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"ABSTRAKManajemen Terpadu Balita Sakit (MTBS) merupakan suatu pendekatan terpadu tatalaksana balita sakit di pelayanan kesehatan dasar, meliputi upaya kuratif, promotif dan preventif. MTBS bertujuan untuk menurunkan angka kematian bayi dan balita. Penelitian ini merupakan penelitian deskriptif bertujuan untuk mengetahui gambaran pasien (usia, jenis kelamin, berat badan, tinggi/panjang badan, kunjungan, keluhan) dan menilai pelaksanaan MTBS sesuai bagan MTBS. Subjek penelitian ini berasal dari sumber sekunder yaitu format MTBS pasien yang berkunjung ke poli MTBS berjumlah 96 sampel, ditentukan berdasarkan simple random sampling. Instrumen yang digunakan merupakan instrumen yang dibuat oleh peneliti sendiri berdasarkan algoritma MTBS. Hasil penelitian ini menunjukkan keseluruhan pasien yang berkunjung merupakan kategori balita, sebagian besar perempuan dengan kunjungan pertama lebih banyak, dan sebagian besar memiliki tingkat keluhan sedang (≥2 - <5). Gambaran pelaksanaan MTBS untuk penilaian MTBS sebagian besar ?tidak lengkap?, klasifikasi ?sesuai?, tindakan/pengobatan ?sesuai lengkap?, dan untuk konseling keseluruhan ?ada namun tidak lengkap?. Ketersediaan sarana dan prasarana didapatkan tidak lengkap. Monitoring, evaluasi dan supervisi perlu ditingkatkan untuk memberikan pelayanan MTBS yang berkualitas.

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ABSTRACT

Integrated Management of Childhood Illness (IMCI) is an integrated implementation for chilldhood illness in the primary care, included curative, promotive, and preventive efforts. IMCI aims to reduce mortality of children under five years old. The research is descriptive and it's aim is to know the patients description (age, sex, weight, height, visits, grievance) and to assess the IMCI implementation according the IMCI chart. Subject of this research is derived from secondary sources that is patient IMCI format who visits IMCI polyclinic, amounted to 96 samples, and determined by simple random sampling. The used Instrument is made by the researcher based IMCI algorithm. Results of this research show that the overall of patients who visit are children under five years old, most are female, first visit, and most of them have middle grievance (≥2-<5). Description of IMCI implementation by IMCI assess, most of them are ?not complete?, clasification ?congruent?, action/medication ?appropriate and complete?, and overall of counseling ?existing but incomplete?. The availability of facilities and infrastructur is incomplete. Monitoring, evaluation, and supervision need to enhanced to give the best quality care of IMCI."

"Tujuan penelitian untuk mengetahui faktor-faktor yang berhubungan dengan kinerja petugas MTBS dalam pelayanan MTBS di Puskesmas Dinas Kesehatan Kota Madiun tahun 2011. Desain cross sectional, dilakukan pada bulan April-Mei 2011 dengan responden 80 petugas MTBS. Hasil penelitian menunjukkan hanya 16,2% petugas MTBS yang berkinerja baik. Motivasi, beban kerja dan supervisi merupakan variabel yang berhubungan dengan kinerja petugas MTBS, sedangkan umur, pendidikan, pelatihan, masa kerja, pengetahuan tentang MTBS dan sarana dan prasarana tidak berhubungan dengan kinerja petugas MTBS. Atas dasar tersebut untuk meningkatkan kinerja petugas MTBS perlu diberlakukan sistem penghargaan, pembagian kerja yang jelas atau menunjuk petugas khusus untuk menjalankan MTBS, serta mengoptimalkan supervisi.

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The aim is this study was to find out factors related to the performance of IMCI officer on serving IMCI in Puskesmas Madiun City Health Office in 2011. Cross-sectional desaign, that was conducted in April-May 2011 with 80 respondents of officers IMCI. The study results showed that only 16.2% IMCI officers who perform well. Motivation, workload, and supervision is a variable related to the performance of IMCI officer, while age, education, training, years of service, knowledge of IMCI and facilities and infrastructure not related to the performance official of IMCI. Based on the result, it is important to improve their performance officer IMCI need to be implemented reward system, a clear division of labor, or appoint a special officer to run the IMCI, and to optimize supervision."

