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"Tingginya tingkat kesalahan petugas laboratorium dalam memeriksa mikroskopis tb positif akan memberi dampak tingginya kesalahan diagnosis penyakit tuberculosa di kota Pontianak dan sekitarnya. Kompetensi tehnis dan keterampilan dalam pelayanan laboratorium khususnya mikroskopis tb harus dikuasai, disamping faktor - faktor yang mempengaruhinya. Sampel penelitian ini berjumlah enam puluh satu orang dengan lokasi dan latar belakang yang berbeda. Kemudian dilakukan analisa dengan univariat, bivariat dengan menggunakan tabel silang dan dilanjutkan dengan multivariat Hasil dari penelitian ini variabel yang berhubungan dan bermakna serta predominan ierhadap keterampilan petugas adalah lingkungan kerja. Kesimpulan dari penelitian ini adalah 54.1 % tingginya tingkat kesalahan petugas dalam pemeriksaan mikroskopis tbc, Diharapkan saran untuk meningkatkan keterampilan petugas laboratorium dalam pemeriksaan mikroskopis the berupa peningkatan lingkungan kerja petugas laboratorium agar program penanggulangan tb berhasil. Daftar pustaka: 53 ( 1974 --1999)

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Factors in Relation to The Skill of The Laboratory Officers of The Public Health Centre in Investigating Positive Microscopic TB in Pontianak Municipality and Surrounding.The heigh of the level of fault of the laboratory in investigating positive microscopic tb should be out come diagnosis tuberculosis high fault in the city of Pontianak and surrounding. For this purpose technical competency and skill in laboratory service especially in investigating positive microscopic the should be well powered beside the factor related to the skill in question. The number of officers joining this research are of sixty one persons with, different location and backround. Afterwards an analysis is carried out with univariat, bivariat by using crosstable and continued with multivariat. The result of this shows variable relating and meaningful and predominant againts the officers skills re work environment. The conclusion of this research is that the error degree is still high in the microscopic positive tb investigation, it is 54.1 %. Suggestion is expected to increase the skill of the laboratory offcers in investigating microscopic the in the form of through laboratory officers increasing work environment, so that the overcoming program sucesed. Reference : 53 ( 1974 -- 1999 )"

"Kanker adalah suatu penyakit yang belum dapat sepenuhnya disembuhkan. Kanker dapat mengakibatkan kecacatan dan kematian serta kemiskinan bagi penderita tersebut dan keluarganya akibat biaya pengobatan yang tinggi.Seberapa penelitian telali membuktikan bahwa shining kesehatan - seperti pemeriksaan petanda tumor - pada pasien asimtomatik sebagai komponen untuk diagnosis dini dan pengobatan yang tepat akan menurunkan angka kesakitan dan angka kematian serta dapat membantu untuk menurunkan biaya. Petanda tumor adalah pemeriksaan laboratorium yang berperan dalam setiap langkah pengawasan dan penataiaksanaan kanker sehingga selayaknya menjadi pemeriksaan yang dominan di pusat pelayanan kanker seperti RSKD.Namun dalam prakteknya, pemeriksaan petanda tumor di RSKD hanya kurang dari 6.45% dari total pemeriksaan laboratorium klinik RSKD pada tahun 1999 dan 2000.Dalam hal ini rujukan dokter adalah komponen terpenting dalam pemanfaatan pelayanan kesehatan penunjang yang tersedia dalam rumah sakit, termasuk pelayanan laboratorium untuk petanda tumor ini.Penelitian ini adalah penelitian kualitatif dengan pendekatan studi kasus yang bertujuan untuk mengetahui faktor-faktor yang menjadi pertimbangan dokter dalam memanfaatkan pelayanan pemeriksaan petanda tumor pads pasien kanker di RSKD.Dari hasil penelitian diketahui bahwa peran dan fungsi belum seluruhnya diketahui semua dokter, status sosial ekonomi, berhubungan dengan tarif pemeriksaan dan sumber pembiayaan menjadi faktor utama yang menjadi pertimbangan dokter dalam memanfaatkan pelayanan ini dan kegiatan pemasaran untuk menjaring pelanggan luar dalam wilayan pelayanan RSKD belum dilakukan. Untuk itu, disarankan pengadaan pelatihan peran dan manfaat petanda tumor, peninjauan kembali terhadap penetapan harga serta melakukan kegiatan pemasaran baik di dalam maupun di luar lingkungan RSKD.

