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"[Perempuan di wilayah perkotaan beresiko tinggi terkena HIV. Ibu hamil dengan HIV beresiko menularkan HIV kepada bayinya. Perawat maternitas berperan dalam memberikan asuhan keperawatan kepada ibu dengan HIV dalam mencegah penularan tersebut. Tujuan penulisan ini menggambarkan asuhan keperawatan pada ibu dengan HIV pada periode perinatal. Tujuan utama intervensi yang dilakukan adalah untuk pencegahan penularan kepada bayi diantaranya dengan memberikan pendidikan kesehatan tentang resiko pemberian ASI dan pentingnya minum obat ARV secara teratur. Intervensi khusus yang dilakukan untuk mengatasi masalah ketidakefektifan koping individu yaitu dengan memberikan dukungan sosial. Evaluasi menunjukkan bahwa dukungan sosial yang dilakukan masih perlu terus diberikan kepada pasien dan keluarganya untuk mengatasi masalah psikososial ketidakefektifan koping individu terkait HIV;Women living in urban area are at higher risk of HIV infection. Pregnant women with HIV are risked to transmit HIV to their babies. A maternity nurse acts as a care provider to give a nursing intervention to pregnant women with HIV in order to prevent the transmission. This study aimed to describe maternity nursing intervention for mother with HIV on perinatal pregnancy. The main goal of nursing interventions given to the mother was to prevent mother to child HIV transmission by giving health education about the risk of breastfeeding and the important of taking ARV regularly as prescribed. A distinctive intervention to overcome ineffective individual coping strategy accomplished by giving social support. The result showed that social support still needs to be done given to patients and their families to overcome the ineffective individual coping psychosocial problems related to HIV., Women living in urban area are at higher risk of HIV infection. Pregnant women with HIV are risked to transmit HIV to their babies. A maternity nurse acts as a care provider to give a nursing intervention to pregnant women with HIV in order to prevent the transmission. This study aimed to describe maternity nursing intervention for mother with HIV on perinatal pregnancy. The main goal of nursing interventions given to the mother was to prevent mother to child HIV transmission by giving health education about the risk of breastfeeding and the important of taking ARV regularly as prescribed. A distinctive intervention to overcome ineffective individual coping strategy accomplished by giving social support. The result showed that social support still needs to be done given to patients and their families to overcome the ineffective individual coping psychosocial problems related to HIV.]"

"Tujuan utama masyarakat tinggal diperkotaan adalah untuk mencari pekerjaan yang lebih layak untuk memenuhi kebutuhan hidup. Perempuan yang bekerja shift sekaligus menjalani kehamilan, akan berisiko tinggi terhadap kehamilannya. Karya ilmiah ini bertujuan untuk memberikan gambaran asuhan keperawatan kehamilan dengan plasenta previa pada perempuan bekerja shift. Berbagai masalah keperawatan yang ditemukan pada Ny. A selama periode antenatal adalah risiko perdarahan, ansietas, deprivasi tidur, dan kesiapan kemampuan memiliki anak sedangkan selama periode postnatal adalah nyeri, keterlambatan pemulihan pasca bedah, konstipasi serta ketidakefektifan pemberian ASI. Masalah keperawatan selama periode antenatal dapat teratasi seluruhnya dengan memberikan implementasi keperawatan yang sesuai. Sedangkan masalah keperawatan selama periode postnatal belum dapat teratasi seluruhnya selama perawatan di rumah sakit, maka dilanjutkan dengan kunjungan rumah untuk memberikan perawatan langsung dan pendidikan kesehatan. Kontrol kehamilan selama periode antenatal adalah hal yang sangat penting bagi ibu bekerja untuk mengetahui pengaruh lingkungan kerja terhadap kehamilannya.

