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Hambatan, peluang, dan strategi skrining dua arah tuberkulosis dan diabetes mellitus: A literature review Reynaldi, Andrean; Juniarti, Neti; Sari, Sheizi Prista
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.924

Background: The increasing prevalence of tuberculosis (TBC) and diabetes mellitus (DM) comorbidities poses a major challenge for global health systems. DM increases susceptibility to TBC, while TBC worsens glycaemic control in DM patients, which raises the risk of complications and mortality. The WHO notes that many TBC patients also have DM, and vice versa, requiring an integrated care approach. In response, the WHO and The Union developed the Collaborative Framework for the Management of TBC and DM to support bidirectional screening and integrated management, aiming to enhance awareness and improve the quality of TBC-DM patient management. Purpose: To identify the barriers, opportunities, and strategies in implementing bidirectional screening for tuberculosis and diabetes mellitus patients. Method: Literature review research (narrative review) and article search were conducted using the PCC (Population, Concept, Context) framework using literature sources taken from four databases: PubMed, SAGE Journals, Scopus, and Taylor & Francis. Keywords used include: challenges OR barriers OR difficulties AND opportunities OR success OR possibilities AND strategies OR strategies AND two-way AND screening AND TB OR mycobacterium tuberculosis infection OR TB AND comorbidities OR comorbidities AND diabetes mellitus OR DM. Article inclusion criteria include articles published in 2014-2024, full text, open access, academic journals, written in English and Indonesian, and original research. Results: This review identified barriers to implementing two-way screening for TB and DM, such as lack of patient awareness, shortage of health workers, and limited diagnostic tools. However, there are opportunities to improve screening through integration of TB and DM services, private sector involvement, and community-based screening. Strategies to overcome barriers and capitalize on opportunities include better training of health workers, provision of diagnostic tools, and patient education to increase participation in screening. Conclusion: Implementation of bidirectional screening for TB and DM faces several barriers, including lack of patient awareness, social stigma, and limited access and equipment in health facilities, especially in rural areas. In addition, shortage of health workers and limited financing in the health system undermine the implementation of screening. Keywords: Diabetes Mellitus; Bidirectional Screening; Tuberculosis. Pendahuluan: Meningkatnya prevalensi komorbiditas tuberkulosis (TBC) dan diabetes melitus (DM) menjadi tantangan besar bagi sistem kesehatan global. DM meningkatkan kerentanan terhadap TBC, sementara TBC memperburuk pengendalian glikemik pada pasien DM, dan meningkatkan risiko komplikasi serta kematian. WHO mencatat bahwa banyak pasien TBC juga menderita DM dan sebaliknya, sehingga diperlukan pendekatan perawatan yang terintegrasi. Menanggapi hal ini, WHO dan The Union mengembangkan collaborative framework for the management of TBC and DM untuk mendukung skrining dua arah dan manajemen terintegrasi untuk meningkatkan kesadaran dan kualitas manajemen pasien TBC-DM. Tujuan: Untuk mengidentifikasi hambatan, peluang, dan strategi dalam pelaksanaan skrining dua arah untuk pasien tuberkulosis dan diabetes melitus. Metode: Penelitian tinjauan pustaka (narrative review) dan pencarian artikel dilakukan dengan kerangka PCC (Population, Concept, Context) menggunakan sumber literatur yang diambil dari empat basis data: PubMed, SAGE Journals, Scopus, dan Taylor & Francis. Kata kunci yang digunakan meliputi: challenges OR barriers OR difficulties AND opportunities OR success OR possibilities AND strategy OR strategies AND bidirectional AND screening AND tuberculosis OR mycobacterium tuberculosis infection OR TB AND comorbidities OR comorbidity AND diabetes mellitus OR DM. Kriteria inklusi artikel antara lain, artikel yang dipublikasi tahun 2014-2024, full-text, akses terbuka, jurnal akademik, ditulis dalam bahasa Inggris dan Indonesia, serta penelitian asli. Hasil: Tinjauan ini mengidentifikasi hambatan dalam pelaksanaan skrining dua arah untuk TBC dan DM, seperti kurangnya kesadaran pasien, kekurangan tenaga medis, dan keterbatasan alat diagnostik. Namun, terdapat peluang untuk meningkatkan skrining melalui integrasi layanan TBC dan DM, keterlibatan sektor swasta, dan skrining berbasis komunitas. Strategi untuk mengatasi hambatan dan memanfaatkan peluang ini meliputi pelatihan tenaga kesehatan yang lebih baik, penyediaan alat diagnostik, dan edukasi pasien untuk meningkatkan partisipasi dalam skrining. Simpulan: Implementasi skrining dua arah untuk TBC dan DM menghadapi berbagai hambatan, termasuk kurangnya kesadaran pasien, stigma sosial, serta keterbatasan akses, dan peralatan di fasilitas kesehatan, terutama di daerah pedesaan. Selain itu, kekurangan tenaga kesehatan terlatih dan terbatasnya pendanaan dalam sistem kesehatan memperburuk tantangan implementasi skrining. Kata Kunci: Diabetes Mellitus; Skrining Dua Arah; Tuberkulosis.

