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Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Published by Universitas Indonesia
ISSN : 19077505     EISSN : 24600601     DOI : https://doi.org/10.7454/kesmas
Core Subject : Health,
Health Professions Public Health
The focus of Kesmas is on public health as discipline and practices related to preventive and promotive measures to enhance the public health through a scientific approach applying a variety of technique. This focus includes areas and scopes such as Biostatistics, Environmental Public Health, Epidemiology, Health Policy, Health Services Research, Nutrition, Occupational Health and Industrial Hygiene, Public Health, Public Health Education and Promotion, Women Health.
Arjuna Subject : Kedokteran - Epidemilogi
Articles 928 Documents
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Determinan Pemilihan Tempat Persalinan di Kabupaten Cirebon, Tahun 2004 Adipriati, Deti
Kesmas Vol. 1, No. 4
Publisher : UI Scholars Hub

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Abstract

Lebih dari 90% kematian ibu disebabkan komplikasi obstetrik yang sering tidak dapat diramalkan pada saat kehamilan. Pada umumnya kematian Ibu dan kejadian kesakitan setelah bayi lahir adalah akibat kegagalan untuk menanggulangi komplikasi persalinan. Kebanyakan komplikasi itu terjadi pada saat atau sekitar persalinan. SDKI 2003 melaporkan bahwa 9% persalinan dilakukan di fasilitas pemerintah dan 31% pada fasilitas swasta, sedangkan 59% masih dilakukan di rumah. Pertolongan persalinan di rumah, dimana sistem rujukan tidak dikembangkan dengan tepat, memiliki pengaruh yang besar terhadap kelangsungan hidup ibu dan bayi. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berpengaruh dalam menentukan pemilihan tempat persalinan di Kabupaten Cirebon tahun 2004. Desain penelitian menggunakan desain potong lintang (cross sectional) pada 447 responden pada 29 desa di Kabupaten Cirebon. Analisa yang digunakan adalah regresi logistik model prediksi. Hasil penelitian didapatkan bahwa ibu berpendidikan rendah akan memilih tempat persalinan di rumah sebanyak 2,94 kali dibandingkan ibu berpendidikan tinggi (OR = 2,94; 95 % CI = 1,764 – 4,890) setelah dikontrol oleh variabel pengetahuan ibu tentang masalah kesehatan pada masa persalinan dan melahirkan dan variabel status ekonomi. Penelitian menyimpulkan bahwa pendidikan Ibu, pengetahuan ibu tentang masalah kesehatan pada masa kehamilan dan persalinan serta status ekonomi mempunyai pengaruh terhadap pemilihan tempat persalinan. More than 90% of maternal death is caused by obstetric complications, which are often unpredictable during pregnancy. In general, maternal death and newborn morbidity are caused by failure to overcome delivery complication. Most of the complication happened at the moment or around delivery. SDKI 2003 reported that 9% birth were delivered in public facilities, 31% were delivered in private health facilities and 59% were still delivered at home. Birth delivery at home with not well-developed referral system, has great influence on mother and newborn lives. The objective of this study is to identify factors that influence selection of delivery place in Cirebon District in 2004 using cross-sectional design among 447 respondents living in 29 villages in Cirebon District. The analysis used is logistic regression using prediction modeling. The results indicate that mother with low education has chance to opt for delivery at home 2.94 times higher than mother with high education level (OR = 2.94; 95% CI = 1.764 – 4.890) after controlled by mother’s knowledge on health problem at birth and economic status. The study concludes that delivery place selection is influenced by mother’s education, mother’s knowledge on health problem at birth and economic status.
Kekerasan pada Setiap Tahap Penempatan TKI Asal Propinsi Sumatera Barat Tahun 2006 Agustin, Helfi
Kesmas Vol. 1, No. 4
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Abstract