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The main purpose for the people that living in urban was looking for a better job to make a better life. Women who work shifts at once through pregnancy, will be at high risk of pregnancy. This paper had purposed to provide an overview of nursing care pregnancy with placenta previa in women working shift. Various nursing problems found in Ny. A during the antenatal period is a risk of bleeding, anxiety, sleep deprivation, and readiness for enhanced childbearing process while during the postnatal period is acute pain, delay post-surgical recovery, constipation and ineffective of breastfeeding. Nursing problems during the antenatal period can be resolved entirely by providing appropriate nursing implementations. While nursing problems during the postnatal period can not be fully resolved during hospitalization, then continued with home visits to provide direct care and health education. Control of pregnancy during the antenatal period is very important for working mothers to determine the effect of work environment on pregnancy."

"Tidur merupakan salah satu kebutuhan dasar manusia yang seharusnya dipenuhi secara kuantitas dan kualitas. Kehamilan menjadi salah satu faktor predisposisi individu mengalami masalah tidur karena adanya perubahan fisik dan fisiologis. Faktor tempat tinggal seperti di wilayah perkotaan juga dapat menjadi pemicu munculnya masalah tidur. Salah satu masalah keperawatan yang dapat muncul yaitu insomnia. Penatalaksanaan masalah tidur dapat dilakukan secara farmakologi dan nonfarmakologi. Adanya efek samping obat yang ditimbulkan bagi kehamilan menyebabkan penatalaksanaan nonfarmakologi lebih diutamakan pada ibu hamil. Karya tulis ilmiah ini bertujuan untuk menganalisis intervensi sleep hygiene dan relaksasi otot progresif untuk meningkatkan kualitas tidur pasien ibu A. Karya tulis ilmiah ini menggunakan metode studi kasus dengan melakukan intervensi selama satu minggu. Intervensi diberikan dengan melakukan edukasi, demonstrasi, serta evaluasi dari pelaksanaan intervensi oleh pasien. Hasil intervensi menunjukan terjadi peningkatan kualitas tidur yang ditunjukan dengan penurunan nilai PSQI 10 menjadi 7 dari total nilai 21. Sleep hygiene dan relaksasi otot progresif yang dilakukan secara teratur dapat menciptakan kebiasaan jam tidur, meningkatkan kenyamanan, dan menginduksi tidur sehingga pola tidur menjadi lebih teratur.

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Sleep is one of the basic human need that should be meet in quantity and quality. Pregnancy become one of the predisposing factors of individuals experiencing sleep problems due to physical and physiological changes. Another factor such as residence in urban area also can be a trigger of sleep problems. One of the nursing diagnoses that can arise is insomnia. Sleep problems can be done with pharmacological and nonpharmacological management. Nonpharmacological management is preffered for pregnant women because of the side effects of drug in pregnancy.

This scientific paper aims to analyze the intervention of sleep hygiene and progressive muscular relaxation PMR to improve sleep quality in Mrs. A. This scientific paper use case study method with one week intervention. Implementation in done by providing education, demonstration, and evaluation of the intervention that performed by the patient during one week.

The result of intervention showed an increase in sleep quality that indicated by a decrease in PSQI value from 10 become 7 with total value is 21. Sleep hygiene and PMR that performed regularly can create sleep habits, improve comfort, and induce sleep so that sleep patterns become more regular."