"Manajemen Terpadu Balita Sakit (MTBS) adalah suatu pendekatan terintegrasi dalam tatalaksana balita sakit secara menyeluruh. Bidan sebagai salah satu tenaga pelaksana MTBS sangat berperan dalam keberhasilan program MTBS, kinerja bidan dipengaruhi oleh faktor individu, psikologik dan organisasi. Penelitian ini dilakukan untuk menganalisis kinerja bidan dalam pelaksanaan MTBS di puskesmas Kabupaten OKU tahun 2013 dengan menggunakan metode kualitatif dan desain RAP (Rapid Assesment Procedure). Pengumpulan data dilakukan dengan wawancara mendalam kepada informan menggunakan pedoman wawancara. Hasil penelitian menyarankan kepada bidan untuk semakin meningkatkan kinerja dengan mengacu kepada standar baku MTBS.

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Integrated Management of Childhood Illness (IMCI) is an integrated approach to the overall management of childhood illness. Midwives as one of the executive power is very instrumental in the success of IMCI IMCI program, midwives' work is influenced by individual factors, psychological and organizational. This study was conducted to analyze the performance of midwives in IMCI implementation in district health centers in 2013 OKU using qualitative methods and designs RAP (Rapid Assessment Procedure). Data was collected through in-depth interviews using an interview guide to the informant. The results suggest the midwives to further improve the performance with respect to the gold standard IMCI."

"Salah satu parameter derajat kesehatan suatu negara adalah kematian bayi dan balita. Dalam Setiap tahun terdapat 12 juta anak meninggal sebelum usia 5 tahun karena pneumonia, diare, malaria, campak, malnutrisi dan kombinasi dari penyakit tersebut. Untuk mencegah kematian tersebut terdapat cara efektif berupa perawatan anak yang menderita penyakit tersebut di fasilitas rawat jalan yaitu Manajemen Terpadu Balita Sakit (MTBS) yang dikembangkan oleh Departemen Kesehatan bekerjasama dengan WHO dan UNICEF. Setiap balita sakit harus dilakukan pendekatan MTBS. Pencapaian MTBS Kabupaten Kulon Progo 2011 55,6% dimana pencapaian cakupan MTBS merupakan gambaran kinerja petugas MTBS. Tujuan penelitian ini untuk mengetahui faktor-faktor yang berhubungan dengan kinerja petugas MTBS. Penelitian ini menggunakan metode Survei analitik dengan pendekatan Cross Sectional. Hasil penelitan persentase kinerja baik dan kinerja kurang hampir sama. Variabel individu yang berhubungan dengan kinerja petugas MTBS adalah masa kerja dan motivasi, variabel organisasi yang berhubungan adalah kepemimpinan dan fasilitas. Saran bagi Dinas Kesehatan adalah meningkatkan pembinaan dan pengawasan melalui supervisi, bagi kepala Puskesmas untuk mendukung pelaksanaan MTBS dan bagi petugas MTBS untuk melaksanakan MTBS pada setiap kunjungan balita sakit.

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One of health degree parameter of country is infant mortality. For every year 12 milions of infant died before 5 years old due to pneumonia, diarrhea, malaria, measles, malnutrition, and it?s combination. To preven of death, there is an affective way by treating infant in outpatient facility by Integrated Management Of Childhood Illness (MTBS) developed by Health Department in collaboration with WHO and UNICEF. Each of infant illness must be treated by MTBS approach. MTBS achievement of Kulon Progo Regency 2011 was 55,6% at which of it was description of MTBS officer performance.

This study aims to find out factors related to MTBS officer performance. It used analytic survey method by Cross Sectional approach.

Study result for percentage of good and poor performance is almost equal. Individual variabel related to MTBS officer performance is length of work and motivation, while related organization variable is leadership and facility.