Surgical hand preparation metode handscrub dan handrub berbasis antiseptik: A scoping review Olivia, Claudia; Ibrahim, Kusman; Kurniawan, Titis
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.925

Background: Healthcare-associated infections (HAIs) are complications of healthcare that can increase morbidity, mortality, length of hospitalization, and additional costs, including surgical site infections (SSIs) caused by various factors such as microorganisms from the surgical environment. One important step in preventing SSIs is surgical hand preparation using antimicrobial soap or alcohol-based fluids which aims to reduce microorganisms, prevent infection, and increase the success of surgical procedures according to WHO and CDC guidelines. Purpose: To determine the effectiveness of implementing surgical hand preparation using antiseptic-based hand washing and hand rubbing methods. Method: Scoping review with article sources from PubMed, Scopus, and ScienceDirect published in the last 6 years in the period 2018-2024. The keywords used are "surgical team" or surgical staff or surgical procedures, "surgical hand preparation" or surgical cleaning or surgical rubbing, "bacteria" or microorganisms. Article assessment uses guidelines from The PRISMA Extension for Scooping Review (PRISMA-ScR). Results: The most widely used type of antiseptic fluid in the operating room area is chlorhexidine gluconate with concentrations of 1%, 3%, and 5% for the handrub method, and a concentration of 4% for the handwash-scrub method. The amount of antiseptic needed for handrub is 6-10 ml and for handwash-scrub 20 ml; and the surgical handwash and surgical handrub methods are equally effective in reducing the number of germs on the hands. Conclusion: Surgical handwash-scrub and surgical handrub are equally effective in reducing the number of bacteria on the hands, but surgical handrub with alcohol-based antiseptic and chlorhexidine is the main choice recommended by WHO and CDC because it is more practical, efficient, and effective than surgical handwash. Keywords: Antiseptic; Handscrub; Handrub; Surgical Hand Preparation. Pendahuluan: Health care–associated infections (HAIs) adalah komplikasi pelayanan kesehatan yang dapat meningkatkan morbiditas, mortalitas, durasi rawat inap, dan biaya tambahan, termasuk infeksi daerah operasi (IDO) yang disebabkan oleh berbagai faktor seperti mikroorganisme dari lingkungan operasi. Salah satu langkah penting dalam pencegahan IDO adalah persiapan tangan bedah menggunakan sabun antimikroba atau cairan berbasis alkohol yang bertujuan mengurangi mikroorganisme, mencegah infeksi, dan meningkatkan keberhasilan prosedur bedah sesuai pedoman WHO dan CDC. Tujuan: Untuk meyelidiki tentang efektivitas dari pelaksanaan surgical hand preparation metode handscrub dan handrub berbasis antiseptik. Metode: Scoping review dengan sumber artikel berasal dari pubMed, Scopus, dan ScienceDirect yang diterbitkan 6 tahun terakhir pada rentang 2018-2024. Kata kunci yang digunakan yaitu “surgical team” or surgical staff or surgical procedures, “surgical hand preparation” or surgical scrubbing or surgical rubbing, “bacteria” or microorganism. Penilaian artikel menggunakan panduan dari The PRISMA Extension for Scooping Review (PRISMA-ScR). Hasil: Jenis cairan antiseptik area kamar operasi yang paling banyak digunakan adalah chlorhexidine gluconate konsentrasi 1%, 3%, dan 5% untuk metode handrub, konsentrasi 4% untuk metode handwash-scrub. Jumlah antiseptik yang diperlukan untuk handrub 6-10 ml dan untuk handwash-brush 20 ml; dan metode surgical handwash dan surgical handrub sama-sama efektif dalam menurunkan jumlah kuman ditangan. Simpulan: Surgical handwash-scrub dan surgical handrub sama-sama efektif dalam menurunkan jumlah bakteri di tangan, tetapi surgical handrub dengan antiseptik berbasis alkohol dan chlorhexidine, menjadi pilihan utama yang direkomendasikan WHO dan CDC karena lebih praktis, efisien, dan efektif dibandingkan surgical handwash. Kata Kunci: Antiseptik; Handscrub; Handrub; Surgical Hand Preparation.

Analisis hubungan pelayanan antenatal care (ANC) terpadu dengan angka kematian ibu Aldila, Salsa Adi; Rejeki, Dwi Sarwani Sri; Wijayanti, Siwi Pramatama Mars; Nurmutia, Paramita Adi
Holistik Jurnal Kesehatan Vol. 19 No. 3 (2025): Volume 19 Nomor 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i3.926

Background: Maternal Mortality Rate (MMR) is still a global health problem, including in Indonesia. One effort to reduce the risk of maternal death is through integrated antenatal care (ANC) health services according to standards. Purpose: To analyze the relationship between integrated antenatal care (ANC) services and maternal mortality rates. Method: Quantitative research with a correlational approach. The research sample was 40 health centers in Banyumas Regency which was implemented in April 2024. The data analysis used was the Spearman Rank Correlation test to test the relationship between integrated ANC service variables which include 10 integrated examinations with maternal mortality variables. Results: This study found that weight measurement (p value = 0.005), blood pressure measurement (p value = 0.005), upper arm circumference measurement (p value = 0.017), uterine fundus height measurement (p value = 0.012), iron tablet administration (p value = 0.012), pregnancy examination (p value = 0.005), hemoglobin examination (p value = 0.011), blood type examination (p value = 0.011), urine glycoprotein examination (p value = 0.016) and consultation/counseling (p value = 0.014) were significantly associated with maternal mortality. Conclusion: Integrated ANC services that are of high quality and meet standards are one of the efforts to reduce high maternal mortality rates. The quality of ANC services that do not meet standards are associated with maternal mortality. Suggestion: There needs to be periodic competency improvement for health workers who carry out integrated ANC services in health centers to strengthen service quality assurance. Keywords: Health Services; Integrated Antenatal Care (ANC); Maternal Mortality Rate (MMR). Pendahuluan: Angka kematian ibu (AKI) masih menjadi isu masalah kesehatan di tingkat global, termasuk di Indonesia. Salah satu upaya untuk mengurangi risiko kematian ibu adalah melalui pelayanan kesehatan maternal antenatal care (ANC) terpadu sesuai standar. Tujuan: Untuk menganalisis hubungan pelayanan antenatal care (ANC) terpadu dengan angka kematian ibu. Metode: Penelitian kuantitatif dengan pendekatan korelasional. Sampel penelitian terdiri dari 40 puskesmas di Kabupaten Banyumas yang dilaksanakan pada bulan April 2024. Analisis data yang digunakan adalah uji Korelasi Rank Spearman untuk menguji hubungan antara variabel pelayanan ANC terpadu yang mencakup pemeriksaan 10 terpadu dengan variabel angka kematian ibu. Hasil: Penelitian ini menemukan bahwa pengukuran berat badan (p value = 0.005), pengukuran tekanan darah (p value = 0.005), pengukuran lingkar lengan atas (p value = 0.017), pengukuran tinggi fundus uterus (p value = 0.012), pemberian tablet tambah darah (p value = 0.012), tes kehamilan (p value = 0.005), pemeriksaan hemoglobin (p value = 0.011), pemeriksaan golongan darah (p value = 0.011), pemeriksaan glukoproterin urin (p value = 0.016) dan temu wicara/konseling (p value = 0.014) berhubungan secara signifikan dengan angka kematian ibu. Simpulan: Pelayanan ANC terpadu yang berkualitas dan sesuai standar merupakan salah satu upaya untuk menurunkan tingginya angka kematian ibu. Kualitas pelayanan ANC yang belum memenuhi standar memiliki hubungan dengan angka kematian ibu. Saran: Perlunya peningkatan kompetensi secara berkala bagi tenaga kesehatan yang melaksanakan pelayanan ANC terpadu di puskesmas untuk memperkuat jaminan mutu pelayanan. Kata Kunci: Angka Kematian Ibu; Antenatal Care (ANC) Terpadu; Pelayanan Kesehatan.