"Latar Belakang : Pandemi COVID-19 merupakan sebuah kejadian dengan dampak luar biasa terutama pada populasi berisiko seperti ibu hamil. Indonesia sebagai salah satu negara dengan jumlah pasien COVID-19 tertinggi di dunia memiliki banyak kasus kehamilan dengan luaran maternal dan perinatal yang buruk akibat infeksi COVID-19. Namun, hingga saat ini belum terdapat studi yang secara komprehensif menilai faktor klinis dan non-klinis yang berpengaruh terhadap luaran buruk pada pasien hamil dengan COVID-19. Tujuan : Mengetahui faktor klinis dan non-klinis yang berhubungan dengan luaran buruk maternal dan perinatal pada ibu hamil dengan COVID-19. Metode : Penelitian kohort retrospektif dilakukan pada perempuan hamil yang terinfeksi COVID-19 yang dirawat Rumah Sakit Pusat Angkatan Darat (RSPAD) Gatot Soebroto selama periode Januari 2021 - April 2022. Pasien dengan data tidak lengkap dieksklusi dari penelitian. Faktor klinis yang dinilai adalah usia maternal, usia gestasi, beratnya gejala COVID-19 saat admisi, status obstetrik, status vaksinasi COVID-19, lama rawat instalasi gawat darurat, lama rawat inap biasa, lama rawat inap intensif, dan komorbiditas. Fakotr non-klinis yang dinilai adalah lama waktu sejak gejala hingga datang ke fasilitas pelayanan kesehatan, keengganan datang ke fasilitas pelayanan kesehatan, tingkat pendapatan, dan tingkat pendidikan. Hasil : Didapatkan sebanyak 79 subjek penelitian yang diikutsertakan dalam penelitian. Sebanyak 9 subjek mengalami luaran buruk berupa kematian ibu (n = 1), janin meninggal (n = 5), dan gejala COVID-19 berat (n = 6). Faktor klinis yang berpengaruh terhadap luaran yang buruk adalah usia maternal yang lebih tua, usia gestasi yang lebih muda, gejala COVID-19 yang lebih berat, serta durasi perawatan di instalasi perawatan intensif yang lebih lama (p < 0,05). Faktor non-klinis yang berpengaruh terhadap luaran yang buruk adalah lama gejala awal yang lebih lama, keberadaan kendala mencari pertolongan, dan pendapatan yang lebih rendah (p < 0,05). Kesimpulan : Luaran maternal dan perinatal yang lebih buruk pada kehamilan dengan COVID-19 terjadi akibat interaksi dari faktor klinis dan non-klinis. Diperlukan edukasi terhadap klinisi maupun masyarakat guna meningkatkan luaran pada kehamilan dengan COVID-19. Kata Kunci : COVID-19, infeksi, kehamilan, maternal, perinatal.

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Background: The COVID-19 pandemic is an event with a tremendous impact, especially on higher risk populations such as pregnant women. Indonesia as one of the countries with the highest number of COVID-19 patients in the world has many cases of pregnancy with adverse maternal and perinatal outcomes due to COVID-19 infection. However, there have been no studies that have comprehensively assessed clinical and non-clinical factors that influence adverse outcomes in pregnant patients with COVID-19.

Objective: To determine clinical and non-clinical factors associated with adverse maternal and perinatal outcomes in pregnant women with COVID-19.

Methods: A retrospective cohort study was conducted on pregnant women infected with COVID-19 who were treated at the Gatot Soebroto Army Central Hospital (RSPAD) during the period January 2021 - April 2022. Patients with incomplete data were excluded from the study. The clinical factors assessed were maternal age, gestational age, severity of COVID-19 symptoms upon admission, obstetric status, COVID-19 vaccination status, length of stay in the emergency department, length of regular hospitalization, length of intensive hospitalization, and comorbidity. The non- clinical factors assessed were the length of time from symptoms to arrival to health care facilities, reluctance to come to health care facilities, income level, and education level.

Results: There were 79 research subjects who were included in the study. A total of 9 subjects experienced adverse outcomes in the form of maternal death (n = 1), fetal death (n = 5), and severe COVID-19 symptoms (n = 6). Clinical factors that influenced poor outcomes were older maternal age, younger gestational age, more severe COVID-19 symptoms, and longer duration of treatment in intensive care (p < 0.05). The non- clinical factors that influenced the poor outcome were a longer duration of initial symptoms, the presence of obstacles in seeking help, and lower income (p < 0.05).

Conclusion: The worse maternal and perinatal outcomes in pregnancies with COVID-19 occur due to the interaction of clinical and non-clinical factors. Education for clinicians and the public is needed to improve outcomes in pregnancies with COVID- 19. Keywords: COVID-19, infection, maternal, perinatal, pregnancy"