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Doctor's Consideration Factors In Utilizing Tumor Marker Tests in Clinical Pathology Laboratory at Dharmais Cancer Hospital.Cancer is a disease that is not 100% curable. It can result in disability or death for a patient and its high cost of treatment can be a serious financial burden for a patient and their family.Studies have proven that screening - such as tumor marker screening - in asymptomatic patients as a tool for early diagnosis and prompt treatment, can decrease morbidity and mortality rates and can help to reduce the overall treatment cost involved. Tumor marker testing can be used in every step in assessing patients with cancer so it would be expected that tumor marker testing would be a dominant laboratory test in a cancer center like . However, in 1999 and 2000, tumor marker tests represented only 6.45% of total laboratory testing undertaken.Doctor referral is the most important component affecting demand for ancillary services at hospitals, including demand for laboratory services and tumor marker tests.This research is a qualitative research with a case study approach to analyze factors that are considered by treating doctors in utilizing tumor marker tests.It is found that not every doctor knows precisely the important role of tumor marker tests in assessing cancer disease. The social economic status of the patient together with the cost of the test and payment resources available to the patient are the major factors considered by a doctor before referring a patient for a tumor marker test. There has not been any education or marketing program undertaken to promote the utilization of this service within the hospital or to doctors outside of the hospital who may be a source of referrals for the hospital's laboratory.Based on these findings, it is recommended education be provided to doctors treating within the hospital on the role and benefits of tumor marker testing and that the hospital consider marketing the benefits .of tumor marker testing to doctors treating within the hospital's catchment area. The hospital could also review the pricing of the tests as a means of increasing utilization.Bibliography : 22 (1987 - 2001)"

"Tuberculosis merupakan penyakit infeksi penyebab kematian terbesar di dunia dimana jumlah penderita tuberculosis di Indonesia adalah nomor tiga terbesar di dunia, dan merupakan penyebab kematian nomor empat di Propinsi Jambi.Indonesia sejak tahun 1995/1996 telah melaksanakan strategi DOTS (Directly Observed Treatment Shortcourse), dimana untuk melaksanakan strategi ini telah dibentuk Puskesmas Rujukan Mikroskopis (PRM). Salah satu komponen yang berperan adalah petugas laboratorium dalam pemeriksaan sputum secara mikroskopis. Kinerja petugas Laboratorium PRM di Propinsi Jambi masih rendah, yang terlihat dari hasil cross check yang dilakukan oleh Balai Laboratorium Kesehatan Jambi mempunyai tingkat kesalahan diatas 5%.Penelitian ini bertujuan untuk memperoleh informasi mengenai gambaran kinerja dan faktor-faktor yang berhubungan dengan kinerja petugas laboratorium dalam pemeriksaan mikroskopis BTA + pada PRM di Propinsi Jambi. Penelitian ini merupakan studi observational dengan rancangan cross sectional. Sampel yang diambil adalah populasi total, dengan jumlah sampel sebanyak 38 orang petugas Laboratorium PRM. Pengumpulan data dilakukan dengan wawancara dan observasi menggunakan instrument berupa kuesioner dan check list.Hasil penelitian menemukan, pada tingkat kepercayaan 95%, terdapat hubungan yang signifikan antara faktor internal seperti pendidikan, pelatihan, motivasi, dan faktor eksternal seperti supervisi, sarana dan prasarana, prosedur tetap, dan imbalan terhadap kinerja petugas laboratorium. Diantara variabel supervisi, pendidikan, pelatihan, imbalan dan prosedur tetap yang paling berhubungan adalah supervisi, diantara variabel motivasi, pendidikan, pelatihan, imbalan dan supervisi yang paling berhubungan adalah supervisi, sedangkan diantara variabel pendidikan, pelatihan, imbalan, sarana prasarana yang paling berhubungan adalah pendidikan.Upaya yang dapat dilakukan untuk mendukung program pemerintah dalam pemberantasan tuberculosis, khusus dibidang laboratorium diantaranya adalah dengan melakukan supervisi oleh pimpinan secara terjadwal serta melengkapi sarana dan prasarana sesuai dengan kondisi puskesmas.Daftar bacaan : 47 (1974 - 2001)

