Pengembangan Model Budaya Keselamatan Lansia Aman Dan Selamat Dari Risiko (ASRi) Dengan Melibatkan Keluarga Dalam Perawatan Di Rumah

Asri Handayani Solihin, Prof. Dr. Christantie Effendy, S.Kp., M.Kes.

2025 | Disertasi | S3 Kedokteran Umum

Latar Belakang: Peningkatan jumlah lansia menimbulkan masalah kesehatan dan  keselamatan pada lansia. Keluarga selaku pendamping lansia di rumah perlu mengembangkan budaya keselamatan agar lansia terhindar dari bahaya. Selama ini budaya keselamatan hanya dikembangkan di tatanan pelayanan kesehatan, sehingga diperlukan model untuk meningkatkan budaya keselamatan lansia di rumah dengan melibatkan keluarga. 

Tujuan: Penelitian bertujuan untuk mengembangkan dan menguji model budaya keselamatan lansia dalam meningkatkan persepsi budaya keselamatan dan menurunkan kejadian tidak diharapkan. 

Metode Penelitian: Disain penelitian ini adalah exploratory sequential mixed method yang dilakukan tiga tahap dari Agustus 2021 hingga November 2022 di Sekolah Lansia Kota Bandung. Tahap pertama dilakukan secara kualitatif melalui wawancara terhadap 8 keluarga, 5 lansia, serta Focus Group Discussion (FGD) terhadap 8 orang tenaga kesehatan, 3 orang kader dan 6 orang pengelola sekolah lansia. Tahap kedua pengembangan model dilakukan dengan Delphi method dua putaran dengan melibatkan 32 expert. Tahap ketiga, pengujian model melalui penelitian kuasi eksperimen pada 135 responden dilaksanakan selama 4 bulan di  8 Sekolah Lansia Kota Bandung. Instrumen yang digunakan adalah kuesioner persepsi budaya keselamatan lansia dan kejadian tidak diharapkan. Analisis data tahap pertama dengan analisis konten, pada tahap ketiga menggunakan Wilcoxon signed rank test, Mann-Whitney U test, chi square, uji marginal homogeneity test, regresi linier berganda dan regresi logistik biner. 

Hasil: Penelitian tahap pertama menghasilkan 3 tema yaitu: 1) budaya keselamatan lansia di rumah; 2) Perlunya edukasi bagi keluarga mengenai keselamatan lansia melalui kerjasama kader dan tenaga kesehatan; 3) keselamatan pendamping. Tahap kedua diperoleh 54 indikator untuk dikembangkan menjadi model berupa modul Budaya Keselamatan Lansia. Hasil penelitian tahap ketiga menunjukkan bahwa ada pengaruh penerapan model budaya keselamatan lansia terhadap penurunan kejadian tidak diharapkan (p-value <0>0,05), namun secara praktis terdapat perubahan perilaku keluarga dalam mengupayakan lingkungan yang aman bagi lansia.  

Kesimpulan: Model ini berpotensi untuk meningkatkan keselamatan lansia di rumah melalui peran aktif  keluarga.

Background: The increasing number of older adults poses health and safety challenges for them. Families, as companions of the elderly at home, need to develop a culture of safety so that the elderly can avoid danger. So far, the culture of safety has only been developed in the health service setting, so a model is needed to improve the safety culture of the elderly at home by involving the family.

Objective: The study aims to develop and test a model of older adults' safety culture in improving the perception of safety culture and reducing adverse events.

Research Method: The design of this study is an exploratory sequential mixed method, which was carried out in three stages from August 2021 to November 2022. The first stage was conducted qualitatively through interviews with 8 families and 5 older adults; a focus group discussion (FGD) with 8 health workers, 3 cadres, and 6 senior school managers. The second stage of model development was carried out with the Delphi method in two rounds involving 32 experts. The third stage, model testing through a quasi-experiment on 135 respondents, was carried out for 4 months in 8 Bandung City Senior Schools. The instrument used was a questionnaire on the perception of older adults' safety culture and adverse events. The first stage of data analysis used content analysis, the third stage used the Wilcoxon signed rank test, the Mann-Whitney U test, the chi-square, the marginal homogeneity test, multiple linear regression, and binary logistic regression.

Results: The first phase of the research produced 3 themes: 1) the safety culture of the older adults at home; 2) the need for education for families regarding the safety of the older adults through the cooperation of cadres and health workers; and 3) companion safety. In the second stage, 54 indicators were obtained to be developed into a model in the form of a Culture of Older Adults Safety module. The results of the third phase of the study showed that there was an effect of the application of the elderly safety culture model on the reduction adverse events (p-value < 0> 0,05), but practically there was a change in family behavior in striving for a safe environment for the elderly. 

Conclusion: This model has the potential to improve the safety of older adults at home through the active role of the family.

Kata Kunci : Budaya Keselamatan, Keluarga, Lansia, Persepsi Budaya Keselamatan, Kejadian tidak diharapkan