"Latar belakang:. Data tahun 2007 menunjukkan prevalensi perempuan dewasa dengan obesitas di Indonesia 13,9% dan terus mengalami peningkatan, yaitu 15,5% pada 2010 dan 32,9% pada 2013. The Royal College of Obstetricians and Gynaecologists (RCOG) mendefinisikan obesitas dalam kehamilan sebagai indeks massa tubuh (IMT) >30 kg/m2 pada kunjungan antenatal pertama. Risiko kehamilan terkait berat badan berlebih dan obesitas diantaranya adalah peningkatan risiko hipertensi dalam kehamilan (termasuk preeklampsia), tromboemboli, dan diabetes melitus gestasional. Peningkatan lama persalinan dan peningkatan risiko seksio sesaria juga diketahui terkait dengan berat badan berlebih dan obesitas. Obesitas dalam kehamilan juga meningkatan risiko janin makrosomi, kematian dalam kandungan, dan malformasi kongenital. Tujuan: a. Diketahuinya luaran maternal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. b. Diketahuinya luaran perinatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya kualitas Asuhan Antenatal pada ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM. c. Diketahuinya pandangan tenaga kesehatan terhadap ibu hamil dengan berat badan berlebih dan obesitas, d. Diketahuinya pandangan ibu hamil , serta keluarga terhadap kehamilan dengan berat badan berlebih dan obesitas Metode: Dilakukan studi kuantitatif dan kualitatif pada kasus ibu hamil dengan berat badan berlebih dan obesitas yang bersalin RSCM tahun 2015-2019. Pengambilan data kuantitatif dilakukan dengan telaah rekam medis dan kelengkapan pengisian buku KIA secara umum, dimana akan dilihat untuk luaran maternal, perinatal serta edukasi ANC yang berhubungan dengan kehamilan dengan berat badan berlebih dan obesitas. Pengambilan data kualitatif dilakukan dengan wawancara mengenai pemahaman ibu hamil dengan berat badan berlebih dan obesitas yang bersalin di RSCM dan tenaga kesehatan pemberi pelayanan asuhan antenatal di fasyankes asal asuhan antenatal serta keluarga Hasil: Terdapat 509 kasus ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM selama tahun 2015-2019, Dari 509 subjek, diketahui 189 subjek (37,1%) mengalami obesitas dan 320 subjek (62,9%) mengalami berat badan berlebih. Berdasarkan data tersebut, didapatkan insidensi obesitas dan berat badan berlebih persalinan di RSCM periode tahun 2015-2019 masing-masing sebesar 4,28% dan 2,53%.Luaran maternal ibu dengan obesitas dan berat badan berlebih yang bersalin di RSCM, ditemukan morbiditas persalinan prematur, ketuban pecah dini, dan preeklampsia, dengan jumlah masing-masing 249 (48.9%), 133 (26.1%), dan 121 (23.8%). Luaran Perinatal luaran perinatal patologis yang paling sering dijumpai adalah asfiksia, IUGR, dan IUFD, dengan jumlah masing-masing sebanyak 113 (22.2%), 46 (9.0%), 31 (6.1%). Luaran cara persalinan Mayoritas subjek melahirkan dengan cara seksio sesarea dan pervaginam, dengan jumlah masing-masing 345 (67.8%) dan 154 (30.2%) orang. Secara kualitatif, didapatkan pandangan ibu hamil dengan obesitas dan berat badan berlebih yang bersalin di RSCM dan tenaga kesehatan pemberi asuhan antenatal serta keluraga masih kurang tepat Kesimpulan: Secara kuantitatif dan kualitatif Terjadi kegagalan Identifikasi Kehamilan dengan berat badan berlebih dan obesitas pada kasus-kasus yang dirujuk ke RSCM pada saat dilakukan ANC di faskes primer
. Kata kunci: Luaran maternal dan perinatal. Pandangan Ibu hamil dengan berat badan berlebih dan obesitas, tenaga kesehatan, keluarga, Asuhan antenatal

