Perilaku petugas terhadap penanganan kejadian pasien tuberkulosis paru mangkir di Kabupaten Aceh Utara Nanggroe Aceh Darussalam

SURYADI, dr. Lutfan Lazuardi, M.Kes, Ph.D

2009 | Tesis | S2 Magister Perilaku Promosi Kesehatan

Latar Belakang :Tuberkulosis (TB) adalah merupakan penyakit menular yang dapat menyebabkan kematian, sehingga semua pasien penyakit TB paru harus diobati sampai sembuh. Hanya dengan pengobatan yang sempurna, penyakit ini dapat disembuhkan dan angka kematian dapat diturunkan. Pasien TB di Provinsi NAD tahun 2007 tercatat 3.424 orang Kabupaten Aceh Utara tahun 2007 terdapat 183 kasus pasien TB paru, 107 orang pasien TB paru BTA positif dan 76 orang pasien TB paru BTA negatif. Pengobatan pasien TB di Kabupaten Aceh Utara masih terkendala dengan banyaknya terjadi kasus pasien TB paru mangkir yaitu mencapai 33 orang (18%) dan pasien drop out sebanyak 17 orang (9,2%). Tujuan Penelitian: Mengetahui tentang perilaku petugas TB terhadap penanganan kejadian pasien TB paru mangkir di Kabupaten Aceh Utara. Metode : Penelitian ini adalah menggunakan metode penelitian kuantitatif dan kualitatif dengan rancangan cross sectional. Populasi yaitu 33 orang petugas TB puskesmas dan 1 orang wasor dari Dinas Kesehatan Kabupaten. Sampel adalah total populasi. Instrumen penelitian ini adalah kuesioner berupa pertanyaan yang dirancang oleh peneliti dan di modifikasi dari kuesioner orang lain. Analisa data dengan menggunakan analisis univariat, bivariat dan multivariat dengan menggunakan uji statistik chi-square. Hasil penelitian: Hasil analisis bivariat menunjukkan karakteristik petugas TB tidak ada hubungan secara signifikan (p>0,05), pengetahuan petugas TB berhubungan secara signifikan (p=0,027), supervisi berhubungan secara signifikan (p=0,006) dan Insentif petugas TB berhubungan secara signifikan (p=0,000) terhadap perilaku petugas TB dalam penanganan kasus pasien TB paru mangkir. Hasil analisis multivariat menunjukkan bahwa pengetahuan, supervisi dan insentif petugas tidak berhubungan secara signifikan terhadap perilaku petugas TB, diantara variabel tersebut supervisi mempunyai kontribusi yang paling tinggi terhadap perilaku petugas TB di puskesmas. Kesimpulan: Faktor yang dapat mempengaruhi perilaku petugas TB yaitu pengetahuan, supervisi dan insentif, dimana supervisi mempunyai kontribusi yang tinggi terhadap perilaku petugas terhadap penanganan mangkir. Saran yaitu perlu ditingkatkan pelatihan pada petugas TB, supervisi harus dijalankan sesuai program, insentif yang sesuai dan perlu dukungan pemerintah daerah dalam program pemberantasan TB di masyarakat

Background: Tuberculosis (TB) is a communicable disease and can cause death. Therefore, TB patients must totally be treated and cured in order to reduce the rate of mortality. In NAD Province, TB patients reached 3.424 patients in 2007. Meanwhile, in Aceh Utara District there were 183 cases of TB in 2007, comprising 107 BTA (+) and 76 BTA (-) patients. The treatment for TB patients in Aceh Utara District still faces some obstacles, among others, cases of missing and dropout patients in their treatment that were 33 (18%) patients and 17 (9.2%) patients, respectively. Objective: To study the behavior of the TB attendants toward the handling of TB patients that missed in the treatment in Aceh Utara District. Method: This study used a method of quantitative and qualitative study with a cross sectional study design. The population was 33 attendants who took care of TB patients in community health center and 1 wasor (supervisor representative) from District Health Office. Sample was the total population. The instrument employed questionnaire in forms of questions designed by the researcher modified from someone else’s questionnaire. Data were analyzed with univariate analysis, bivariate analysis, and multivariate analysis using Chi-Square test. Results: The findings from bivariate analysis showed that the characteristics of TB attendants (p>0.05) did not have a significant relationship to attendants’ behavior in taking care of missing TB patients. Meanwhile, TB attendants’ knowledge (p=0.027), supervision (p=0.006) and incentive (p=0.000) were significantly related to attendants’ behavior in taking care of missing TB patients. Multivariate analysis result showed that knowledge, supervision and attendants’ incentive were insignificantly related to the TB attendants’ behavior. However, supervision was the variable that had a high contribution toward the TB attendants’ behavior in handling of missing TB patients with health center. Conclusion: Factors that affected the TB attendants’ behavior were knowledge, supervision and incentive in which supervision posed a high contribution toward the TB attendants’ behavior in handling of missing TB patients. Therefore, the recommendations are that training for attendants should be improved, supervision should be implemented in line with the programs, the incentive should be increased, and the local government should fully support the programs of TB eradication in community.

Kata Kunci : Perilaku petugas,Penanganan pasien,TB paru mangkir,Attendants’ behavior toward the management of missing TB patients