Peningkatan jumlah tenaga kerja Indonesia yang diberangkatkan keluar negeri seiring dengan kebijakan nasional diikuti oleh peningkatan berbagai masalah yang mengarah pada pelanggaran hak azasi manusia. Penelitian ini bertujuan mengetahui berbagai kekerasan yang menyertai setiap tahap penempatan tenaga kerja Indonesia dan dampaknya terhadap kesehatan. Penelitian ini menggunakan metoda kualitatif dengan metode pengumpulan data wawancara mendalam dan metoda analisis tema. Penelitian diadakan di Propinsi Sumatera Barat, pada bulan April-Mei 2006. Hasil penelitian menemukan semua TKI berangkat pada usia muda. TKI dengan tingkat pendidikan/akses informasi terbatas mudah terjebak dalam pemberangkatan ilegal. Semua TKI mengalami beberapa bentuk kekerasan secara bersamaan dan berulang dan besar dampak kekerasan bergradasi menurut jenis kelamin. TKI legal mengalami eksploitasi karena peraturan dan mekanisme penempatan yang belum melindungi hak azasi manusia. Kekerasan tidak hanya terjadi ketika TKI bekerja di luar negeri, tetapi sejak pra pemberangkatan sampai saat pemulangan. TKI ilegal menghadapi resiko pelanggaran hak azasi manusia yang lebih besar dan mengalami kekerasan dengan gradasi dampak yang lebih berat. Untuk menghentikan pemberangkatan ilegal, disarankan pada Dinas Tenaga Kerja Propinsi Sumatera Barat untuk meningkatkan kesadaran masyarakat tentang aspek migrasi internasional melalui informasi publik. Kepada Depnakertrans RI diharapkan dapat merevisi peraturan dan melakukan upaya diplomasi yang berorientasi pada perlindungan hak azasi manusia dengan merujuk pada kesepakatan internasional. Indonesian government has determined a policy of employment placement as national program. With the raising number of Indonesian migrant workers, the related problems are also raising. The research is qualitative research and data were taken by in-depth interview method. The aim of this study is to know the form of abuse of Indonesian migrant workers in all placements and its health impact. Thematic analysis was used in this study. The study was held in West Sumatera Province in April–May 2006. The research finds that all of Indonesian Migrant Workers left the country at young ages. Those workers with low education level or had limited access to information were easily trapped in illegal departure. The form and magnitude of abuse were gradual according to sex. All Indonesian migrant workers experienced various kind of abuses simultaneously and repeatedly. Illegal Indonesian migrant workers are exploited because of the rule and mechanism of placement do not comply to human rights protection. Abuse does not only happen when Indonesian migrant workers are abroad but also before leaving and after coming home. Illegal Indonesian migrant workers faced higher risk of human rights violation and undergo abuse with greater impact. Government should improve citizen awareness to prevent abuse through elimination of illegal departure by giving information to wider public, and to have strong political commitment to revise rules related to migrant workers as well as to foster diplomatic efforts towards human right protection of Indonesian migrant workers.
A Qualitative Exploration of Exclusive Breastfeeding Practices Among Karen Ethnicity Mothers in Northern Thailand Remote Rural Areas Ritthimon, Wanchalerm; Thongprachum, Aksara; Wungrath, Jukkrit
Kesmas Vol. 18, No. 3
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Abstract

Low exclusive breastfeeding rates among the Karen ethnic group in Northern Thailand's remote rural areas underscore the need to understand knowledge, attitudes, and social support to develop targeted interventions. This qualitative study examined exclusive breastfeeding practices and the factors influencing breastfeeding behavior among 14 Karen Ethnicity Mothers (KEMs) in Northern Thailand. A structured interview was used to collect the data, a triangular method to determine the data's validity, and a content analysis method to examine the data revealed seven themes and 14 subthemes. This study identified three key factors for successful breastfeeding: self-motivation, social support, and effective problem management, which included overcoming the family's anti-breastfeeding beliefs. Conversely, unsuccessful breastfeeding stemmed from four issues: inadequate maternal knowledge and misconceptions, family beliefs and culture, maternal health problems, and economic constraints. Therefore, the success of breastfeeding was heavily influenced by both personal and environmental factors. As a result, every KEM should be encouraged to recognize the importance of breastfeeding and to exclusively breastfeed for at least six months, especially those living in remote rural areas and have a different way of life than the natives.
Healthy Lifestyle Behaviors and Sociodemographic Characteristics Among Medical Students in Indonesia During the New Normal Era: A Cross-Sectional Study Vionnetta, Sharren Shera; Tanumihardja, Tommy Nugroho; Kristian, Kevin
Kesmas Vol. 18, No. 3
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Abstract