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Background: Data shows in 2007 the prevalence of obese adult women in Indonesia is 13.9% and continues to increase, namely 15.5% in 2010 and 32.9% in 2013. The Royal College of Obstetricians and Gynecologists (RCOG) defines obesity in pregnancy as body mass index (BMI) >30 kg/m2 at the first antenatal visit. Obesity-related pregnancy risks include an increased risk of hypertension in pregnancy (including preeclampsia), thromboembolism, and gestational diabetes mellitus. Increased length of labor and increased risk of cesarean section are also known to be associated with obesity. Obesity in pregnancy also increases the risk of fetal macrosomy, stillbirth, and congenital malformations Aim: (1) To determine the maternal outcomes in overweight and obese pregnant women who give birth in RSCM. b. To determine perinatal outcomes in overweight and obese pregnant women who give birth in RSCM. c. To know the quality of Antenatal Care in pregnant women with overweight and obesity who gave birth in RSCM. c. To determine the views of health workers on pregnant women with excess weight and obesity, d. To determine the views of pregnant women, as well as their families towards overweight and obesity pregnancies Method: A set of Quantitative and qualitative studies were conducted on cases of overweight and obese pregnant women who gave birth to RSCM in 2015-2019. Quantitative data retrieval was carried out by reviewing medical records and the completeness of filling out the ANC book in general which to see for maternal, perinatal and ANC education related to pregnancy with overweight and obesity. Qualitative data was collected by deep interviewing about the understanding of pregnant women with excess weight and obesity who gave birth at the RSCM and health workers who provide antenatal care services in health facilities from antenatal care and families. Result: There were 509 cases of pregnant women with obesity and overweight who gave birth at the RSCM during 2015-2019. From 509 subjects, 189 subjects (37.1%) were obese and 320 subjects (62.9%) were overweight. Based on these data, the incidence of overweight and obesity in labor at the RSCM for the 2015-2019 period was 4.28% and 2.53%, respectively. preterm, premature rupture of membranes, and preeclampsia, with a total of 249 (48.9%), 133 (26.1%), and 121 (23.8%). Perinatal Outcomes The most common pathological perinatal outcomes were asphyxia, IUGR, and IUFD, with a total of 113 (22.2%), 46 (9.0%), 31 (6.1%). Outcomes of mode of delivery The majority of subjects gave birth by caesarean section and vaginally, with a total of 345 (67.8%) and 154 (30.2%) people, respectively. Qualitatively, it was found that the views of pregnant women with obesity and overweight who gave birth at the RSCM and health workers who provided antenatal care and their families were still inaccurate. Conclusion : Quantitatively and qualitatively there was a failure to identify pregnancies with excess weight and obesity in cases referred to the RSCM at the time of ANC at primary health facilities. Keyword: Maternal and perinatal outcomes. Views of pregnant women with excess weight and obesity, health workers, families, antenatal care"

"Praktik residensi keperawatan maternitas bertujuan untuk meningkatkan pengetahuan ketrampilan dan sikap dalam memberikan asuhan keperawatan pada masalah kesehatan perempuan sepanjang periode kehidupannya baik di rumah sakit maupun komunitas Residensi keperawatan maternitas mencapai tujuan tersebut melalui pengembangan fungsi dan peran perawat Tujuan penulisan laporan ini untuk memberikan gambaran peran spesialis keperawatan maternitas sebagai pemberi asuhan keperawatan konselor advokat edukator koordinator kolaborator komunikator agen pembaharu dan peneliti Spesialis keperawatan maternitas memberikan asuhan keperawatan dengan menggunakan model konsep dan teori keperawatan yang sesuai dengan kondisi klien Penerapan teori self care Orem sesuai untuk memandirikan ibu hamil dengan gestational diabetes mellitus dalam merawat kehamilannya Kata kunci Gestational diabetes mellitus Spesialis keperawatan maternitas Teori keperawatan Daftar Pustaka 37 1995 ndash 2011.

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Maternity nursing residency practice aims to improve knowledge skills and attitudes in providing nursing care to women 39 s health problems during the period of their life either in the hospital or community Maternity nursing residency achieves these goals through the development of nurse rsquo s function and role The purpose of this report is to provide an overview of maternity nursing specialist rsquo s role as a care provider a counselor an advocate an educator a coordinator a collaborator a communicator an innovator and a researcher Maternity nursing specialists provide nursing care with the application of nursing conceptual models and theories suitable to the client 39 s condition The application of Orem rsquo s self care nursing theory is appropriate for pregnant women with gestational diabetes mellitus to meet theirself care needs during pregnancy Keywords Gestational diabetes mellitus Maternity nursing specialist nursing theory Bibliography 37 1995 ndash 2011 "