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Analysis of Factor that Related to Microscopic Referral Health Center Laboratory Officer's Performance at Jambi Province, 2002.Tuberculosis is an infection disease that causes the biggest death in the world, which the number of tuberculosis sufferers in Indonesia was the third biggest in the world, and as the number four causes of death in Jambi Province.Since 1995/1996 Indonesia has conducted the Directly Observed Treatment Short Course (DOTS), where to did this strategy has been established Microscopic Referral Health Center (MRH}. One of the component that having role was the laboratory officer who checking the sputum microscopically. The performance of MRH officer at Jambi Province is still low, it was seen from the result of cross-check that conducted by the Health Laboratory Center of Jambi that having error level over than 5%.The objective of this study is to obtain an information on the description of performance and the factors that related to the performance of laboratory officer in checking the BTA microscopic + on MRH at Jambi Province. This study was as observation study by cross-sectional design. The sample that taken was total population, with the number of sample was 38 MRH laboratory officers. The data collection that conducted was in-depth interview and observation using instrument in the form of questionnaire and checklist.The result of this study found that on the level of belief was 95%, there was significant relationship between internal factor, such as education, training, motivation, and external factor such supervision, means and infrastructure, permanent procedure, also income of laboratory officer's performance. Between supervisor variable, education, training, income and permanent procedure that the most relationship was supervision.Between motivation variable, education, training, income and supervision that the most having relationship was supervision, whereas between education variable, training, income, means and infrastructure that the most having relationship was means and infrastructure.The effort that can be done to support the government program in combating tuberculosis, especially in the field of laboratory, among others doing supervision by the leader as schedule and accompanied with the means and infrastructure that correspond to the health center condition.References: 47 (1974-2001)."

"Kewaspadaan Universal/Standar direkomendasikan untuk mencegah pajanan penyakit infeksi lewat darah seperti HIV, Virus Hepatitis B, dan Virus Hepatitis C di pelayanan kesehatan. Di RS PMI Bogor, kepatuhan penerapan Kewaspadaan Universal/Standar diantara perawat dan bidan adalah rendah, dilihat dari kasus kecelakaan tertusuk jarum suntik yang terjadi diantara perawat tahun 2009-2011, masing-masing 6, 4, dan 8 kasus. Penelitian ini bersifat deskriptif dengan menggunakan rancangan cross sectional. Sebanyak 100 self administered questionnaires disebarkan dan hanya 82 kuesioner lengkap yang kembali. Tujuan penelitian ini adalah untuk mengetahui gambaran tingkat kepatuhan perawat dan bidan dalam penerapan Kewaspadaan Universal/Standar dan faktor ? faktor yang berhubungan. Dalam penelitian ini, hanya 52,4 % perawat dan bidan yang memiliki tingkat kepatuhan yang baik. Dari hasil uji chi square, variabel yang secara signifikan berhubungan dengan kepatuhan penerapan Kewaspadaan Universal/Standar adalah iklim keselamatan kerja dan pelatihan dan ketersediaan APD. Peneliti menyarankan diadakan pelatihan dan sosialisasi SOP dan kebijakan terkait kewaspadaan universal.Universal/Standard Precautions are recommended to prevent blood-borne infections (e.g. HIV, HBV, and HCV) exposure in health care setting. Compliance with Universal/Standard Precautions among nurses and midwives is suboptimal at PMI Hospital, Bogor. It was showed from needle stick injury cases occurred among nurses each of 6, 4, and 8 cases in 2009 ? 2011. This research is descriptive using cross sectional design. A total of 100 self administered questionnaires were distributed to nurses and midwives, and 82 completed questionnaires were returned. The purpose of this study is to find out compliance rate with Universal/Standard Precautions among nurses and midwives and factors related. In this research, only 52.4 % nurses and midwives who had a high compliance rate. Based on chi square test, safety climate and training and availability of PPE were significantly associated with compliance to Universal/Standard Precautions. The researcher suggests establishing the training and socializing SOP and policy related to Universal/Standard Precautions"