Faktor-faktor yang memengaruhi ibu dalam pemberian makanan tambahan pada anak bawah dua tahun (Baduta) Silitonga, Angelienne Maria Prayscyllia; Fajar, Nur Alam; Kusumaningrum, Arie; Saci, Muhammad Amin Arigo
Holistik Jurnal Kesehatan Vol. 19 No. 3 (2025): Volume 19 Nomor 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i3.932

Background: Toddlers (under two years old) are the first 1000 days of life, which is the period that begins from the formation of the fetus until the child is 2 years old. This period is the most important period in the growth and development period as an individual who will continue the nation and is expected to produce a reliable generation in competition in the global arena. To produce a reliable generation during this period, good growth and development stimulation is needed. Growth and development stimulation in the form of providing adequate nutrition and growth and development stimulation carried out by parents. Purpose: To analyze the factors that influence mothers in providing additional food to children under two years of age (toddlers). Method: Quantitative research with cross-sectional design. The population in this study were all mothers who had babies aged 6-24 months in Banyuasin Regency. In determining the sample of this study, the formula used was the Lemeshow formula with sampling using a simple random sampling technique. The independent variables in this study include; age, education, occupation, number of children in the family, and income, while the dependent variable is the provision of additional food. Data collection was carried out using a questionnaire method that was distributed directly to respondents. Data analysis carried out in this study used univariate analysis and bivariate analysis of the chi-square statistical test. Results: Based on the characteristics of the respondents' age, they are in the range of 20-34 years, as many as 57 respondents (53.8%) with a p value of 0.069 (>0.05). In general, respondents are included in the higher education category as many as 69 respondents (65.1%) with a p value of 0.010. Most respondents have a good level of knowledge as many as 65 respondents (61.3%) with a p value of 0.000 (<0.05). Almost all respondents are unemployed as many as 89 respondents (84.0%) with the results of the statistical test analysis showing a p value of 0.006. Most families have children >2 as many as 60 respondents (56.6%) with a p value of 0.000. Furthermore, most respondents' income < regional minimum wage as many as 73 respondents (68.9%) obtained a p value of 0.001 (<0.05). The variables of education, knowledge, occupation, number of children in the family, and parental income have a significant relationship to the provision of additional food. Meanwhile, there is one variable, namely age, which does not have a significant influence. Conclusion: The variables of education, knowledge, work, number of children in the family, and parental income have an effect on the provision of additional food with a p value <0.05. Meanwhile, the age variable does not significantly affect the provision of additional food in children under two years old. Keywords: Additional Food; Mother; Under Two Years (Toddlers). Pendahuluan: Baduta (bawah dua tahun) merupakan 1000 hari pertama kehidupan merupakan periode mulai dari janin terbentuk sampai nak berusia 2 tahun. Pada periode ini merupakan periode terpenting pada masa pertumbuhan dan perkembangan sebagai individu penerus bangsa yang dapat diharapakan untuk mencetak generasi yang handal dalam persaingan di kancah global. Agar menghasilkan genarasi yang handal pada periode tersebut memerlukan stimulasi pertumbuhan dan perkembangan yang baik. Stimulasi pertumbuhan berupa pemberian gizi yang adekuat dan stimulasi perkembangan yang dilakukan oleh orang tua. Tujuan: Untuk menganalisis faktor-faktor yang memengaruhi ibu dalam pemberian makanan tambahan pada anak bawah dua tahun (Baduta). Metode: Penelitian kuantitatif dengan rancangan cross-sectional. Populasi dalam penelitian ini adalah seluruh ibu yang memiliki bayi usia 6-24 bulan di wilayah Kabupaten Banyuasin. Dalam penentuan sampel penelitian ini, rumus yang digunakan adalah rumus Lemeshow dengan pengambilan sampel menggunakan teknik simple random sampling. Variabel independen dalam penelitian ini meliputi; umur, pendidikan, pekerjaan, jumlah anak dalam keluarga, dan pendapatan, sedangkan variabel dependennya adalah pemberian makanan tambahan. Pengumpulan data dilakukan dengan metode angket yang dibagi langsung ke responden. Analisis data yang dilakukan dalam penelitian menggunakan analisis univariat dan analisis bivariate uji statistic chi-square. Hasil: Berdasarkan karakteristik usia responden berada pada kisaran 20-34 sebanyak 57 responden (53.8%) dengan nilai p 0.069 (>0.05). Secara umum, responden masuk dalam kategori pendidikan tinggi sebanyak 69 (65.1%) dengan nilai p 0.010. Mayoritas responden memiliki tingkat pengetahuan baik sebanyak 65 (61.3%) dengan nilai p sebesar 0.000 (<0.05). Hampir seluruh responden tidak bekerja sebanyak 89 (84.0%) dengan hasil analisis uji statistik menunjukkan nilai p 0.006. Sebagian besar dalam satu keluarga memiliki jumlah anak >2 anak sebanyak 60 (56.6%) dengan nilai p 0.000. Selanjutnya mayoritas pendapatan responden < UMR sebanyak 73 (68.9%) diperoleh nilai p 0.001 (<0.05). Variabel pendidikan, pengetahuan, pekerjaan, jumlah anak dalam keluarga, dan pendapatan orangtua memiliki hubungan yang signifikan terhadap pemberian makanan tambahan. Sementara, terdapat satu variabel yaitu umur tidak berpengaruh secara signifikan. Simpulan: Variabel pendidikan, pengetahuan, pekerjaan, jumlah anak dalam keluarga, dan pendapatan orang tua berpengaruh terhadap pemberian makanan tambahan dengan perolehan p-value < 0.05. Sementara itu, variabel umur tidak berpengaruh secara signifikan terhadap pemberian makanan tambahan pada anak bawah dua tahun. Kata Kunci: Anak Bawah Dua Tahun (Baduta); Ibu; Pemberian Makanan Tambahan.

