Pengembangan Model Interprofessional Collaboration Practice Pada Pasien Diabetes Melitus Tipe 2 Di Rumah Sakit

Siti Ma'rufah, Prof. Dr. Satibi, M.Si.,apt; Dr. Nanang Munif Yasin, M.Pharm., apt; Prof. Dr. Susi Ari Kristina, M.Kes.,apt.

2025 | Disertasi | S3 Ilmu Farmasi

Diabetes Melitus Tipe 2 (DMT2) termasuk penyakit kronis yang membutuhkan perawatan komprehensif dan terintegrasi oleh tim Interprofessional Collaboration Practice (IPCP) untuk mencegah progresi komplikasi yang lebih serius. Tujuan dari penelitian ini adalah mengetahui persepsi and kesiapan tenaga kesehatan dalam IPCP, mengetahui kepuasan and kebutuhan pasien DMT2 yang rawat inap di Rumah sakit (RS), mengembangkan model IPCP pasien DMT2 di RS dengan metode delphi, menganalisis efektivitas model IPCP berdasarkan parameter Hemoglobin A1c (HbA1c), tekanan darah dan kepuasan pasien.

Pengembangan model IPCP pada pasien DMT2 di RS menggunakan pendekatan mixed-methods. Tahap membangun model dan validasi melibatkan 15 pakar dengan metode delphi dua putaran dan data dianalisis dengan uji Kendall-W. Tahap implementasi model IPCP melibatkan 66 pasien rawat inap di RS UNS Surakarta. Terbagi menjadi 2 kelompok, yaitu intervensi dengan ‘PD Plan VisitE Weekly’ yaitu pelatihan, Diskusi harian, plan perawatan bersama,visit, edukasi pasien dan pertemuan ilmiah mingguan melibatkan (34 orang) dan kontrol dengan pelayanan konvensional (32 orang) selama 4 bulan. Variabel penelitian ini adalah nilai HbA1c, tekanan darah dan kepuasan pasien. HbA1c dan tekanan darah diukur pada bulan ke-0 dan ke-4, sedangkan kepuasan pasien pada bulan ke-4. Analisis data HbA1c dan tekanan darah dengan wilcoxon dan kepuasan pasien diuji Mann whitney.
 
Kesiapan tenaga kesehatan dalam pelaksanaan IPCP DMT2 di RS adalah baik dengan median 259. Kepuasan dan kebutuhan pasien saat rawat inap di RS, masuk kategori sedang dengan mean 3,66. Pasien saat rawat inap membutuhkan: kecukupan makanan, keramahan tenaga kesehatan, kecepatan dan ketepatan dalam pelayanan selama rawat inap di RS. Faktor diatas (kesiapan, kepuasan dan kebutuhan) mendukung model “PD Plan VisitE Weekly” sehingga valid dan bisa diaplikasikan dengan indikator kecocokan penilaian (?= 0,017). Model “PD Plan VisitE Weekly” efektif menurunkan nilai HbA1c dan meningkatkan kepuasan pasien dengan nilai signifikansi (0,010 dan 0,026), hal ini dikarenakan adanya kolaborasi antar profesi mempengaruhi pelayanan. Model ini tidak menurunkan tekanan darah baik sistolik maupun diastolik (?= 0,137dan 0, 837), dikarenakan penelitian hanya dalam waktu empat bulan dan terapi DMT2 dengan hipertensi lebih komplek. Model “PD Plan VisitE Weekly” dapat diaplikasikan dan terbukti memperbaiki nilai HbA1c dan kepuasan pasien.

Type 2 diabetes mellitus (DMT2) is a chronic disease that requires comprehensive and integrated care by the Interprofessional Collaboration Practice (IPCP) team to prevent the progression of more serious complications. The purpose of study is to determine the perception and readiness of health workers in IPCP, to determine the satisfaction and needs of Type 2 DM patients who are hospitalized in hospitals, to develop an IPCP model of DMT2 patients in hospitals using the delphi method, to analyze the effectiveness of the IPCP model based on (Hemoglobin A1c) HbA1c parameters, blood pressure and patient satisfaction.

The development of the IPCP model in DMT2 patients in hospitals used a mixed-methods approach. The model building and validation phase involved 15 experts with the two-round delphi method and the data were analyzed with the Kendall-W test. The implementation phase of the IPCP model involved 66 inpatients at UNS Surakarta Hospital. It was divided into 2 groups, namely intervention with 'PD Plan VisitE Weekly', namely training, daily discussion, joint care plan, visit, patient education and weekly scientific meetings involving (34 people) and control with conventional services (32 people) for 4 months. The variables of this study were HbA1c values, blood pressure and patient satisfaction. HbA1c and blood pressure were measured at the 0th and 4th months, while patient satisfaction was at the 4th month. Analysis of HbA1c and blood pressure data with wilcoxon and patient satisfaction tested Mann whitney.
 
The readiness of health workers in the implementation of IPCP DMT2 in hospitals is good with a median of 259. Patient satisfaction and needs during hospitalization were in the medium category with a mean of 3.66. Patients during hospitalization need: adequate food, friendliness of health workers, efficient and precision in services during hospitalization. The above factors (readiness, satisfaction and needs) support the "PD Plan VisitE Weekly" model so that it is valid and can be applied with an assessment match indicator (?= 0.017). The "PD Plan VisitE Weekly" model was effective in lowering HbA1c values and increasing patient satisfaction with significant values (0.010 and 0.026), this is because collaboration between professions affects services. This model did not lower blood pressure either systolic or diastolic (?= 0.137 and 0.837), because the study was only four months and DMT2 therapy with hypertension was more complex. The "PD Plan VisitE Weekly" model can be applied and proven to improve HbA1c values and patient satisfaction.

Kata Kunci : DMT2, Interprofessional relations, HbA1c, Patient satisfaction