Perilaku petugas mikroskopis TB Paru Puskesmas di Kabupaten Bengkulu Selatan

DEVIZA, Deva, dr. Titi Savitri, MA.,M.Med.,Ph.D

2005 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang : Program penanggulangan tuberkulosis paru merupakan salah satu program prioritas pada Dinas Kesehatan Propinsi Bengkulu. Hasil evaluasi pelaksanaan program pada tahun 2003 diperoleh informasi bahwa tahun 2002 angka penemuan kasus (Case Detection Rate=CDR) belum mencapai target yaitu 25% dari target nasional CDR 40%. Tahun 2003 CDR hanya terealisasi 39,9% dari target nasional CDR 50%, dan tingginya angka kesalahan laboratorium (Error Rate) dengan angka kumulatif Propinsi Bengkulu 26,89%, angka kesalahan laboratorium tertinggi terdapat di Kabupaten Bengkulu Selatan mencapai 66,0%. Salah satu kemungkinan tingginya error rate dan rendahnya case detection rate diakibatkan oleh perilaku kerja petugas, dimana perilaku kerja seseorang dipengaruhi oleh 3 (tiga) faktor yakni : faktor individu, faktor psikologis, dan faktor organisasi. Tujuan Penelitian : Untuk mengetahui perilaku petugas mikroskopis TB paru puskesmas dan faktor-faktor yang berpengaruh terhadap perilaku petugas mikroskopis TB paru puskesmas dalam melakukan pemeriksaan sediaan BTA di Kabupaten Bengkulu Selatan Propinsi Bengkulu. Metode: Jenis penelitian Observasional dengan rancangan Cross Sectional. Subjek penelitian berjumlah 34 petugas mikroskopis TB paru puskesmas diambil secara total sampling. Penelitian di Kabupaten Bengkulu Selatan termasuk Kabupaten pengembangan yaitu, Kabupaten Seluma dan Kabupaten Kaur. Pengumpulan data dengan kuesioner dan chek list. Analisa data secara deskriptif dan analitik. Analisis statistik dengan menggunakan Chi Square dan Regresi logistik dengan taraf signifikansi 95 %. Hasil Penelitian : Hasil analisis univariat diperoleh proporsi faktor individu seperti: umur petugas seimbang, sebagian besar berjenis kelamin laki-laki, latar belakang pendidikan non analis kesehatan, masa kerja >10 tahun, telah mengikuti pelatihan, namun sebagian besar mempunyai tugas rangkap. Faktor psikologis menunjukkan sebagian besar pengetahuan petugas tinggi dan proporsi sikap seimbang. Faktor Organisasi menunjukkan sebagian besar puskesmas kurang lengkap sarana dan prasarana. Hasil analisis bivariat faktor individu menunjukkan bahwa tidak ada satupun yang berpengaruh terhadap perilaku secara signifikan (p>0,05) . Hasil analisis faktor psikologis, hanya sikap dengan nilai p=0,015 (p<0,05), dan ketersediaan buku panduan & register (faktor organisasi) p = 0,035 (p<0,05) yang berpengaruh terhadap perilaku petugas. Hasil analisis multivariat menunjukkan faktor dominan yang berpengaruh secara signifikan terhadap perilaku yaitu sikap (p= 0,018). Kesimpulan : Faktor yang dapat mempengaruhi perilaku yaitu sikap (faktor psikologis) dan ketersediaan buku panduan dan register (faktor organisasi), dimana faktor yang dominan adalah sikap petugas mikroskopis TB paru puskesmas.

Background: The program of lung TB disease control is one of the priority programs in the Provincial Health office of Bengkulu. The result of lung TB program implementation evaluation in the year of 2003 obtained information that in the year 2002, the Case Detection Rate (CDR) was not yet achieved the target of 25% from the national target of CDR with 40%. In the year of 2003, CDR only realized 39,9% from the national target of CDR 50% and the high laboratory error rate investasi the province of Bengkulu was quite high with cumulative rate of 26,89%, the highest laboratory error rate was located in the district of south Bengkulu with 66%. One of the possibility of the high error rate and the low of case detection rate was caused by working behavior of the officer. Working behavior of someone is influenced by 3 (three) factors, individual factor, psychological factor, and organization factor. Objective: To find out the behavior of lung tuberculosis microscopes officer in Primary Health Care and factors that influenced the behavior of lung tuberculosis microscopes officer in Primary Health Care in implementing the check up of BTA providence in the district of South Bengkulu, province of Bengkulu. Method: This was an observational research with cross sectional design. The subject of the research was 34 lung tuberculosis microscopes officers in Primary Health Care which was taken with total sampling. This research was located in the district of south Bengkulu that includes development districts such as Seluma and Kaur districts. Data was collected with questioner and check list. Data was analyzed with descriptive and analytic tests. Statistic analysis used chi square and logistic regression with significance level of 95%. Result: The analysis result of univariat obtain describtion of the proportional of individual factors such as : officer’s age was balance, most of the officers were man sexed, education background was non analytic health, had working period of more than 10 years, have followed training, and most of the officers had double duties. Psychological factor showed that most of the officer’s knowledge was high and the attitude proportional was balance. Organization factor showed that most the primary health care had incomplete facility and infrastructure. The result of bivariat analysis of individual factor showed that there was nothing that influenced the behavior significantly (p>0,05). The analysis result of psychological factor, only attitude with value of p=0,015 (p<0,05), and the availability of guidance and registration book (organization factor) with p=0,035 (p<0,05) that influenced the officer’s behavior. The analysis result of multivariat showed that the dominant factor that significantly influenced the behavior was attitude (p=0,018). Conclusion: Factor that could influenced the behavior was attitude (psychological factor) and the availability of guidance book and register (organization factor), where the dominant factor was attitude of lung TB microscopes officer in Primary Health Care.

Kata Kunci : Promosi Kesehatan,TB Paru,Perilaku Petugas Mikroskopis, behavior, lung TB microscopes, officer in Primary Health Care