Pengembangan Model Pelatihan Kepolar (Keterampilan Pencegahan Risiko Perilaku Kekerasan Remaja) bagi Perawat Puskesmas di Kotamadya Palembang : Studi Mixed Method

Sri Maryatun, Prof. Intansari Nurjannah, S.Kp., M.NSc., Ph.D; Ariani Arista Putri Pertiwi, S.Kep., Ns., MAN., DNP

2026 | Disertasi | S3 Kedokteran Umum

Latar Belakang. Peningkatan kasus perilaku kekerasan remaja setiap tahunnya belum diimbangi dengan pendekatan intervensi  pada remaja sebagai pelaku kekerasan dan sistem sosial terdekatnya. Penanganan untuk masalah tersebut lebih banyak berfokus pada korban kekerasan dibandingkan pelaku kekerasan sehingga intervensi yang diberikan cenderung berorientasi pada pelayanan kesehatan secara kuratif dan rehabilitatif dibandingkan promotif dan preventif. Padahal, tanpa adanya upaya untuk mengidentifikasi secara dini faktor risiko dan protektif serta mencegah terjadinya risiko perilaku kekerasan remaja, siklus kekerasan akan terus berlanjut dari korban menjadi pelaku (cycle of violence). Oleh karena itu penelitian yang mengembangkan model intervensi secara komprehensif bagi remaja melalui pemberdayaan dan peningkatan kapasitas tenaga kesehatan khususnya perawat puskesmas di pelayanan primer dan komunitas merupakan kebutuhan yang mendesak untuk mengurangi prevalensi kekerasan remaja secara efektif dan berkelanjutan
Tujuan penelitian: Mengembangkan model dan instrumen pelatihan mengenai pencegahan risiko perilaku kekerasan remaja bagi perawat puskesmas
Metode penelitian: Penelitian ini merupakan mixed methods research exploratory sequential design. Tahap pertama penelitian kualitatif dengan mengeskplorasi faktor risiko, faktor protektif dan upaya pencegahan risiko perilaku kekerasan remaja. Partisipan pada tahap pertama melibatkan 55 informan terdiri dari 15 perawat dengan focus group discussion dan 40 orang terdiri dari remaja, orangtua, guru, kepala puskesmas, kepala sekolah dan penanggung jawab program kesehatan jiwa Dinas Kesehatan Kotamadya Palembang dengan in depth interview. Analisis kualitatif yang digunakan adalah content analisis. Selanjutnya tahap kedua penelitian dengan pengembangan model dan instrumen pelatihan berdasarkan analisis sintesis hasil tahap pertama, tinjauan literatur, masukan pakar dan uji coba modul dan instrumen. Tahap ketiga penelitian kuantitatif melalui rancangan nonequivalent (pre-test dan post-test) control group design. Sampel dalam penelitian ini sebanyak 82 orang perawat puskesmas sesuai dengan kriteria inklusi terdiri dari 40 responden kelompok intervensi mendapatkan pelatihan Kepolar selama lima hari dan 42 responden kelompok kontrol mendapatkan edukasi mengenai pencegahan risiko perilaku kekerasan remaja selama satu hari. Analisa data bivariat menggunakan uji independent T test dan Mann Whitney
Hasil : Didapatkan 12 tema yaitu masalah dalam diri remaja, disfungsi keluarga, permasalahan dengan teman sebaya, ketidaksiapan sekolah, ketidakmampuan perawat dalam intervensi keperawatan, ketahanan diri, dukungan keluarga, kelompok suportif teman sebaya, dukungan sekolah, dukungan sosial, upaya pelayanan komprehensif dan upaya penerapan strategi pelatihan.  Dihasilkan empat modul pelatihan keterampilan pencegahan risiko perilaku kekerasan remaja (Kepolar) perawat untuk remaja, orangtua, guru dan pihak sekolah dengan hasil uji validitas berkisar 0,875 - 1,00 yang dianggap sangat valid. Dihasilkan juga empat instrumen yaitu pengetahuan, sikap, efikasi diri dan keterampilan perawat dalam edukasi pencegahan risiko perilaku kekerasan remaja dengan hasil uji validitas untuk pengetahuan dan sikap (0,98), efikasi diri (1,00) dan keterampilan 0,96 yang artinya instrumen sangat valid serta nilai reliabilitas pengetahuan (0,97), sikap (0,824), efikasi diri (0,873) dan keterampilan (0,9) yang artinya instrumen memiliki reliabilitas sangat baik.  Terdapat perbedaan pengetahuan, sikap, efikasi diri, dan keterampilan perawat yang signifikan dan bermakna secara statistik pada kelompok intervensi dan kelompok kontrol dengan nilai p= 0,000 dan nilai Effect Size Cohen's d >1 mengindikasikan pelatihan Kepolar memiliki dampak yang besar terhadap peningkatan pengetahuan, sikap, efikasi diri dan keterampilan perawat.
Kesimpulan : Model pelatihan Kepolar berpengaruh pada peningkatan pengetahuan, sikap, efikasi diri dan keterampilan perawat terhadap pencegahan risiko perilaku kekerasan remaja

