Perilaku klinis tenaga kesehatan terhadap penatalaksanaan malaria di RSU Gunungsitoli, Kabupaten Nias

MARUHAWA, Contesa Prihatin Familynard, dr. Adi Utarini, M.Sc.,MPH.,Ph.D

2007 | Tesis | S2 Ilmu Kesehatan Masyarakat (Manaj. Rumah Sakit)-

Latar belakang: Berdasarkan data Dinkes Nias tahun 2005 diketahui bahwa penyakit malaria menempati urutan pertama sepuluh penyakit terbanyak yaitu 23.237 kasus (34,45%) dan data RSU Gunungsitoli sebanyak 1189 kasus (tahun 2005). Sedangkan RSU Gunungsitoli memiliki tenaga kesehatan dan fasilitas kesehatan yang cukup mendukung dalam pemeriksaan darah malaria. Tujuan: Mengeksplorasi perilaku klinis tenaga kesehatan dalam penatalaksanaan malaria dan mendiskripsikan faktor-faktor yang mempengaruhi perilaku klinis tenaga kesehatan. Metode: Jenis penelitian ini adalah deskriptif kualitatif. Subjek penelitian berjumlah 12 orang tenaga kesehatan di RSU Gunungsitoli. Variabel penelitian terdiri dari perilaku klinis tenaga kesehatan, faktor predisposing, enabling, dan reinforcing. Pengumpulan data dilakukan dengan cara observasi dan wawancara mendalam dengan 3 dokter umum, 2 dokter spesialis (penyakit dalam dan anak) dan petugas laboratorium serta diskusi kelompok terfokus dengan para perawat. Analisis data menggunakan content analysis. Hasil: Penanganan penderita malaria di RSU Gunungsitoli yang hanya berdasarkan pengalaman petugas kesehatan, menyebabkan adanya variasi pengobatan dan penegakkan diagnosis malaria secara klinis, yang disebabkan karena adanya ketidakpercayaan terhadap hasil pemeriksaan laboratorium. Selain itu, tidak adanya pelatihan yang pernah diikuti, SOP penatalaksanaan malaria dan penghargaan dari pihak RS menyebabkan tenaga kesehatan dalam menangani penderita malaria hanya berdasarkan pada pengalaman. Kesimpulan: Perilaku klinis tenaga kesehatan kurang mendukung dalam penatalaksanaan dan penanganan malaria di RSU Gunungsitoli.

Background: Clinical malaria is major disease in Nias. Based on data of Nias Health Office at 2005 there are 23,237 case (34.45%). Furthermore, there are 1189 case notified by Gunungsitoli Hospital. Although Gunungsitoli Hospital has sufficient health staffs and facilities which support examination of malaria blood. Objective: To explore clinical behavior of health staffs toward malaria and to identify factors affecting their clinical behavior. Method: This was a qualitative study. The subjects were twelve health staffs of Gunungsitoli Hospital. The variables were clinical behavior, comprising predisposing, enabling and reinforcing factors. Data were obtained through observation and indepth interview with three general practitioners, two specialist doctors (internist and paediatrician) and laboratory staffs in addiction focus group discussion with the nurses, also carried out . Data were analysed using content analysis. Result: Not all health staffs of Gunungsitoli Hospital complied with malaria standard operating procedure. It was reflected from various practices diagnostic and treatment of malaria. It was related to distrust against the laboratory result. Hospital staffs did not receive any training, as well as having standard operating procedure for malaria and reward from the hospital. Basically, they managed malaria based on their own experience. Conclusion: Clinical behavior of health staffs does not support the standard operating procedure and treatment of malaria at Gunungsitoli Hospital.

Kata Kunci : Tenaga Kesehatan,Perilaku Klinis,Standar Operating Prosedur,Malaria, Malaria, clinical behavior, standard operating procedure, predisposing factor, enabling factor, reinforcing factor