Analisis Faktor-faktor Yang Mempengaruhi Kepatuhan Penderita TB Paru Menggunakan Obat Anti Tuberkulosis di Kota Bukittinggi
NURDIN, Prof. dr. Hari Kusnanto, DrPH
2008 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang: WHO telah merekomendasikan strategi baru yaitu DOTS (Direcly Obseved Treatment Shourtcourse), Sejalan dengan kebijakan pemerintah pusat tersebut, sejak tahun 1995 Dinas Kesehatan Kota Bukittinggi telah melaksanakan program ini. Rekapitulasi laporan kegiatan program TB tahun 2007, terdapat sebanyak 103 kasus, dengan prevalensi 101,7 per 100.000 penduduk, meninggal sebanyak 5 orang (4,95%). kambuh 1 orang (0,99%) dan angka konversi triwulan III (82,7%). Dilakukan penelitian untuk mengetahui faktor-faktor yang mempengaruhi kepatuhan penderita TB Paru dalam menggunakan Obat Anti Tuberkulosis dihubungkan dengan pengetahuan penderita, self efficacy, peran petugas menurut penderita, keaktifan PMO dan efek samping obat. Metode: Penelitian ini merupakan penelitian survei dengan rancangan “cross sectionalâ€, menggunakan metode kuantitatif. Populasi dan sampel adalah penderita TB yang menjalani pengobatan TB di puskesmas (total sampling) dan rumah sakit (purposive sampling), total sampel 118 orang. Variabel dalam penelitian ini adalah faktor-faktor yang berhubungan dengan kepatuhan penderita TB menggunakan OAT, yaitu tingkat pengetahuan, peran petugas menurut penderita, self efficacy, keaktifan PMO dan efek samping obat menurut responden. Analisis data yang digunakan analisis deskriptif, bivariat dengan uji statistik dan analisis regresi. Hasil: Proporsi responden yang patuh menggunakan obat lebih banyak pada tingkat pengetahuan kategori rendah (88,4%), peran petugas kategori baik (74,4%), self efficacy kategori tinggi (89,7%), PMO kategori aktif (88,7%) dan responden kategori tidak ada keluhan (92,3%). OR yang paling besar diantara variabel indevenden adalah OR peran petugas = 20,58. dan paling kecil adalah OR efek samping obat = 0,06. Hasil analisis uji statistik diketahui yang berpengaruh paling besar terhadap self efficacy adalah peran petugas (β=0,235), disusul dengan efek sampig obat (β=-0,135). Yang paling berpengaruh terhadap kepatuhan menggunakan OAT adalah peran petugas (β=0,440), efek samping obat (β=-0,197) dan self efficacy (β=0,146). Kesimpulan: Hasil analisis uji statistik, faktor-faktor yang paling berpengaruh terhadap kepatuhan menggunakan obat TB adalah peran petugas, efek samping obat dan self efficacy.
Background: WHO has recommended a new strategy that is DOTS (Directly Observed Treatment Shortcourse), along with the policy of central government since the year of 1995, and indeed, municipality health office of Bukittinggi has implemented this program. The recapitulation of TB program activity report in the year of 2007 indicated 103 cases prevalence of 101,7 per 100.000 people, fatalities were 5 people (4,95%), relapsed was 1 person (0,99%) and the conversion rate was 82,7%. This research was conducted to identify factors that influenced the compliance of pulmonary TB patient in taking anti tuberculosis drugs, namely patient’s knowledge, Self efficacy, officer’s role according to patient, PMO’s effort and side effects of drugs. Method: This was a survey research that used cross sectional design and quantitative method. The population and the sample were TB patients who undertake TB treatment in Primary Health Care (total sampling) and hospital (purposive sampling), and the total sample was 118 people. Variable in this research were factors that had correlation with compliance of TB patient in using OAT that is level of knowledge, the role of public health personnel according to patient, self efficacy, PMO’s effort and side effect of drugs according to respondent. Data analysis being used was descriptive analysis, bivariat statistics and regression analysis. Result: The proportion of respondents who complied to consuming drugs was more in those with low category of knowledge level (88,4%), officer’s role in good category (74,4%), self efficacy in high category (89,7%), PMO in active category (88,7%) and respondent in the category without side effects (92,3%). The biggest OR between independent variable was OR of officer’s role = 20,58 and the smallest was OR of drugs side effect = 0,06. The analysis suggested that the biggest influence toward self efficacy was officer’s role (β=0,235), and followed by drugs’s side effect (β=-0,135). The most influential factors toward compliance in using OAT was officer’s role (β=-0,197) and self efficacy (β=0,146). Conclusion: The analysis result of statistics test showed that the most influential factors toward compliance in using TB drugs were officer’s role, side effect of drugs and self efficacy.
Kata Kunci : Kepatuhan Penderita Tuberkulosis Paru,PMO,Self Efficacy,Peran Petugas,Efek Samping Obat, the compliance of TB patient, knowledge, officer’s role, self efficacy, PMO and side effects of OAT