Suggestion for Health Departemen is to improve development and monitoring by supervision, for head of Public Health Center to support MTBS implementation and for MTBS officer to apply MTBS to every childhood illness."

"Keberhasilan suatu program berhubungan dengan kinerja petugasnya. Penelitian ini bertujuan untuk mengetahui kinerja petugas Manajemen Terpadu Balita Sakit (MTBS) dan hubungan antara variabel indepeden yang terdiri dari faktor individu (umur, masa kerja, pengetahuan dan motivasi), dan faktor organisasi (pelatihan, fasilitas, kepemimpinan) dengan variabel dependen yaitu kinerja petugas MTBS. Jenis penelitian yang digunakan adalah kuantitatif dengan rancangan penelitian cross sectional. Jumlah sampel 50 responden petugas MTBS.Pengumpulan data dilakukan dengan pengisisan kuesioner dan wawancara serta observasi.Pengolahan data dengan menggunakan perangkat lunak computer, analisis data dengan univariat, bivariat dengan uji statistik chi-square dan multivariat dengan uji statistik multipel regresi logistik. Hasil penelitian menunjukkan bahwa 62% petugas MTBS mempunyai kinerja baik. Terdapat hubungan antara umur, masa kerja, pengetahuan, motivasi, fasilitas dan kepemimpinan dengan kinerja petugas MTBS. Faktor dominan yang mempengaruhi kinerja petugas MTBS adalah masa kerja dan kepemimpinan.

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The success of a program related to the performance of its officers This study aims to determine the performance of Integrated Management of Childhood Illness (IMCI) officers and determine the relationship between the independent variables consisting of individual factors (age,length of work, knowledge and motivation) and organizational factors (training, facilities, leadership) with the dependent variable which is the performance of IMCI officer.

This type of research is quantitative with cross sectional study design. The sample of 50 respondents IMCI officer.Collecting data by filling the questionnaire and interviewing and observation.Processing data using computer software, data analysis with univariate, bivariate statistical test chi-square and multivariate multiple logistic regression statistical test.

The results of this study showed that 62% good performance of IMCI officer. There was correlation between age, length of work,knowledge, motivation, training and leadership with performance of IMCI officer. The dominant factor affecting performance is the IMCI officers working life and leadership."

"Angka Kematian Balita di Indonesia tahun 2015 diharapkan 23 per 1000 Kelahiran Hidup. Penyebab kematian balita di Indonesia antara lain diare sebesar 25,2% dan pneumonia sebesar 15,5%. Untuk menurunkan angka kematian akibat pneumonia dikembangkan MTBS. Peran petugas terutama paramedis sangat penting dalam MTBS.Tujuan penelitian untuk mengetahui gambaran tingkat pengetahuan, sikap dan perilaku tentang MTBS pada paramedis di Kota Palangka Raya tahun 2012. Telah dilakukan pengumpulan data dengan metode survei pada bulan Mei-Juni 2012 pada 76 responden paramedis dan didapat ternyata hanya bidan sebanyak 2,8% dan perawat 10% yang memiliki pengetahuan yang lengkap tentang MTBS.Hal ini memberikan gambaran bahwa tingkat pengetahuan paramedis tentang MTBS sangat minim. Dari 36,8% paramedis yang pernah dilatih, inipun tingkat pengetahuan yang lengkap hanya 27,8%. Perlu peningkatan pengetahuan, sikap dan perilaku pada paramedis di Kota Palangka Raya sehingga tingkat pengetahuan meningkat dan ada respon terhadap sikap tentang MTBS dengan perilaku yang lebih baik.Five mortality rate in Indonesia is expected by 2015 23 per 1000 live births. Causes of infant mortality in Indonesia, among others, diarrhea and pneumonia by 25.2% at 15.5%. To reduce mortality due to pneumonia developed IMCI. The role of paramedical personnel is very important especially in IMCI.

Research purposes to know the description of the level of knowledge, attitudes and behaviors of IMCI in Palangkaraya City paramedic in 2012. Have been carried out by the method of data collection survey in May-June 2012 in 76 respondents was obtained paramedics and midwives just as much as 2.8% and 10% of nurses who have a complete knowledge of IMCI.