Pengaruh peran suami dan pijat oksitosin terhadap kelancaran ASI pada ibu nifas Kartika, Jenny; Kamalia, Rita; Putri, Nia Clarasari Mahalia
Holistik Jurnal Kesehatan Vol. 19 No. 3 (2025): Volume 19 Nomor 3
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i3.933

Background: Postpartum mothers often experience complaints, one of which is irregular breast milk flow. The preliminary research sample in this study was taken from secondary data from postpartum mothers' notebooks of 95 respondents, some respondents stated that breast milk was irregular and did not know the benefits of oxytocin massage. Efforts that can be made to provide smooth breast milk for postpartum mothers are oxytocin massage performed by health workers or husbands. Purpose: To determine the relationship between the role of the husband and oxytocin massage on smooth breast milk flow in postpartum mothers. Method: Quantitative research with a Cross Sectional design, conducted at the Independent Practice of Midwife Semiyati, Muara Enim Regency on January 1 - May 31, 2025. The independent variables consisted of the role of the husband and oxytocin massage, while the dependent variable was smooth breast milk flow. The sampling technique used purposive sampling and data were analyzed using the chi square test. Results: The role of the husband is most involved in oxytocin massage as many as 63 respondents (66.3%) with a smooth breastfeeding category of 50 respondents (82.0%), while the husband is not involved in providing oxytocin massage, most of the breast milk is not smooth as many as 21 respondents (61.8%). The results of the statistical analysis obtained a p value of 0.000, meaning that there is a significant relationship between the role of the husband and oxytocin massage on the smoothness of breast milk in postpartum mothers. Conclusion: There is a significant relationship between the role of the husband and oxytocin massage on the smoothness of breast milk with a sig value (2-tailed) of 0.000 (<0.05). Suggestion: It is hoped that the role of the husband and oxytocin massage can continue to be utilized as an alternative therapy to increase the smoothness of breast milk in postpartum mothers. In addition, for further researchers, they can conduct similar studies with other variables that are suspected of being able to affect the smoothness of breast milk in postpartum mothers. Keywords: Oxytocin Massage; Role of Husband; Smooth Breast Milk Flow. Pendahuluan: Ibu nifas banyak mengalami keluhan, salah satunya adalah ketidaklancaran ASI. Studi pendahuluan pada penelitian ini, sampel diambil dari data skunder dari buku pencatatan ibu nifas, terdapat 95 responden, sebagian responden mengatakan bahwa ASI tidak lancar dan belum mengetahui tentang manfaat pijat oksitosin. Upaya yang dapat dilakukan untuk memberikan kelancaran ASI ibu nifas yaitu dengan pemijatan oksitosin yang dilakukan oleh tenaga kesehatan maupun suami. Tujuan: Untuk mengetahui hubungan peran suami dan pijat oksitosin terhadap kelancaran ASI pada ibu nifas. Metode: Penelitian kuantiatif menggunakan desain Cross Sectional, dilaksanakan di PMB Semiyati Kecamatan Muara Enim pada tanggal 1 Januari - 31 Mei 2025. Variabel independen terdiri dari peran suami dan pijat oksitosin, sedangkan variabel dependen yaitu kelancaran ASI. Teknik pengambilan sampel menggunakan purposive sampling dan data dianalisis menggunakan uji chi-square. Hasil: Peran suami sebagian besar terlibat dalam pemijatan oksitosin sebanyak 63 responden (66.3%) dengan kategori ASI lancar sebanyak 50 responden (82.0%), sedangkan suami tidak terlibat dalam memberikan pijat oksitosin, sebagian besar ASI tidak lancar sebanyak 21 responden (61.8%). Hasil anlisis statistik ditemukan bahwa perolehan nilai p 0.000, artinya ada hubungan yang signifikan antara peran suami dan pijat eksitosin terhadap kelancaran ASI pada ibu nifas. Simpulan: Terdapat hubungan yang signifikan antara peran suami dan pijat oksitosin terhadap kelancaran ASI dengan nilai sig (2-tailed) 0.000 (< 0.05). Saran: Diharapkan peran suami dan pijat oksitosin dapat terus dimanfaatkan sebagai salah satu terapi alternatif untuk meningkatkan kelancaran ASI pada ibu nifas. Selain itu, peneliti selanjutnya dapat melakukan penelitian yang serupa dengan variabel lainnya yang diduga berpengaruh terhadap kelancaran ASI pada ibu nifas. Kata Kunci: Kelancaran ASI; Peran Suami; Pijat Oksitosin.