"Angka kejadian anemia pada ibu hamil di puskesmas kecamatan Kemayoran masih tinggi walaupun cakupan ibu hamil yang mendapatkan tablet tambah darah minimal 90 butir selama hamil sudah mencapai 100%. Besarnya suplementasi zat besi juga harus disesuaikan dengan kebutuhan dan kondisi masing-masing ibu. Tidak efektifnya program pemberian TTD untuk menurunkan kejadian anemia kehamilan karena belum adanya media yang efektif untuk memberikan informasi dan edukasi tentang anemia dan TTD. Penelitian ini bertujuan mengetahui efektifitas intervensi pendidikan kesehatan melalui diagram bantu konseling anemia dan pemberian dosis terapi TTD terhadap peningkatan kadar hemoglobin ibu hamil di wilayah puskesmas kecamatan Kemayoran tahun 2019. Penelitian ini merupakan jenis penelitian quasi eksperiment dengan menggunakan desain nonequivalent control group design. Penelitian dilakukan di wilayah puskesmas kecamatan Kemayoran dari rentang waktu Maret-November 2019. Populasi dalam penelitian ini adalah semua ibu hamil di wilayah puskesmas kecamatan kemayoran dan teknik pemilihan sampel dengan cara purposive sampling. Hasil penelitian pengaruh intervensi pendidikan kesehatan melalui diagram bantu konseling anemia dan pemberian dosis terapi TTD terhadap peningkatan kadar hemoglobin ibu hamil di wilayah puskesmas kecamatan Kemayoran tahun 2019 pada analisis bivariat menggunakan uji Anova didapatkan nilai p = 0.0005, hubungan pengetahuan dan kepatuhan mengkosumsi TTD dengan Kadar Hemoglobin didapatkan r=0.288, p value=0.035; r=0.422, p value=0.001. Kesimpulan ada pengaruh intervensi pendidikan kesehatan melalui diagram bantu konseling anemia dan pemberian dosis terapi TTD terhadap peningkatan kadar hemoglobin ibu hamil di wilayah puskesmas kecamatan Kemayoran tahun 2019 (nilai p < 0.05). Semakin tinggi pengetahuan dan kepatuhan mengkonsumsi TTD maka semakin besar kadar hemoglobin.

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The incidence of anemia in pregnant women in the Kemayoran Health Centre is still high considering that pregnant women who get iron tablets of at least 90 during pregnant are reaching 100%. The amount of iron supplementation must also be adjusted to the needs and conditions of each mother. Ineffective iron supplementation delivery program for pregnant women to reduce the incidence of anaemia because there is no effective media to provide information and education about anaemia and iron supplementation.

This study aims to know the effectivity of health educational intervention through anaemia counseling helping diagram and giving iron suplement therapeutic doses to increasing haemoglobin levels for pregnant women at Kemayoran public health center area in 2019. This study uses a quasi experimental research type using the nonequivalent control group design. The study was conducted in the area of Kemayoran health center from the period March-November 2019. The population in this study were all pregnant women in the area of Kemayoran health center and sample selection techniques by purposive sampling.

The results of research on health educational intervention through anaemia counseling helping diagram and giving iron suplement therapeutic doses to increasing haemoglobin levels for pregnant women at Kemayoran public health center in 2019 on bivariate analysis using Anova test obtained p value = 0.0005, the relationship of knowledge and compliance consuming iron suplement with haemoglobin levels obtained r = 0.288, p value = 0.035; r = 0.422, p value = 0.001. Conclusion: there is influence of health educational through anaemia counseling helping diagram and giving iron suplement therapeutic doses to increasing haemoglobin levels for pregnant women at Kemayoran public health center in 2019 (p value <0.05). The higher of knowledge and compliance of consuming iron suplement, the greater the hemoglobin level. "