This suggests that the level of knowledge of the paramedics on IMCI was minimal. 36.8% of the paramedics who had been trained, even this level of knowledge that only 27.8% complete. Need to increase the knowledge, attitudes and behavior at paramedics in the city of Palangkaraya thus increasing the level of knowledge and there is a response to the attitude of IMCI with better behavior."

"Penelitian kualitatif ini bertujuan untuk menganalisis faktor-faktor yang berhubungan dengan angka rujukan peserta selama bulan Januari-Maret 2015. Sampel adalah Puskesmas Cimanggis dengan angka rujukan tinggi dan Puskesmas Cipayung dengan angka rujukan rendah. Hasil penelitian menunjukkan bahwa angka rujukan dipengaruhi oleh kebijakan, ketersediaan obat, peralatan penunjang pelayanan kesehatan, pemahaman dokter tentang prosedur rujukan dan peran gatekeeper. Diagnosis penyakit yang banyak dirujuk di kedua puskesmas adalah penyakit jantung. Hal tersebut berhubungan dengan ketersediaan obat dan peralatan penunjang pelayanan kesehatan serta peran gatekeeper. Pasien penyakit jantung memerlukan tindakan promotif preventif serta kontrol rutin setiap bulan untuk pemeriksaan dan menebus obat di RS, sehingga mempengaruhi angka rujukan. Diharapkan BPJS Kesehatan untuk meningkatkan koordinasi dengan pihak Puskesmas dalam mengendalikan pelayanan rujukan.

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This qualitative study aimed to analyze the factors associated with the referral of BPJS members during January until March 2015. Samples were Cimanggis and Cipayung health centers representing high and low referral cases respectively. The results showed that the referral numbers were influenced by the policy, availability of drugs, medical equipment, physician perceptionabout the referral procedure as well asthe role of gatekeeper. Heart disease was the diagnosis with the highest referral number in the sampled health centers. Factors were related to the availability of drugs, medical equipment as well as the role of gatekeeper. Patients with heart disease require preventive and promotive actions, regular controls, and monthly check up and drugs in hospitals, this has made increased referral numbers. It is expected that BPJS Kesehatan will improve coordination with the health center to manage the referral system."

"Analysis on the Compliance Rate of Health Personnel towards the Integrated Management of Childhood Illness at DKI Jakarta Health Center Year 2001The Ministry of Health Republic of Indonesia in collaboration with the World Health Organization, since 1997, has developed an approach in managing sick child under-five at the primary health services known as Integrated Management of Childhood Illness (IMCI). Today, IMCI has been implemented in 26 provinces (of 30 provinces present) covering 128 districts/municipalities in Indonesia.The province of DKI Jakarta, using regional budget 2000, has started socializing the IMCI to 14 health centers in 5 regions of Jakarta. How is the compliance of health worker in implementing the IMCI has never been studied.The objective of this study is to have a outline information on factors related to the health worker's compliance towards IMCI implementation at HC in Jakarta. The study will use "cross-sectional" design with quantitative and qualitative approach and total sample of 23 IMCI-implement health workers. Data collection is conducted by direct observation to the health workers during sick child examination using a checklist. After the observation, the health workers will fill in a questionnaire. Some secondary data will also be collected using the checklist for Monitoring IMCI record and checklist for supporting facilities.The result of the study shows that of 23 IMCI-implement health workers in DKI Jakarta 21.72% comply with interval value 58.61% - 90.28%, with cut off point value 80. The Internal factors is proven to have significant correlation with health worker's compliance with p = 0.04. While the external factors is proven to have significant correlation with human resources/MMCI facilities with p = 0.02 and leader's commitment with p = 0.009.In conclusion, the compliance rate of HC personnel in DKI Jakarta towards IMCI has not adequate. It is suggested to the Provincial Health Services DKI Jakarta to provide a health policy in managing sick child under-five using IMCI approach and at the same time improving quality of its monitoring and supervision.Health Center needs to have a clear task description for each of their personnel and a continued monitoring/supervision. A reward system should also be considered. The Ministry of Health needs to review the IMCI Monitoring and Supervision Checklist also considers Cut of Point of IMCI compliance rate and finalizing the Essential Drug for IMCI."