Background: The annual increase in cases of violent behavior among adolescents has not been matched by intervention approaches targeting adolescents as perpetrators of violence and their immediate social networks. Efforts to address this issue have focused more on victims of violence than on perpetrators, resulting in interventions that tend to be oriented toward curative and rehabilitative health services rather than promotive and preventive ones. However, without efforts to identify risk and protective factors early on and prevent the occurrence of violent behavior among adolescents, the cycle of violence will continue, with victims becoming perpetrators. Therefore, research that develops a comprehensive intervention model for adolescents through the empowerment and capacity building of health workers particularly community health center nurses in primary care and community settings is an urgent need to effectively and sustainably reduce the prevalence of adolescent violence.
Purpose: The purpose of this study is to develop a training model and instruments on the prevention of violent behavior among adolescents for community health center nurses.
Methods: This study employs a mixed-methods research design with an exploratory sequential approach. The first stage was qualitative research that explored risk factors, protective factors, and efforts to prevent violent behavior among adolescents. Participants in the first stage included 55 informants: 15 nurses who participated in focus group discussions, and 40 others including adolescents, parents, teachers, community health center directors, school principals, and the mental health program coordinator at the Palembang Municipal Health Office who were interviewed in depth. Content analysis was used for the qualitative analysis. The second phase of the study involved the development of a model and training instruments based on a synthesis of the results from the first phase, a literature review, expert input, and pilot testing of the modules and instruments. The third phase was a quantitative study using a nonequivalent (pre-test and post-test) control group design. The sample in this study consisted of 82 community health center nurses who met the inclusion criteria, comprising 40 respondents in the intervention group who received five days of Kepolar training and 42 respondents in the control group who received one day of education on preventing the risk of adolescent violent behavior. Bivariate data analysis was performed using the independent t-test and the Mann-Whitney U test.
Results: Twelve themes were identified: personal issues among adolescents, in effective family functioning, negative friendship environment, limited participation by the school, nurses’ inability to provide nursing interventions, personal resilience, family support, peer support groups, school support, social support, efforts toward comprehensive care, and efforts to implement training strategies. Four training modules on skills for preventing adolescent violent behavior (Kepolar) were developed for nurses, adolescents, parents, teachers, and school officials, with validity test results ranging from 0.875 to 1.00, which is considered highly valid. Four assessment instruments were also developed: knowledge, attitudes, self-efficacy, and skills of nurses in education for the prevention of adolescent violent behavior. The validity coefficients were 0.98 for the knowledge and attitude instruments, 1.00 for self-efficacy, and 0.96 for skills, indicating that the instruments are highly valid. Additionally, the reliability coefficients were 0.97 for knowledge, attitudes (0.824), self-efficacy (0.873), and skills (0.9), indicating that the instruments have very good reliability. There were statistically significant differences in nurses’ knowledge, attitudes, self-efficacy, and skills between the intervention and control groups, with a p-value of 0.000 and a Cohen’s d effect size >1, indicating that the Kepolar training had a large impact on improving nurses’ knowledge, attitudes, self-efficacy, and skills.
Conclusions: The Kepolar training model has an impact on improving nurses’ knowledge, attitudes, self-efficacy, and skills regarding the prevention of violent behavior among adolescents.

Kata Kunci : Pelatihan, perawat, perilaku kekerasan, remaja, pengetahuan, sikap, efikasi diri, keterampilan/Training, nurses, violent behavior, adolescents, knowledge, attitudes, self-efficacy, skills