"Tujuan Kemampuan penalaran kliiik odotoh salah salu kompetensi utama yang harus dimiliki oleh lulusan dokter sehingga perlu dilatih sejak mahasiswa. Akan tetapi, pembuktian kuantitatif tentangfaktor-faktor yang mempengaruhi kemampuan penalaran klinik mahasiswa masih sangat sedikit. Penelitian ini bertujuan untuk menenlukan pengaruhpengetahuan dan faktor lainnya terhadap kemampuan penalaran klinik mahasiswa sebagai bahan acuan dalam menentukan metode pembelajaran penalaran klinik.Melode Penetritian potong linlang dilakukan terhadap mahasiswa Fakuhas Kedokteran Universitas Sriwijaya program KBK semester IV Data yang diambil adalah tentang kemampuan penalaran klinik dengan faktor risikonya pada kasus sistem urogenital karena saat data diambil pada April 2008, mahasiswa baru menyelesaikan pembelajaran blokurogenilal. Kemampuan penalaran klinik dinilai dengan /es script concordance danfaktor risiko dinilai berdasarkanhasil evaluasiformatif, sumatif blok dan karakterisitk mahasiswa. Analisis data dilakukan dengan metode regresi Cox. Hasil Hasil penelitian terhadap 132 mahasiswa menunjukkan persentase kemampuan penalaran klinik yang rendah sebesar 38,694. Mahasiswa yang mempunyai pengetahuan yang rendah dibandingkan dengan yang tinggi mempunyai 63% lebih tinggi risiko mengalami penalaran klinik yang rendah (kR suaian : 1,63; 9594 interval kepercoyaan (C[): I,l0-2,42). Dibanding dengan kelompok mahasiswa yang lerampil berpikir kritis, mahasiswa yang tidak terampil berpikir ltritis lebih berisiko dua kali lebih mempunyai penalaran klinikyang rendah (M suaian: 2,30; 95% interval kepercayaan (CD: 1,55 - 3,41).Kesimpulan Dari penelitian ini dapat disimpulkan bahwa mahasiswa yang tidak terampil berpikir kritis atau memiliki pengetahuan yang rendah memiliki kemampuan penalaran klinik yang rendah.

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AbstractAim Clinical reasoning is one of the essential competencies for medical practitioners, so that it must be exercised by medical students. Studies on quantitative evidence of factors influencing clinical reasoning abilicy of students are limited. The aim of this study was to determine the influence of knowledge and other factors on the clinical reasoning abiliry ofthe students, which can serve as reference to establish methods for learning ctinical reasoning. Methods This is a cross-sectional study on fourth semester students enrolled in the Competency-based Curriculumof the Medical Faculty, University of Sriwijaya. Data on clinical reasoning abilily and risk factors during urogenital blockwere collected inApril 2008, when the students have just completed the btock. Clinical reasoning abiliry was tested using the Script Concordance test and the risk factors were evaluated based on formative tests, block summativeassessments, and student characteristics. Data were analyzed by Cox regression.Results The prevalence of low clinical reasoning ability of the 132 students was 38.6%. The group with low basic knowledge was found to have 63% risk ol low clinical reasoning abiliry when compared to those with high basic knowledge (adjusted RR = 1.63; 95% conidence intewal (Ct): 1.10 -2.42). When compared to students with high critical thinking skitls, those with lory critical thinking skills had 2.3 time to be low clinical reasoning abitity (adjusted RR : 2.30; 9s% CI: 1.55 - 3.41).Conclusion Students with low critical thinking skills or with inadequate knowledge had a higher risk of low clinical reasoning ability."