Peran bedaquiline untuk tuberkulosis resisten obat: A literature review Darmanto, Arief Gunawan; Dewi, Desak Nyoman Surya Suameitria
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.940

Background: Multidrug-resistant tuberculosis (MDR/RR-TB) is a serious challenge in global TB elimination efforts. Indonesia as a country with a high TB burden faces the problem of MDR/RR-TB therapy, where the effectiveness of second-line treatment is still limited. Bedaquiline, a new drug from the diarylquinoline group, has emerged as a leading candidate in the treatment of MDR/RR-TB with a unique mechanism of action. Purpose: To provide a comprehensive understanding of bedaquiline in the context of its mechanism of action, clinical efficacy, safety profile, development of resistance, and national and global guidelines for its use. Methods: This study is a literature review with reference searches from the PubMed and ScienceDirect databases using the keywords: Tuberculosis, MDR/RR-TB, and Bedaquiline. Articles that met the inclusion criteria were from 2005–2024 and included various types of research, including clinical studies, experiments, and systematic reviews. Results: Bedaquiline has been shown to increase the rate of culture conversion and the success of MDR/XDR-TB therapy. This drug is also recommended by WHO and the Indonesian Ministry of Health in short and long regimens for MDR-TB. However, the risk of side effects such as QT interval prolongation and the emergence of resistance through genetic mutations remain major concerns, so ECG monitoring and genetic resistance testing are essential. Conclusion: Bedaquiline is a major advancement in drug-resistant TB treatment, offering new hope for improving patient outcomes. Nevertheless, its use must be accompanied by careful monitoring of adverse effects and resistance. Suggestion: Further research is needed to identify optimal drug combinations, determine ideal treatment durations, and monitor long-term resistance development to ensure sustained effectiveness of bedaquiline. Keywords: Bedaquiline; Drug Resistance; Tuberculosis. Pendahuluan: Tuberkulosis resisten obat (MDR/RR-TB) menjadi tantangan serius dalam upaya eliminasi TB global. Indonesia sebagai negara dengan beban TB tinggi menghadapi permasalahan terapi MDR/RR-TB, di mana efektivitas pengobatan lini kedua masih terbatas. Bedaquiline, obat baru dari golongan diarylquinoline, muncul sebagai kandidat utama dalam pengobatan MDR/RR-TB dengan mekanisme kerja yang unik. Tujuan: Untuk memberikan pemahaman komprehensif tentang bedaquiline dalam konteks mekanisme aksi, efikasi klinis, profil keamanan, perkembangan resistensi, serta pedoman nasional dan global penggunaannya. Metode: Studi literature review dengan pencarian referensi dari database PubMed dan ScienceDirect menggunakan kata kunci Tuberculosis, MDR/RR-TB, dan Bedaquiline. Artikel yang memenuhi kriteria inklusi yaitu yang diterbitkan tahun 2005–2024 dan mencakup berbagai jenis penelitian, termasuk studi klinis, eksperimen, dan tinjauan sistematis. Hasil: Bedaquiline terbukti meningkatkan tingkat konversi kultur dan keberhasilan terapi MDR/XDR-TB. Obat ini juga direkomendasikan oleh WHO dan Kementerian Kesehatan RI dalam rejimen pendek dan panjang untuk MDR-TB. Namun, risiko efek samping seperti pemanjangan interval QT dan munculnya resistensi melalui mutasi genetik tetap menjadi perhatian utama, sehingga pemantauan EKG dan pengujian resistensi genetik sangat diperlukan. Simpulan: Bedaquiline merupakan inovasi penting dalam terapi TB resisten obat, memberikan harapan baru dalam meningkatkan outcome pasien. Namun, penggunaannya harus disertai dengan pemantauan ketat terhadap efek samping dan resistensi. Saran: Diperlukan penelitian lanjutan terkait kombinasi optimal, durasi terapi yang ideal, serta pemantauan jangka panjang terhadap resistensi untuk memastikan efektivitas jangka panjang bedaquiline. Kata Kunci: Bedaquiline; Resisten Obat; Tuberkulosis.

Faktor-faktor yang berhubungan dengan pengetahuan dan sikap remaja terhadap HIV/AIDS: Analisa Data Sekunder Survei Demografi dan Kesehatan Indonesia (SDKI) 2017 Purwanto, Edi; Cinta, Griselda Zahira
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.986

