PENGEMBANGAN INSTRUMEN CARING PELAYANAN KEPERAWATAN GAWAT DARURAT RUMAH SAKIT

JEBUL SUROSO, Prof. dr. Sri Suparyati Soenarto, Sp.A (K)., Ph.D.; Dra. Yayi Suryo Prabandari, M.Si., Ph.D.; Dr. Fitri Haryanti, S.Kp, M.Kes

2016 | Disertasi | S3 Ilmu Kedokteran

Latar belakang: Caring merupakan inti dari praktik keperawatan yang pada pelaksanaannya sesuai dengan karakteristik area pelayanan, dan tidak terbatas hanya pada aspek perilaku. Instrumen yang ada saat ini belum spesifik mengukur caring pelayanan keperawatan instalasi gawat darurat (IGD)rumah sakit, dan masih terbatas pada aspek perilaku, belum komprehensif memasukan aspek lingkungan dan administrasi sesuai dengan kebutuhan pasien. Tujuan: Untuk menghasilkan instrumen caring pelayanan keperawatan IGD yang komprehensif, valid dan reliabel berdasarkan kebutuhan pasien. Metode: Kualitatif dan kuantitatif dengan tiga tahap penelitian, meliputi; 1)mengeksplorasi kebutuhan caring pasien IGD, 2) menyusun instrumen caring pelayanan keperawatan IGD berdasarkan kebutuhan pasien, dan 3)menguji coba instrumen. Penelitian melibatkan responden yang terdiri dari; 32 orang pakar keperawatan dalam expert judgment, dan pasien IGD dari tiga RSUD di wilayah Banyumas yang diambil dengan teknik purposive sampling, terdiri dari; 50 pasien pada tahap eksplorasi kebutuhan caring, 30 pasien pada pengujian awal, dan 300 pasien pada pengujian akhir. Analisis data kualitatif menggunakan content analysis dengan formula Aiken v, uji diskriminasi item dengan Pearson product moment, reliabilitas dengan cronbach alpha, dan validitas konstruk dengan confirmatory factor analysis. Hasil: Pada eksplorasi kebutuhan caring diperoleh tiga konstruk, yaitu; perilaku, lingkungan dan administrasi, serta sepuluh indikator caring, yang menjadi dasar disusunnya instrumen caring pelayanan IGD berjumlah 46 item pernyataan. Hasil uji coba instrumen diperoleh hasil; content validity index 0,55-0,93, dengan ratarata 0,79; daya diskriminasi item diperoleh r hitung 0,510-0,755; reliabilitas instrumen adalah 0,968; dan contruct validity dengan loading factor semua konstruk caring > 0,50, yaitu: perilaku (0,59-0,83); lingkungan (0,73-0,82); dan administrasi (0,76-0,86). Hasil uji validitas konstruk relevan dengan uji t, yang menunjukkan nilai t hitung > 2, artinya semua konstruk mampu menjelaskan dan mendukung model instrumen caring pelayanan IGD. Kesimpulan: Penelitian ini telah menghasilkan instrumen yang valid dan reliabel untuk mengukur caring pelayanan IGD rumah sakit secara spesifik dan komprehensif berdasarkan kebutuhan pasien. Instrumen ini disarankan dapat digunakan untuk mengukur caring pelayanan keperawatan IGD rumah sakit, khususnya di wilayah Banyumas dan rumah sakit lain yang setara di Indonesia.

Research Background: Caring is a core of nursing practice which is in its implementation; it is in accordance with characteristics of service area, and it is not only limited in behavior aspect. Recently, the available instruments are not specific yet to measure caring of nursing service at emergency department in hospitals; it is also limited in behavior aspect and comprehensively it does not include environment aspect and administration based on patients needs. Research Objective: It was aimed to result comprehensive, valid, and reliable caring instruments of nursing service at emergency department in hospitals based on the patients needs. Research Method: It was a qualitative and quantitative research including three phases:1)Exploring caring needs of patients in emergency department, 2) Arranging caring instruments of nursing service at emergency department based on patients needs, and 3) testing the instruments. This research involved respondents. They were: 32 nursing experts on expert judgment, and the patients at emergency department from three Regional Public Hospitals in Banyumas regency whom the researcher took using purposive sampling consisting of 50 patients in phase of caring needs exploration, 30 patients in preliminary test, and 300 patients in the final test. The analysis of qualitative used was content analysis with Aiken v formula, test of discrimination with Pearson Product Moment, reliability test with cronbach alpha, validity construct with confirmatory factor analysis. Research Result: In exploring patients caring needs, the researcher got three constructs; behavior, environment, and administration as well as ten caring indicators becoming the base in arranging caring instruments of emergency department nursing service, it was 46 items of statements. The result of instrument testing was; content validity index 0.55-0.93 with its average 0.79; form discrimination item, it was r count 0.510-0.755; instrument of reliability was 0.968; and construct validity with loading factor of all caring construct > 0.50 was: behavior (0.59-0.83); environment (0.73-0.82); and administration (0.760.86). The result of construct validity test was relevant with t test showing t count > 2, it meant all of constructs were able to explain and support caring instrument model of emergency department service. Conclusion: This research results valid and reliable instrument for measuring caring service at emergency department in hospitals specifically and comprehensively based on the patients need. It is recommended to use the instrument in hospitals, especially in Banyumas regions and other equal hospitals in Indonesia.

Kata Kunci : caring instrument, nursing service at emergency department, hospital