"Sistem Informasi telah menjadi penunjang di era modern, termasuk di dunia medis, salah satunya di bidang pendidikan kedokteran. Dalam pendididkan kedokteran, Sistem Informasi digunakan dalam membantu kelancaran pendidikan kedokteran, baik untuk pengajaran, pengujian hingga penilaian. Salah satu metoda pengujian dalam Pendidikan kedokteran yaitu OSCE (Objective Structured Clinical Examination). Dalam OSCE membutuhkan sumber daya yang besar. Sistem Informasi diintegrasikan dengan sistem audio visual diterapkan untuk meningkatkan efisiensi. Sistem Informasi dikembangkan untuk pelaksanaan OCSE di fakultas Kedokteran Unswagati. Kemudian desain yang dibuat diujicobakan untuk melihat pengaruhnya terhadap reliabilitas, validitas dan efisiensi. Hipotesis awal mengharapkan bahwa tidak ada perbedaan dalam reliabilitas dan validitas OSCE, tetapi ada perubahan peningkatan efisiensi. Hasil pengujian menunjukan bahwa dengan penerapan Sistem Informasi terintegrasi audiovisual, menjadikan pelaksanaan OSCE reliabel, valid tetapi dengan peningkatan efisiensi.

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Information system has been suppoting this modern era, including in the medical world, such as in medical education. In medical education, information system is being used to assist its fluency, such in teaching, examining and grading. One of the method to exam in medical education is called OSCE (Objective Structured Clinical Examination. OSCE requires massive resources. An information system integrated with audiovisual system is applied to enhance the efficiency.

This Information system is developed for implementation of OSCE in Medical Faculty of Unswagati. The design is tested to see the influence to its reliability, validity and efficiency. Early hypothesis is there will be no significant difference on OSCE?s Reliability and Validity, but there will be a significant improvement on efficiency. The test result shows that with implementation of Audiovisual integrated Information system, causing a reliable and valid OSCE with improved eviciency."

"Supervisi konsisten mempengaruhi kinerja perawat tetapi pelaksanaannya pada pelayanan keperawatan di Indonesia cenderung bersifat pengawasan dan kurang memberikan upaya-upaya untuk mendidik, memotivasi, melatih, dan memberi arahan. Model supervisi klinik educative, supportive and Administrative Cycle (ESA-C) dibuat untuk meningkatkan nilai positif dari supervisi. Model ini disintesa dari model supervisi Kadushin, Proctor dan mengintegrasikannya dengan teori interpersonal relationships Peplau serta nilai caratif Watson. Penelitian bertujuan menguji efektifitas model supervisi klinik ESA-C dalam meningkatkan kinerja perawat, menggunakan desain kuasi eksperimen pre-post test pada dua kelompok. Dua rumah sakit dirandom dari 5 rumah sakit umum, sampel diambil secara random sebanyak 90 perawat dan 270 pasien secara purposif. Hasil penelitian menunjukkan model supervisi klinik ESA-C mampu meningkatkan kinerja perawat secara signifikan (p Value < 0.05) pada dimensi task performance: keterampilan teknis sebesar 2%, pemberian edukasi 9%, pemberian dukungan emosionl kepada pasien 14%, dan contextual performance: pemberian bantuan bagi pasien dan keluarga 21%. Model ini disarankan digunakan pada pelayanan keperawatan terutama di rumah sakit dalam upaya meningkatkan kinerja perawat dalam memberikan asuhan keperawatan kepada pasien.

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Supervision is a consistent variable that affect to job performance. Unfortunately, the supervision that had done only just controlled rather than an effort to educating, coaching, directing, and nurse potential reinforcement. ESA-C clinical supervision model that developed is to eliminate negative side of supervision these times. Educative, supportive, and administrative cycle of clinical supervision model was a result from synthesize of Kadushin's, Proctor's, Heron's, Faugier's, and Experimental's models. The ESA-C model was synthesizing with interpersonal relationship from Peplau's and carative value from Watson's. ESA-C clinical supervision model use a group approach in an educative supervision and individual approach for supportive and administrative supervision.

The purpose of this research is to determine the effect of ESA-C clinical supervision model to increasing nurses' job performance. This research used quasi experiment design with intervention and control group. The sample of this research use a random method to 90 nurses (each group has 45 nurses) and 270 patients (each group has 135 patients).