This study aimed to identify medical students’ healthy lifestyle behaviors during the new normal era and to determine its relationship with sociodemographic factors, bearing in mind that, as future physicians and health role models, medical students play an important role in adopting and promoting healthy lifestyle behaviors to reduce the risk of future health problems as well as optimize communities’ health status. This cross-sectional study was conducted at the School of Medicine and Health Sciences of Universitas Katolik Indonesia Atma Jaya, with 111 medical students selected through stratified random sampling. Data were collected using sociodemographic characteristics (sex, residence, year of study, and participation in health promotion training) and the Health-Promoting Lifestyle Profile-II (HPLP-II) questionnaire and analyzed using descriptive and bivariate analyses. The results showed a moderate total HPLP-II score (2.46± 0.37). Interpersonal relations had the highest mean score, and health responsibility had the lowest. A significant difference in the total HPLP-II scores was identified between students participating in health promotion training and those who did not (p-value = 0.049). Further study is needed to explore other factors influencing healthy lifestyle behaviors among medical students.
Comparison of Prevalence and Associated Factors of Multisystem Health Symptoms Among Workers in the Gas Station Area, Thailand Polyong, Chan Pattama; Thetkathuek, Anamai
Kesmas Vol. 18, No. 3
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This cross-sectional study aimed to compare the prevalence of multisystem health symptoms (MHS) of workers in gas station areas before and after their employment and examine the factors affecting the MHS of workers. Data were collected by an interview questionnaire from 200 workers inside and outside refueling areas at eight gas stations in Rayong Province, Thailand. This study found that employees had a statistically significant increase in the prevalence of current MHS in comparison to before starting work (p-value<0.05), with 31.5%. Working overtime for more than 6 hours per week led to respiratory symptoms (OR = 2.63, 95% CI = 1.14–6.07) and psychological symptoms (OR = 2.69, 95% CI = 1.12–6.49). Wearing respiratory protective equipment for less than three hours affected ear/throat/nose systems (OR = 4.26, 95% CI = 1.43–12.65). Petrol refueling resulted in liver (OR = 2.32, 95% CI = 1.4–12.65) and eye symptoms (OR = 2.57, 95% CI = 1.10–5.39). Therefore, gas station owners should set up enclosed rooms to reduce the duration of fuel exposure, and workers should wear personal protective equipment when refueling or near the dispenser.
Development of a Medication Compliance Determinant Instrument for Low-Middle Literate Patients with Type 2 Diabetes Mellitus Panduwiguna, Ivans; Sauriasari, Rani; Sartika, Ratu Ayu Dewi; Riyadina, Woro; Renaldi, Fransiskus Samuel
Kesmas Vol. 18, No. 3
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Abstract

Diabetes, a leading cause of 6.7 million deaths in 2021, poses a significant challenge despite existing interventions. Non-adherence to treatment remains a barrier to diabetes management. However, a comprehensive instrument to assess medication adherence determinants in diabetes patients’ population in Indonesia with low-medium literacy levels and following the sociocultural characteristics of Indonesian society has been lacking. This study aimed to develop and evaluate a valid and reliable instrument for measuring medication adherence in type 2 diabetes mellitus patients based on the Borg and Gall model. Through the input of an expert panel, a valid and reliable instrument was developed, which comprised 21 questions and encompassed all medication adherence determinants, with a CVR and CVI value of 1 and a final Cronbach’s alpha value of 0.731. This instrument is still being tested and needs to be implemented in the right and wider population to obtain more accurate results.
Workload and Stress Level in Non-COVID-19 Zoning Nurses at National Central Public Hospital Jakarta Zakiyah, Zakiyah; Karim, Ulfah Nuraini; Dewi, Aliana; Nuraini, Siti; Sutandi, Aan; Alnur, Rony Darmawansyah
Kesmas Vol. 18, No. 3
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Abstract

