EVALUASII KUALIITAS PEMERIIKSAAN SKRIINIING IIVA ((IINSPEKSII VIISUAL ASAM ASETAT)) BAGII PETUGAS YANG TELAH MENDAPATKAN PELATIIHAN KHUSUS DAN YANG BELUM DII PUSKESMAS KOTA KEDIRI TAHUN 2010

Sismiati, SST, Prof. dr. M. Hakimi, SpOG(K), Ph.D.

2011 | Tesis | S2 Kesehatan Masyarakat/KIA

Latar Belakang: Petugas terlatih dalam skrining IVA di kota Kediri sangat terbatas, dalam membantu kelancaran skrining diperlukan petugas yang lebih banyak. Untuk itu dilakukan on the job training bagi bidan, dokter dan perawat dalam membantu skrining IVA. Ketrampilan petugas dalam konseling dan pemeriksaan klinis IVA akan memberikan kepuasan sehingga proses pemeriksaan menjadi lancar, kelainan IVA positif atau lesi pra kanker dan kanker invasive lebih mudah ditemukan. Tujuan Penelitian: Mengevaluasi kualitas pemeriksaan IVA bagi petugas yang telah dilatih dan belum dilatih khusus (on the job training) Metoda Penelitian: Jenis penelitian observasional dengan rancangan studi potong lintang (cross sectional study). Populasi: Dokter, perawat, dan bidan. Tempat penelitian di 9 (Sembilan) Puskesmas kota Kediri. Pengumpulan data primer untuk menilai langsung kualitas petugas pada saat pemeriksaan. Analisa data menggunakan deskriptif untuk univariat, bivariat dan multivariate. uji statistik menggunakan chi-squre Hasil penelitian: Analisis Binomial Regresi setelah dikontrol variabel lama bekerja dan kelengkapan sarana nilai RP=1,6 (95% CI=1,17-2,23) berarti petugas yang dilatih memiliki peluang sebesar 1,6 kali lebih baik kualitasnya dibandingkan petugas yang belum dilatih. Pada nilai R 2 didapatkan 0,10 berarti petugas yang telah dilatih memberikan kontribusi sebesar 10 % terhadap kualitas pemeriksaan. Wawancara mendalam faktor yang mempengaruhi kualitas pemeriksaan: ketrampilan petugas, sarana, sikap dan pengalaman petugas. Kesimpulan: Hasil evaluasi kualitas pemeriksaan IVA yang sesuai dengan standar ada hubungan yang signifikan dengan kompetensi petugas terlatih, lama bekerja dan kelengkapan sarana.

Background: The number of officers trained in VIA screening in Kediri Municipaly is very limited. To facilitate the screening, more officers are required. Therefore, on-the-job training was conducted for midwives, physicians, and nurses in assisting VIA screening. The skill of the officers in counseling and clinical screening of VIA contributes to the clients’ satisfaction. This accelerates the examination process and makes the identification of positive VIA abnormalities, pre-cancerous lesions, and invasive cancerous lesions easier. Objective: To evaluate the quality of VIA screening among the officers with and without special training (on the job training) Method: An observational study with cross sectional design had been conducted. Populations of the study were physicians, nurses, and midwives. The study was conducted in 9 (nine) health centers in Kediri Municipaly. Primary data were collected to assess the quality of the officers directly during the screening. Data were analyzed in descriptive way for univariate, bivariate, and multivariate analyses. The data were statistically analyzed using chi square test. Results: Logistic Binomial regression analysis after controlling for tenure and facility support RP=1,6 (95% CI=1,17-2,23), implying that the officers with special training had a quality of 1,6 higher than the officers without special training,. R 2 value was 0.10; it means that trained officers gave 10% of contribution to the screening quality. In-depth interview was conducted to explore the factors that contribute to the screening quality, officers’ expertise, facilities, attitudes, and experience. Conclusion: The results of evaluation on VIA screening based on the standards are significantly correlated with train among the officers, tenure, and facility support.

Kata Kunci : Evaluasi, Kualitas pemeriksaan IVA.