"ABSTRAKPERMASALAHAN : HIV/AIDS dan Hepatitis B merupakan masalah kesehatan masyarakat yang sangat penting karena belum ditemukan obatnya sampai saat ini. Wanita usia subur, khususnya yang berpenghasilan rendah pengunjung Puskesmas semakin rentan terhadap risiko penularan kedua penyakit tersebut. Sampai saat ini belum ada model upaya promotif dan preventif di Puskesmas yang mengintegrasikan pelayanan penyakit menular seksual (PMS) ke dalam pelayanan BP/KIA/KB di Puskesmas.TUJUAN PENELITIAN : Mengembangkan model intervensi guna menurunkan risiko infeksi PMS termasuk HIV/AIDS dan Hepatitis B bagi wanita usia reproduksi, wanita hamil dan peserta KB berpenghasilan rendah melalui keterpaduan program PMS dengan program kesehatan reproduksi di klinik KIA/KB dan BP di Puskesmas daerah perkotaan dan pedesaan.HASIL KEGIATAN : Desain penelitian adalah Kuasi eksperimen, yaitu one group pre dan post test tanpa kelompok kontrol. Dalam intervensi ini dilakukan observasi awal, intervensi dan observasi akhir tanpa menggunakan kelompok kontrol. Hasil penelitian tahun I dapat diperoleh informasi bahwa infeksi saluran reproduksi pada wanita usia subur pengunjung BP/KIA/KB di Puskesmas perkotaan maupun pedesaan di daerah penelitian cukup tinggi. Dari pemeriksaan oleh staf laboratorium Puskesmas sendiri diperoleh angka infeksi sebesar 2-29%. Sesudah di periksa ulang oleh Lab. Bagian Ilmu Penyakit Kulit dan Kelamin, FKUI/RSCM diperoleh angka lebih tinggi yaitu 30-40%. Di lain pihak pengetahuan mengenai PMS termasuk HIV/AIDS dan Hepatitis B di kalangan mereka masih sangat terbatas. Bahkan pengetahuan dan kemampuan petugas kesehatan sendiri yang berkaitan dengan PMS termasuk HIV/AIDS dan Hepatitis B juga masih kurang.Pada tahun ke II telah dilakukan intervensi di Puskesmas terpilih. Telah dilakukan persiapan intervensi berupa telaah hasil temuan, penyusunan silabus pelatihan petugas Puskesmas, penyusunan draft materi & media penyuluhan, lokakarya penyusunan jadwal dan model intervensi bersama Puskesmas daerah penelitian, uji coba dan penyempurnaan materi penyuluhan serta perbaikan dan penggandaan materi penyuluhan. Selanjutnya pelaksanaan intervensi dilakukan berupa: pelatihan petugas Puskesmas (dokter, bidan, perawat, tenaga laboratorium) mengenai manajemen dan pencegahan PMS, HIV/AIDS dan Hepatitis B, cara sterilisasi alat kesehatan termasuk jarum suntik, penyuluhan (pendidikan dan motivasi) ibu pengunjung BP/KIA/KB (beserta suaminya) oleh petugas Puskesmas yang telah dilatih, serta pemantauan kegiatan penyuluhan oleh tim peneliti.SIMPULAN DAN SARAN : Telah dikembangkan model intervensi berupa pelatihan petugas Puskesmas mengenai manajemen dan pencegahan PMS termasuk HIV/AIDS dan Hepatitis B serta materi baku yang terdiri dari silabus dan bahan serta penunjang pelatihan. Selain itu juga dikembangkan model serupa bagi ibu pengunjung BP/KIA/KB di Puskesmas termasuk materi dan penunjang penyuluhan. Kegiatan penyuluhan kepada pengunjung BP/KIA/KB di Puskesmas dilakukan langsung oleh petugas Puskesmas yang telah terlatih. Materi dan peraga yang telah diberikan di Puskesmas belum digunakan sebagaimana sesuai petunjuk. Hal ini disebabkan antara lain petugas belum menguasai teknik penyuluhan.Disarankan dilakukan adaptasi dan penyederhanaan materi penyuluhan yang digunakan oleh petugas Puskesmas. Pelaksanaan penyuluhan bagi pengunjung BP di Puskesmas hendaknya tidak dilakukan secara bersamaan dengan pengunjung Klinik KIA/KB. Perlu adanya pemantapan teknik penyuluhan bagi petugas pelaksana, khususnya KIA/KB. Evaluasi akhir mengenai dampak dan hasil akhir model ini harus dilakukan sehingga diperoleh masukan bagi pembuat kebijakan pelayanan, khususnya dalam upaya pencegahan dan penanganan PMS, AIDS/HIV dan Hepatitis B melalui jajaran pelayanan tingkat primer.