The COVID-19 pandemic has increased the workload for nurses directly handling COVID-19 patients and those working in non-COVID-19 zones. As the number of COVID-19 cases rises, nurses face psychological problems, including stress. This study aimed to determine the relationship between workload and stress levels in a non-COVID-19 zoning ward using a cross-sectional approach and Spearman’s correlation test conducted on 94 nurses at one hospital in Jakarta, Indonesia, selected through simple random sampling. The workload questionnaire with 15 items and the DASS 42 questionnaire were used to measure stress levels. The results indicated that most nurses (73.4%) experienced a heavy workload. Regarding stress levels, most nurses (66%) reported severe stress, while a small number experienced mild (2.1%) and moderate stress (2.1%). The Spearman’s test revealed a significant relationship between workload and stress levels in the non-COVID-19 zoning ward (p-value = 0.001). Based on these findings, hospitals are urged to effectively manage nurses’ workload during the COVID-19 pandemic and implement specific interventions for nurses experiencing occupational stress.
Effects of Early Hospital-Based Palliative Care Consultation on Length of Stay and Costs of Care at Indonesian Tertiary Hospital Putranto, Rudi; Shatri, Hamzah; Rajabto, Wulyo; Sumariyono, Sumariyono; Faisal, Edward; Sihwastuti, Sihwastuti
Kesmas Vol. 18, No. 3
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Despite the numerous benefits of palliative care for cancer patients, there have been few studies on palliative care services for terminal cancer patients, particularly near the end of life. This study aimed to evaluate whether there were differences in length of stay and cost of care associated with how early or late a patient received palliative care intervention. Another objective was to compare the length of stay and cost of care of those who received palliative care intervention and those who did not. This study used a cohort retrospective design at Hospital A, Jakarta, Indonesia, from January to December 2019. The diagnosis of terminal cancer was based on medical records. Data on length of stay and costs of care were based on medical records and finance billing. The hospitalized terminal cancer patients (392) were recruited by consecutive sampling. The length of stay and costs of care for patients with advanced cancer who received palliative care consultations were longer and higher than for patients who did not receive them. However, if palliative care consultation is provided early, the increase in length of stay and costs are less.
Risk Factors of Worsening of Systemic Lupus Erythematosus in Patients at Two Tertiary Hospitals in Jakarta Aji, Giri; Sudaryo, Mondastri Korib; Djuwita, Ratna; Sukamto, Sukamto
Kesmas Vol. 18, No. 3
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Systemic Lupus Erythematosus (SLE) is a prototypical multiorgan autoimmune disease with a fluctuating and chronic disease course. As an emerging disease in this century, SLE will burden stakeholders and the country. This study was conducted to determine the prognostic factors for SLE worsening, especially in ambulatory patients. This ambispective study used logistic regression to view the risk factors for worsening SLE in patients. Anemia, age, body mass index, education level, employment status, marital status, hydroxychloroquine, and immunosuppressants were the independent variables in this study. This study concludes that anemia is statistically significant and, therefore, a risk factor for worsening SLE in patients (RR = 5.31; p-value
Maternal Factors Influencing Postpartum Depression in Indonesia Sari, Nurhalina; Muhani, Nova; Dewi, Friska Novira Maya
Kesmas Vol. 18, No. 3
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The estimated prevalence of postpartum depression differs in developed and developing countries. Due to the increasing number of cases in developing countries like Indonesia, postpartum depression has become a serious issue. This study aimed to identify factors influencing postpartum depression in Bandar Lampung, Indonesia, in 2023 using the Edinburgh Postnatal Depression Scale instrument. This study employed a cross-sectional design with a sample size of 251 respondents, selected based on inclusion and exclusion criteria using a purposive sampling technique. The multiple logistic regression results indicated that women with abortion records had a three times higher risk (95% CI = 1.394–7.648; p-value = 0.013) of experiencing postpartum depression after controlling for other variables (record of depression, employment status, education, and family support). Postpartum women should be followed by midwives and given regular assistance from their loved ones, such as their spouse or family, to prevent depression. These experts can monitor the mother’s well-being and share information on maternal and infant health.

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