Background: Adolescents are residents aged 10–19 years. The number of Indonesian adolescents aged 10–19 years reaches around 43.5 million people, equivalent to 18% of the total population. It was recorded in 2014 that there were around 1.2 billion adolescents in the world, which also includes 18% of the global population. Adolescents are more vulnerable than adults to unplanned pregnancies, sexually transmitted diseases and HIV/AIDS. The level of adolescent knowledge about healthy lifestyles and information on various diseases is very minimal. In 2021, it was recorded that 650,000 people died from HIV, while around 1.5 million people were infected with the virus. To prevent the worst-case scenario, namely 7.7 million HIV-related deaths in the next ten years, a significant increase in prevention efforts is needed. Purpose: To determine factors related to adolescent knowledge and attitudes towards HIV/AIDS. Method: Quantitative research with cross-sectional design to analyze factors related to adolescent knowledge and attitudes towards HIV/AIDS. Information in this study refers to secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). For analysis purposes, researchers combined three datasets, namely IDBR71FL (Birth Code), IDCR71FL (Couple Code), and IDHR71FL (Household Code) to find relevant variables. Based on the inclusion criteria with stratified random sampling technique, the number of samples used was 168 respondents. The collected data were analyzed using chi square. Results: The majority of respondents had high school education as many as 96 (57.1%), lived in urban areas as many as 117 respondents (69.6%), did not get knowledge about HIV/AIDS as many as 132 (78.6%), did not get information about HIV/AIDS as many as 119 (70.8%), and most respondents did not get HIV/AIDS School as many as 110 (65.5%). Based on the chi square test, the most dominant variable was age (p value = 0.000). Conclusion: There is an increase in adolescent knowledge and attitudes about HIV-AIDS through school-based education programs (HIV/AIDS Schools). Age factors have the most dominant influence on adolescent knowledge and attitudes towards HIV/AIDS. Suggestion: It is hoped that further researchers can conduct analysis and interventions with more specific factors to see the increase in adolescent knowledge and attitudes towards HIV/AIDS. Keywords: Adolescents; Attitude; HIV/AIDS; Knowledge. Pendahuluan: Remaja adalah penduduk dalam rentang usia 10–19 tahun. Jumlah remaja Indonesia dalam rentang usia 10–19 tahun mencapai sekitar 43.5 juta jiwa, setara dengan 18% dari total penduduk. Tercatat pada tahun 2014 bahwa terdapat sekitar 1.2 miliar remaja di dunia, yang juga mencakup 18% dari populasi global. Remaja lebih rentan daripada orang dewasa dari kehamilan yang tidak direncanakan, penyakit menular seksual dan HIV/AIDS. Tingkat pengetahuan remaja tentang pola hidup sehat dan informasi berbagai penyakit sangat minim. Pada tahun 2021, tercatat sebanyak 650.000 orang meninggal akibat HIV, sementara sekitar 1.5 juta orang terinfeksi virus tersebut. Untuk mencegah skenario terburuk, yakni terjadinya 7.7 juta kematian terkait HIV dalam sepuluh tahun ke depan, diperlukan peningkatan yang signifikan dalam upaya penanggulangan. Tujuan: Untuk mengetahui faktor-faktor yang berhubungan dengan pengetahuan dan sikap remaja terhadap HIV/AIDS. Metode: Penelitian kuantitatif dengan desain cross-sectional untuk menganalisis faktor yang berhubungan terhadap pengetahuan dan sikap remaja terhadap HIV/AIDS. Informasi dalam riset ini merujuk pada data sekunder dari Survei Demografi dan Kesehatan Indonesia (SDKI) tahun 2017. Bagi keperluan analisis, peneliti mengombinasikan tiga dataset yaitu IDBR71FL (Births Recode), IDCR71FL (Couples Recode), dan IDHR71FL (Household Recode) guna menemukan variabel yang relevan. Berdasarkan kriteria inklusi dengan teknik stratified random sampling, jumlah sampel yang digunakan sebanyak 168 responden. Data akumulasi dianalisis menggunakan chi square. Hasil: Mayoritas responden memiliki tingkat pendidikan SMA yaitu sebanyak 96 (57.1%), wilayah tempat tinggal di perkotaan sebanyak 117 responden (69.6%), tidak mendapatkan pengetahuan tentang HIV/AIDS sebanyak 132 (78.6%), tidak mendapatkan informasi tentang HIV/AIDS sebanyak 119 (70.8%), dan sebagian besar responden tidak mendapatkan HIV/AIDS School sebanyak 110 (65.5%). Berdasarkan uji chi square, variabel paling dominan adalah usia (p-value=0.000). Simpulan: Terdapat peningkatan pengetahuan dan sikap remaja tentang HIV-AIDS melalui program pendidikan berbasis sekolah (HIV/AIDS School). Faktor usia memiliki pengaruh paling dominan terhadap pengetahuan dan sikap remaja terhadap HIV/AIDS. Saran: Diharapkan peneliti selanjutnya dapat melakukan analisa dan intervensi dengan faktor yang lebih spesifik untuk melihat peningkatan pengetahuan dan sikap remaja terhadap HIV/AIDS. Kata Kunci: HIV/AIDS; Pengetahuan; Remaja; Sikap.

Model pelayanan kesehatan dengan pendekatan profesionalisme keperawatan berbasis metoda tim Mulyani, Sri; Pratiwi, Arum; Hudiyawati, Dian
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.992

Background: The professionalism of health worker care plays an important role in increasing nurse and patient satisfaction. Negative responses to services indicate that performance is not optimal, one of which is caused by the role of health workers in care giving. Professional nursing care methods can increase patient satisfaction, but have not been applied in many services, so a pilot project is needed to apply these methods and analyze their impact. Purpose: To develop a health service model with a professional nursing approach based on team methods. Method: Quantitative research with a mix-method method, conducted at TK.III Slamet Riyadi Hospital, Surakarta in August 2024 - March 2025. The independent variable is the professional health service model, and the dependent variable is nurse and patient satisfaction. The sampling technique used accidental sampling with a total sample of 296 participants. Data analysis used univariate in the form of frequency distribution and bivariate using wilcoxon and mann whitney tests. Results: There was a statistically significant difference in nurse satisfaction before and after the MAKP intervention (Z = -4.377, p = 0.001), as well as a significant difference in patient satisfaction between the intervention and control groups (p = 0.001), with the Mean Rank of the intervention group (190.50) higher than the control group (106.50). These findings indicate that the MAKP intervention is effective in increasing satisfaction in both nurses and patients. Conclusion: The Team Method Professional Nursing Care Model is effective in improving patient and nurse satisfaction. Its implementation is shown to create structured, responsive, and patient-focused care, while establishing a supportive work environment for nurses. Keywords: Health Care Model; Nursing Professionalism; Team Method. Pendahuluan: Profesionalisme pelayanan tenaga kesehatan berperan penting dalam meningkatkan kepuasan perawat dan pasien. Respon negatif terhadap pelayanan menunjukkan bahwa kinerja belum optimal, salah satunya disebabkan oleh peran tenaga kesehatan dalam pemberian layanan. Metode asuhan keperawatan profesional dapat meningkatkan kepuasan, namun belum banyak diterapkan di beberapa layanan, diperlukan pilot project untuk mengaplikasikan metode ini dan menganalisis dampaknya. Tujuan: Untuk mengembangkan model pelayanan kesehatan dengan pendekatan profesionalisme keperawatan berbasis metoda tim. Metode: Penelitian kuantitatif dengan metode mix-method, dilaksanakan di Rumah Sakit TK.III Slamet Riyadi, Surakarta pada bulan Agustus 2024 – Maret 2025. Variabel independen dalam penelitian ini adalah model pelayanan kesehatan professional, sedangkan variabel dependen adalah kepuasan perawat dan pasien. Teknik pengambilan sampel menggunakan accidental sampling dengan jumlah sampel sebanyak 321 partisipan. Analisis data yang digunakan univariat dalam bentuk distribusi frekuensi dan bivariat menggunakan uji wilcoxon dan mann whitney. Hasil: Menunjukkan perbedaan yang signifikan secara statistik pada tingkat kepuasan perawat sebelum dan sesudah intervensi Metode Asuhan Keperawatan Profesional (MAKP) (Z = -4.377, p = 0.001), serta perbedaan signifikan tingkat kepuasan pasien antara kelompok intervensi dan kontrol (p = 0.001), dengan mean rank kelompok intervensi (190.50) lebih tinggi dari kelompok kontrol (106.50). Temuan ini mengindikasikan bahwa intervensi MAKP efektif meningkatkan kepuasan baik pada perawat maupun pasien. Simpulan: Model asuhan keperawatan profesional metode tim efektif meningkatkan kepuasan pasien dan perawat. Penerapannya terbukti menciptakan pelayanan yang terstruktur, responsif, dan berfokus pada kebutuhan pasien, sekaligus membentuk lingkungan kerja yang mendukung bagi perawat. Kata Kunci: Metoda Tim; Model Pelayanan Kesehatan; Profesionalisme Keperawatan.