The result of this research revealed that ESA-C clinical supervision model can increase nurses' job performance including task performance dimension (clinical skill, patient education, emotional support) and contextual job performance (assisting patient and the family). This research recommended the using of ESA-C model in hospital to increasing nurses' job performance in giving of nursing care to the patient."

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Pendahuluan: Tahap pendidikan klinik adalah fondasi penting dalam pendidikan kedokteran karena pada tahap ini pengembangan identitas profesional peserta didik terjadi. Peran pengajar klinis pun menjadi salah satu determinan penting dalam menentukan kualitas pembelajaran di tahap pendidikan klinik. Oleh karena itu, kualitas pengajar klinis harus dijaga dan ditingkatkan. Salah satu upaya yang dapat dilakukan untuk menjaga kualitas pengajar klinis adalah memahami pengembangan identitas profesional sebagai pengajar klinis. Integrasi identitas profesional pengajar klinis ke dalam identitas profesional klinisi dianggap penting dalam menjaga well-being dan resistensi dalam menjalankan peran sebagai pengajar klinis. Metode: Penelitian ini menggunakan desain penelitian kualitatif dengan pendekatan fenomenologi. Responden penelitian adalah pengajar klinis yang dipilih menggunakan strategi maximum variety sampling dengan mempertimbangkan lama menjadi pengajar klinis, jenis kelamin, peran sebagai koordinator, dan rotasi pendidikan klinik.Terdapat tiga focus group discussion dengan jumlah peserta 5-6 orang pengajar klinis untuk setiap kelompok dan tiga belas wawancara mendalam terhadap tiga belas orang pengajar klinis untuk mengeksplorasi proses pengembangan identitas profesional pengajar klinis. Hasil penelitian: Dalam penelitian ini teridentifikasi faktor-faktor yang berkaitan dengan self, situation, support, dan strategy sebagai faktor yang berpotensi mempengaruhi pengembangan identitas profesional. Diketahui bahwa kemampuan reflektif dan peran community of practice merupakan faktor esensial dalam menjalani masa transisi dan pengembangan identitas profesional. Ditemukan tiga narasi integrasi identitas profesional oleh responden, yaitu koalisi I-position pengajar klinis dan klinisi, bertahan pada I-position klinisi, serta metaposisi antara I-position profesional dan personal. Simpulan: Faktor-faktor yang terkait dengan self, situation, support, dan strategy berpotensi mendukung atau pun menghambat pengajar klinis dalam masa transisi. Selain itu gambaran proses integrasi identitas profesional pengajar klinis mencerminkan refleksi responden terhadap pengalaman dan peran mengajar.

 

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Introduction: Clinical clerkship is an important foundation in medical education because at this stage the development of students professional identity occurs. Clinical teachers play an important role in determine the quality of learning in clinical rotation. Therefore, the quality of clinical teachers should be maintained and improved. One of the strategies to maintain and improve the quality of clinical teachers is to understand the clinical teachers professional identity development. The integration of clinical teachers professional identity into clinicians identity is considered important to maintain the well-being and resistance in carry on the role as clinical teacher. Method: This is a qualitative study with phenomenological approach. Respondents were clinical teachers who were selected using maximum variety sampling strategy by considering the length of time being clinical teacher, gender, role as coordinator, and clinical rotation. There were three focus group discussion in which each group consists of 5-6 clinical teachers and thirteen in-depth interviews with thirteen clinical teachers to explore the development of clinical teachers professional identity. Result: This study identified factors related to self, situation, support, and strategy that could influence the development of clinical teachers professional identity. It was found that reflective abilities and community of practice were essential factors in undergoing a period of transition and the development of professional identity. Three narratives of integration of professional identity by respondents were found, namely the coalition of I-position as clinical teachers and clinicians, holding on to the clinicians I-position, and meta-position between professional and personal I-positions. Conclusion: Factors related to self, situation, support and strategy were identified as potential factors to support or hinder clinical teacher in transition. In addition, the narration of the integration process reflects the clinical teachers reflection upon their teaching roles and experiences.

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