"Depresi merupakan salah satu masalah psikososial yang sering di temui pada lansia. Namun, depresi bukan hal normal yang terjadi pada lansia. salah satu penyebab depresi pada lansia adalah pensiun. Pensiun menyebabkan penurunan pendapatan, perubahan peran serta berkurangnya waktu produktif lansia yang berdampak pada kondisi psikologis lansia. Tujuan penelitian ini yaitu untuk mengetahui bagaimana gambaran depresi pada lansia setelah memasuki masa pensiun. Penelitian dilakukan dengan purposive sampling menggunakan metode cross sectional dengan mewawancarai responden menggunakan kuesioner Geriatric Depression Scale (GDS) 30 pertanyaan. Hasil penelitian terhadap 96 lansia pensiun di Kecamatan Cimanggis, Kota Depok diperoleh 74% responden mengalami depresi sedang, dan 16,7% responden mengalami depresi berat. Tingginya kejadian depresi pada lansia dikomunitas terutama pada lansan pensiun maka perlu dilakukan peningkatan pelayanan keperawatan psikososial terhadap lansia dikomunitas sehingga kejadian depresi dapat menurun.

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Depression is one of the psychosocial issues which often found in older adults. However, depression is not normal happened. One of the causes to depression is retirement. It causes a decrease in income, change in role as well as reduction in productivity of older adults that will have an impact on their psychological condition. The aim of this research is to describes the depression in older adults during retirement. The research was conducted on purposive sampling using cross sectional method by interviewing the participants with Geriatric Depression Scale (GDS) 30-item questionnaire. The results show that, of the total 96 retired older adults in Cimanggis, Depok, 74% experienced mild depression and 16.7% experienced severe depression. A high depression in older adults in communities, particularly those who retired, thus need to enhance the service of psychosocial nursing so that the depression level will be lower."

"Kualitas tidur yang buruk pada pasien diabetes melitus akan berdampak pada kualitas hidupnya. Kualitas tidur yang buruk disebabkan oleh tanda gejala serta komplikasi diabetes melitus yang mengakibatkan gangguan tidur pada penderitanya. Penelitian ini bertujuan mengidentifikasi faktor-faktor yang berhubungan dengan kualitas tidur pada pasien diabetes melitus. Desain penelitian ini adalah deskriptif korelasi dengan pendekatan cross sectional, melibatkan 106 pasien diabetes melitus di Puskesmas Cimanggis Depok yang dipilih dengan teknik consecutive sampling. Pengambilan data penelitian dilakukan dengan pengisian kuesioner. Kualitas tidur diukur dengan Pittsburgh Sleep Quality Index (PSQI). Hasil penelitian ini menunjukkan sebagian besar responden memiliki kualitas tidur yang buruk dan dari beberapa faktor yang diteliti hanya kondisi cahaya saat tidur (p=0,007), insomnia (p<0,001) dan restless leg syndrome (p=0,019) yang berhubungan dengan kualitas tidur. Penelitian ini merekomendasikan kepada perawat agar memberikan intervensi yang sesuai untuk mengatasi gangguan tidur yang dialami pasien diabetes melitus agar kualitas tidurnya semakin baik.

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Poor sleep quality may negatively impact on the quality of diabetic patient‟s life, resulting from the signs, symptoms, and complications of diabetes experienced by the patients. This study aimed to identify factors associated with sleep quality among patients living with diabetes.

This descriptive study used cross sectional design, involving 160 respondents in the Cimanggis Health Center who were selected by using consecutive sampling technique. Data were collected by questionnaires to measure the respondent‟s sleep quality.

The study revealed that the majority of respondents had poor sleep quality according to the Pittsburgh Sleep Quality Index. The study further showed that lighting (p = .007), insomnia (p < .001), and restless leg syndrome (p = .019) were significantly associated to sleep quality. Interventions to enhance sleep quality can be suggested to patients by nurses as part of diabetes nursing care."