Prediksi penerimaan terapi pencegahan tuberkulosis pada kontak serumah dengan pendekatan health belief model (HBM) Fadhilah, Nur; Bowo, Iwan Tri
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.993

Background: Tuberculosis (TB) remains a global health problem, Indonesia ranks second only to India with an estimated 1,060.000 cases, but only 820,789 cases have been reported, posing a risk of transmission, including the risk of Infectious Latent Tuberculosis (ILTB). The WHO recommends Tuberculosis Preventive Therapy (TPT) to prevent ILTB, but Indonesia's TPT achievement is still low, only 2.6% by 2023, far from the target of 68%. Purpose: To analyze the prediction of acceptance of tuberculosis preventive therapy in household contacts using the health belief model (HBM) approach. Method: Analytic observational research design with cross-sectional design, involving 308 respondents from nine health centers. The dependent variable was TPT acceptance, while the independent variables included perceived susceptibility, severity, benefits, barriers, and cues to action. The research instrument used a questionnaire that had been tested for validity and reliability. Bivariate analysis was conducted using the chi-square test, and multivariate analysis using logistic regression. Results: The mean age was 38.21 years, mostly female (50.3%), with high school education (23.1%). The results of the chi-square test showed that all variables had a significant association with TPT acceptance (p-value <0.001), with consecutive ORs: vulnerability 7.347 (4.367-12.363), severity 7.796 (4.597-13.222), benefits 7.197 (4.293-12.065), barriers 5.684 (3.427-9.429), and cues to action 6.266 (3.732-10.519). Logistic regression analysis identified perceived benefits of TPT as the dominant factor with an OR of 3.208 (95% CI: 1.762-5.842). Conclusion: There was a significant association between susceptibility, severity, benefits, barriers, and cues to action with TPT acceptance, with TPT benefits as the dominant influencing factor. Suggestion: Increase TPT campaigns and education through various media, with an emphasis on strengthening beliefs in benefits and involving active community participation. Keywords: Health Belief Model (HBM); Household Contact; Receipt of Preventive Therapy; Tuberculosis. Pendahuluan: Tuberkulosis (TBC) masih menjadi masalah kesehatan global, Indonesia menempati peringkat kedua setelah India dengan estimasi 1,060.000 kasus, namun baru 820,789 kasus yang terlaporkan, hal ini berisiko menularkan, termasuk risiko Infectious Latent Tuberculosis (ILTB). WHO merekomendasikan Tuberculosis Preventive Therapy (TPT) untuk mencegah ILTB, namun capaian TPT di Indonesia masih rendah, hanya 2.6% pada tahun 2023, jauh dari target 68%. Tujuan: Untuk menganalisis prediksi penerimaan terapi pencegahan tuberkulosis pada kontak serumah dengan pendekatan health belief model (HBM). Metode: Desain penelitian observasional analitik dengan rancangan cross-sectional, melibatkan 308 responden dari sembilan puskesmas. Variabel dependen adalah penerimaan TPT, sedangkan variabel independen meliputi persepsi kerentanan, keparahan, manfaat, hambatan, dan isyarat untuk bertindak. Instrumen penelitian menggunakan kuesioner yang telah diuji validitas dan reliabilitasnya. Analisis bivariat dilakukan dengan uji chi-square, dan analisis multivariat dengan regresi logistik Hasil: Rerata usia 38.21 tahun, sebagian besar perempuan (50.3%), berpendidikan SMA (23.1%). Hasil uji chi-square menunjukkan semua variabel memiliki hubungan signifikan dengan penerimaan TPT (p-value < 0.001), dengan OR berturut-turut: kerentanan 7,347 (4.367–12.363), keparahan 7.796 (4.597–13.222), manfaat 7.197 (4.293–12.065), hambatan 5.684 (3.427–9.429), dan isyarat bertindak 6.266 (3.732–10.519). Analisis regresi logistik mengidentifikasi persepsi manfaat TPT sebagai faktor dominan dengan OR 3.208 (95% CI: 1.762–5.842). Simpulan: Terdapat hubungan yang signifikan antara kerentanan, keparahan, manfaat, hambatan, dan isyarat untuk bertindak dengan penerimaan TPT. Dengan variable manfaat TPT sebagai faktor dominan yang memengaruhi. Saran: Meningkatkan kampanye dan edukasi TPT melalui berbagai media, dengan penekanan pada penguatan keyakinan manfaat serta melibatkan partisipasi masyarakat secara aktif. Kata Kunci: Health Belief Model (HBM); Kontak Serumah; Penerimaan Terapi Pencegahan; Tuberkulosis.