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ABSTRACTIntervention To Reduce Risk Of HIV/AIDS And Hepatitis B Among Low Income Reproductive Age Women Attending An Ambulatory/Mother & Child Health And Family Planning Clinic At The Puskesmas In Dki Jaya And West Java, 1995 - 1996THE RESEARCH PROBLEM : In Indonesia, HIV/AIDS and Hepatitis B have become major and critical public health problems. At present there is no cure for these two diseases. The low income married women of reproductive age (MWRA) are becoming more and more susceptible to the risk of infection of sexually transmitted diseases (STDs) including HIVI AIDS. Currently a model of integrating STD services into the existing ambulatory/ mother & child health (MCH)/ family planning (FP) services in the Puskesmas is nonexistent.THE RESEARCH OBJECTIVES : To develop an intervention model in reducing the risk of STDs including HIV/AIDS and Hepatitis B infection for low income MWRA through integrating STD services into MCH/FP services in the Puskesmas both for urban as well as rural areas.METHODOLOGY AND RESULTS OF THE STUDY : The design of the study is one group pre and post test without a control group (a Quasi-experimental design). A measurement was conducted at the beginning of the study then followed by intervention and evaluation/ measurement after the intervention. Three different measurements were conducted prior to the intervention period namely both qualitative and quantitative study (survey) and STD screening.Results of the first year study are as follows: there is a significantly high proportion of STD among the MWRA visiting the ambulatory, MCH and FP clinic both in the urban and rural public health centers (Puskesmas). Screening test by lab technician of the Puskesmas indicated infection proportion of 2-29%. The results of the screening were rechecked by the Dept. of Dermatovenereology of the Cipto Mangunkusumo Hospital, Jakarta and showed higher infection proportion i.e. 30-40%. On the other hand, knowledge on STD including HIV/AIDS and Hepatitis B among the women visiting the Puskesmas was very limited. Besides that, the knowledge and skills of the health personnel of the Puskesmas concerning the same subject was also relatively low.During the second year of the study (199511996) an intervention was conducted in the four Puskesmas under the study. Preparation of the intervention was completed such as review of the study results, development of syllabus of training for the Puskesmas staff, development of draft of materials and media for health education, workshop on the scheduling and model of intervention with the participating Puskesmas, pre test and revision and reproduction of information, education & communication (IEC) materials. Furthermore, the following intervention was conducted in each Puskesmas namely training for Puskesmas staff (doctor, midwives, nurses and lab technicians) concerning management and prevention of STD including HIVIAIDS and Hepatitis B, methods of sterilization of medical instruments, education and motivation (health education) for women attending ambulatory, MCH and FP clinic of the Puskesmas by trained health personnel and monitoring of the activity at the Puskesmas by selected trained personnel as well as research team members.CONCLUSIONS AND RECOMMENDATIONS: A model of intervention to prevent risk of STD including HIV/AIDS and Hepatitis B infection has been developed. It consists of syllabus and training materials including visual aids for STD including HIV/AIDS and Hepatitis B management and prevention for the health personnel of the Puskesmas, and training materials of the same subject for women (including their spouses) attending ambulatory, MCH and FP clinics at the Puskesmas.An adaptation and simplification of the educational materials for the ultimate target audience namely women attending service at the Puskesmas should be made. During the education session, the attendants of the ambulatory clinic should be separated from these attending MCH/FP services. In addition, it is indispensable to improve the technical skills in health education among the personnel of MCH/FP section of the Puskesmas.It is strongly recommended to evaluate both the impact and outcome of the above intervention. Hopefully, the results will be useful for advocating policy concerning prevention and management of STD including HIV/AIDS and Hepatitis B at the primary care level namely at the Puskesmas in Indonesia."