Persepsi penderita TB Paru terhadap bahaya penyakit, manfaat pengobatan dan peran PMO di puskesmas Kabupaten Tegal
RISNANTO, dr. Sri Retna Irawati, SpA.,M.Kes
2005 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar belakang: Indonesia telah menerapkan strategi DOTS di seluruh dinas kesehatan. Kabupaten Tegal telah melaksanakan program DOTS dan saat ini cure rate mencapai 92% (target nasional >85%). Namun demikian, pencapaian tersebut belum merata di seluruh puskesmas. Conversi rate pada triwulan III tahun 2004 mencapai 89% (target nasional > 80%), error rate 6,5% (target nasional <5%) dan CDR 46% (target nasional 60%). Permasalahan yang muncul berkaitan dengan pencapaian indikator tersebut diantaranya adalah penderita tidak mengalami konversi pada fase intensif dan kasus drop out yang menjadi salah satu kendala keberhasilan program pemberantasan TB paru. Kegagalan dan ketidakteraturan dalam pengobatan dapat terjadi karena penderita TB belum memahami bahwa obat harus ditelan sekaligus dalam waktu 6 bulan. Persepsi penderita terhadap bahaya penyakit, manfaat pengobatan dan peran PMO mempunyai peranan penting dalam memunculkan kemungkinan melakukan tindakan pengobatan. Tujuan: Mengkaji persepsi penderita TB selama menjalani masa pengobatan di Puskesmas Kabupaten Tegal. Secara khusus, bertujuan: 1) Mengkaji persepsi penderita TB terhadap bahaya penyakit, manfaat pengobatan dan peran PMO, 2) Mengkaji persepsi pada penderita TB di puskesmas dengan cure rate di atas dan di bawah standar nasional. Metode: Penelitian ini merupakan penelitian kualitatif dengan menggunakan rancangan studi kasus dan hasil penelitian disajikan secara deskriptif. Subjek penelitian adalah penderita TB di Puskesmas Kabupaten Tegal dengan metode purposive sampling. Pengumpulan data dilakukan dengan wawancara mendalam. Data dianalisis dengan menggunakan analisis kualitatif. Triangulasi sumber digunakan untuk meningkatkan keabsahan data. Hasil: Persepsi penderita terhadap bahaya penyakit, manfaat pengobatan dan peran PMO tidak sama. Bervariasinya persepsi ini diakibatkan adanya faktor pemicu terhadap persepsi penderita itu sendiri. Faktor pemicu tersebut adalah pengalaman, interaksi keluarga dan sosial, penjelasan petugas dan pandangan dari diri informan yang bersangkutan. Penjelasan petugas kepada PMO masih minimal. Kesimpulan: Persepsi informan atas bahaya penyakit di puskesmas cure rate rendah dan tinggi sudah baik. Persepsi atas manfaat pada puskesmas cure rate rendah dikategorikan cukup, sedang pada cure rate tinggi sudah baik. Persepsi informan terhadap peran PMO pada puskesmas cure rate rendah dikategorikan kurang, sedang pada cure rate tinggi dikategorikan cukup
Background: Indonesia has been applying DOTS strategy in all district health office. DOTS program has been conducted in Tegal and right now its cure rate reaches 92 % (national target >85 %). However, this achievement has not evenly spread yet in all primary health care. It is noted that conversion rate on Third Quarter 2004 is 89% (national target >80%), error rate is 6,5% (national target < 5%), and CDR is 46% (national target 60%). The set of problems which appear relating to that indicator achievement are the patients who do not have sputum conversion in intensive phase and drop out cases which become one of obstacles to the success of TB program. The failure and the irregular treatment can be happened because of the lack of TB information, such as, the patients have not understand yet that the drugs must be taken during 6 months fully. Therefore, the perception of patients toward the danger of disease, benefit of treatment, and role of drug observer participation is the important part in appearing the probability of treatment measuring. Objective: This research was aimed to study TB patients perception during having treatment period in primary health care in District of Tegal. Specifically, it is purposed to :1) To study the perception of TB patients toward the danger of disease, benefit of treatment, and role of drug observer participation; 2) To study the perception of TB patients in primary health care whose cure rate is above and below the national standard. Method: This research is a qualitative research with case study design and the result of research was presented descriptively. The subject of research are TB patients in primary health care of Tegal District, was taken by using purposive sampling method. Data was collected with Indepth interview. Data was analyzed by using qualitative analysis. Triangulation of source was used to increase the trusworthiness of data. Result: The perception of patients toward the danger of disease, benefit of treatment, and role of drug observer participation is not equal one anothers. This varied perception is caused by the existence of trigger factors to the perception of TB patient itself. The trigger factors are the experience, the family and social interaction, TB officer explanation and the view of informan’s mind his self. Beside, officer explanations to those who become drug observer participation are still minimum. Conclusion: The informan’s perception to the danger of disease, both in primary health care with low-cure rate and high-cure rate, is good. The perception to the benefit of treatment in low-cure rate primary health care is categorized adequate, while in high-cure rate primary health care is categorized good. The informan’s perception to role of drug observer participation in low-cure rate primary health care is categorized less, while in high-cure rate is categorized adequate
Kata Kunci : Perilaku Sehat,Penderita TB Paru,Pengobatan dan Peran PMO