Hubungan persepsi kepercayaan dalam pemberian ASI eksklusif dengan pencegahan stunting Nurazila, Nurazila; Fajar, Nur Alam; Sari, Yona Wia Sartika; Amalia, Risa Nur
Holistik Jurnal Kesehatan Vol. 19 No. 4 (2025): Volume 19 Nomor 4
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i4.1007

Background: Stunting is a public health problem that is of global concern, especially in developing countries. This condition is characterized by failure to thrive in children due to chronic malnutrition, recurrent infections, and suboptimal parenting practices. Exclusive breastfeeding for the first six months of a baby's life is recommended by WHO and the Indonesian Ministry of Health as an effort to meet the nutritional needs of babies and protect them from infectious diseases. Breast milk contains all the nutrients needed by babies to grow and develop optimally. However, the level of exclusive breastfeeding in Indonesia is still far from the national target of 70%. One of the factors that influences the low practice of exclusive breastfeeding is the mother's perception and belief in the benefits of breast milk. Purpose: To determine the relationship between the perception of belief in exclusive breastfeeding and the prevention of stunting. Method: Quantitative research with a cross-sectional correlation design to determine the relationship between the perception of belief in exclusive breastfeeding and the prevention of stunting. The population in this study were mothers who have children aged 6–24 months in Banyuasin Regency. The sampling technique used the proportional stratified random sampling method and obtained a sample size of 108 respondents. The instrument used was a questionnaire sheet given to respondents and data analysis using univariate and bivariate Chi-Square analysis or Spearman correlation test. Results: Most respondents aged 20-35 years as many as 88 (83.0%) with the last education ≥ high school as many as 72 respondents (67.9%), as many as 99 respondents (93.4%) did not work, had children > 2 children as many as 69 respondents (65.1%), family income more ≥ UMR as many as 87 respondents (82.1%), as many as 79 respondents (74.5%) had good knowledge about exclusive breastfeeding, and most respondents provided exclusive breastfeeding as many as 69 respondents (65.1%). Based on the variable of perception of trust (Perceived Susceptibility, Severity, Benefit, and Barriers), the results of the statistical test p value <0.05, indicating a significant relationship between perception of trust and exclusive breastfeeding. Conclusion: There is a significant relationship between perception of mother's trust and the practice of exclusive breastfeeding with efforts to prevent stunting. Children who receive exclusive breastfeeding for the first six months have a lower risk of experiencing stunting, characterized by better physical growth and cognitive development. This shows that exclusive breastfeeding is not only a nutritional strategy, but also a long-term preventive measure against stunting. Keywords: Exclusive Breastfeeding; Perception; Stunting; Trust. Pendahuluan: Stunting merupakan salah satu masalah kesehatan masyarakat yang menjadi perhatian global, terutama di negara-negara berkembang. Kondisi ini ditandai dengan gagal tumbuh pada anak akibat kekurangan asupan gizi kronis, infeksi berulang, dan praktik pengasuhan yang kurang optimal. ASI eksklusif selama 6 bulan pertama kehidupan bayi merupakan rekomendasi dari WHO dan Kementerian Kesehatan Indonesia sebagai upaya untuk memenuhi kebutuhan gizi bayi dan melindungi mereka dari penyakit infeksi. ASI mengandung semua nutrisi yang diperlukan bayi untuk tumbuh dan berkembang secara optimal. Namun, tingkat pemberian ASI eksklusif di Indonesia masih jauh dari target nasional. Salah satu faktor yang memengaruhi rendahnya praktik pemberian ASI eksklusif adalah persepsi dan kepercayaan ibu terhadap manfaat ASI. Tujuan: Untuk mengetahui hubungan persepsi kepercayaan dalam pemberian ASI eksklusif dengan pencegahan stunting. Metode: Penelitian kuantitatif dengan menggunakan desain cross-sectional correlation. Populasi dalam penelitian ini adalah ibu yang memiliki anak usia 6–24 bulan di Kabupaten Banyuasin. Teknik pengambilan sampel menggunakan metode proportionate stratified random sampling dan didapatkan jumlah sampel sebanyak 108 responden. Instrumen yang digunakan berupa lembar kuesioner yang diberikan kepada responden dan analisis data menggunakan analisis univariat dan bivariat chi-square atau uji korelasi Spearman. Hasil: Sebagian besar responden berusia 20-35 tahun sebanyak 88 (83.0%) dengan pendidikan terakhir ≥SMA sebanyak 72 responden (67.9%), sebanyak 99 responden (93.4%) tidak bekerja, mempunyai anak > 2 anak sebanyak 69 responden (65.1%), pendapatan keluarga lebih banyak ≥ UMR sebanyak 87 responden (82.1%), sebanyak 79 responden (74.5%) berpengetahuan baik mengenai ASI eksklusif, dan sebagian besar responden memberikan ASI secara eksklusif.sebanyak 69 responden (65.1%). Berdasarkan variabel persepsi kepercayaan, (susceptibility, severity, benefit, dan barriers), didapatkan nilai p < 0.05, menunjukkan adanya hubungan yang signifikan antara persepsi kepercayaan dengan pemberian ASI eksklusif. Simpulan: Terdapat hubungan yang signifikan antara persepsi kepercayaan ibu dan praktik ASI eksklusif dengan upaya pencegahan stunting. Kata Kunci: ASI Eksklusif; Kepercayaan; Persepsi; Stunting.

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Abstract

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Teguh Pribadi

Contact Email teguh@malahayati.ac.id

Phone +6282282204653

Journal Mail Official holistik@malahayati.ac.id

Editorial Address Jalan Pramuka No.27 Kemiling Bandar Lampung -Indonesia.

Location Kota bandar lampung, Lampung INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Teguh Pribadi

Contact Email
teguh@malahayati.ac.id

Phone
+6282282204653

Journal Mail Official
holistik@malahayati.ac.id

Editorial Address
Jalan Pramuka No.27 Kemiling Bandar Lampung -Indonesia.

Location
Kota bandar lampung,

Lampung

INDONESIA