrimination. Conclusions: Barriers to integrate ART services into puskesmas consist of structural barriers from internal puskesmas as well as external barriers such as stigma and discrimination towards PLWHA.
Risk Factors of Poor Glycaemic Control among Patients with Type 2 Diabetes Mellitus at the Primary Health Center of Kembiritan Banyuwangi Regency Rizki Yulia Purwitaningtyas; I Wayan Gede Artawan Eka Putra; Dewa Nyoman Wirawan
Public Health and Preventive Medicine Archive Vol. 3 No. 1 (2015)
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53638/phpma.2015.v3.i1.p13

Abstract

Background and purpose: Number of patients with type 2 diabetes mellitus in Kembiritan Primary Health Center has increased as many as 160 in 2013 to 215 in 2014. This study was conducted to determine risk factors of poor glycaemic control among patients with type 2 diabetes mellitus in the Primary Health Center of Kembiritan Banyuwangi. Methods: The research design was a case control study of 55 patients with poor glycaemic control of diabetes mellitus as cases and 55 patients with good glycaemic control of diabetes mellitus as controls (1:1), who were randomly selected from the registers of patients with diabetes mellitus at the primary health center during 2014. Data was collected through interviews at the primary health center during March-May 2015 using questionnaires. Data was analyzed by univariate, bivariate (chi square test) and multivariate using logistic regression. Results: Bivariate analysis showed that duration of disease and nutritional status significantly increase risks of poor glycaemic control respectively with OR=2.9 (95%CI: 1.20-7.54) and OR=5.7 (95%CI: 1.82-21.04). Multivariate analysis showed four factors that increase the risk of poor glycaemic control, namely duration of disease with adjusted OR=3.8 (95% CI: 1.37 to 10.59), medication adherence, with adjusted OR=3.7 (95% CI : 1.30 to 10.59), nutritional status, with adjusted OR=6.6 (95%CI: 2.01-21.44) and distance of health facilities, with adjusted OR=3.1 (95%CI: 1.19-7.95). Conclusion: Risk factors for poor glycaemic control among patients with type 2 diabetes mellitus were disease duration, adherence of medication, nutritional status and distance to health facilities.

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