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"Penyakit kusta masih menjadi masalah kesehatan masyarakat di Indonesia. Kabupaten Majalengka saiah satu daerah endemis kusta di Indonesia dengan angka kecacatan tingkat 2 tertinggi di Jawa Barat yang berhubungan dengan keterlambatan penemuan kasus baru dan pengobatan. Berdasarkan hal tersebut, maka diperlukan suatu penelitian yang mendalam mengenai pencarian pertolongan pengobatan pada penderita kusta. Tujuan penelitian ini adalah untuk memperoleh informasi yang mendalam mengenai pencarian pertolongan pengobatan penderita kusta serta faktor penghambat dan penunjangnya. Penelitian ini dilakukan di Kecamatan Sindangwangi, Argapura, dan Sumberjaya Kabupaten Majalengka dengan metode kualitatif yang pengumpulan datanya dilakukan dengan wawancara mendalam. Jumlah informan dalam penelitian ini sebanyak 31 orang yang meliputi informan penderita kusta dan informan kunci. Untuk menguji validitas hasil penelitian, dilakukan triangulasi sumber dan metode. Pengolahan data yang dilakukan terdiri dari mengumpulkan catatan hasil wawancara, membuat rekapitulasi hasil wawancara, membuat kategorisasi data, dan membuat matriks. Analisis yang dilakukan adalah analisis isi atau content analysis untuk melihat kecenderungan hubungan antar variabel. Hasil penelitian menunjukkan, bahwa pencarian pertolongan pengobatan memiliki kecenderungan berhubungan dengan persepsi keparahan dan bahaya penyakit, dorongan tokoh masyarakat, keluarga, media, dan penyuluhan petugas kesehatan. Pemilihan pelayanan kesehatan memiliki kecenderungan berhubungan dengan kebiasaan dan pengalaman berobat, sedangkan keteraturan berobat memiiiki kecenderungan berhubungan dengan persepsi terhadap kualitas pelayanan kesehatan. Keterlambatan mencari pertolongan pengobatan memiliki kecenderungan berhubungan dengan pengetahuan penderita kusta mengenai penyakit kusta yang rendah, ketidaktahuan penderita kusta kalau di Puskesmas terdapat pengobatan untuk kusta dan salah diagnosa. Untuk itu perlu dilakukan advokasi terhadap Pemerintah Daerah Kabupaten Majalengka dan Dinas Kesehatan Kabupaten Majalengka, meningkatkan promosi kesehatan dengan mengikutsertakan petugas promosi kesehatan di Puskesmas, menjalin kerjasama dengan lintas program dan Iintas sektor, pelatihan keterampiian deteksi tanda kusta bagi petugas puskesmas, sosialisasi tentang pengobatan kusta dan keterampilan deteksi tanda kusta bagi dokter praktek di wilayah kerja puskesmas, peiatihan (training of trainers) penyuluhan kusta, penyuluhan intensif dan pemberdayaan masyarakal.

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Leprosy disease is still become the problem for public health in Indonesia. This matter happened, caused by factor pursuing effort of early case finding and leprosy treatment directly and also indirectly. Based on these. hence it is needed a circumstantial research in health seeking behavior of leprosy patient. The objective this research is to obtain circumstantial information on heatlh seeking behavior of leprosy patient. This research was conducted in Sindangwangi, Argapura. and Sumberjaya Sub-distriets with qualitative method, which its data collecting conducted by indepth interview. The number of informants in this research is 31 people. which consisting of leprosy patient and key informant. To assess the validity of result of the research, it was conducted triangulation resources. The Data analysis consist of collect the record of interview results, made summary of the result of interview, made the transcript, made data categorization, and made matrix. The next step is content analysis to see the tendency of the relationship between those variables.

The result of this research show, that seeking help of medication have tendency relate to hard perception and the severeness of discase, motivation of community leader, family, media, and education of health service officer. Election of the health service have tendency relate to experience and habit of medication, while regularity of medication have tendency relate to perception to the quality of health service. The delay in seeking help of medication have tendency relate to knowledge of leprosy suspect on leprosy disease is still low, the lack of knowledge of leprosy patient, where in Community Health Center there is medical treatment for leprosy and wrong diagnosed. Thereby require to be conducted advocacy to Local Government of Majalengka District, and health service of Majalengka District for the allocation of fund and support Leprosy Program with curative and preventive priorities,improving health promotion by involve health promotion officer in Community Health Center, cooperation between cross section that is religion section, and education in order to apply the Leprosy Progrnm specially counseling, training about leprosy detection for health workers. socialization about leprosy treatment and leprosy sign for private doctors in Puskesmas area, training of trainers for leprosy IEC (information, education, and communication), intensive counseling with the target is leprosy patient, family member of leprosy patient, and also community, and enforce community participation in leprosy control."

"Kusta dapat menyebabkan kecacatan permanen dan mempengaruhi aspek sosial serta ekonomi penderita. Di Kota Pariaman, persentase penderita kusta yang menyelesaikan pengobatan menurun dalam beberapa tahun terakhir. Penelitian ini bertujuan untuk mengeksplorasi bentuk dukungan sosial yang diterima penderita kusta selama pengobatan berdasarkan Social Support Theory for Health, menggunakan metode kualitatif dengan desain studi kasus. Informan penelitian terdiri dari delapan penderita kusta, tujuh petugas Puskesmas, seorang pemegang program kusta di Dinas Kesehatan, dan delapan anggota keluarga penderita. Data dikumpulkan melalui wawancara mendalam dan Focus Group Discussion pada bulan Maret-April 2024 dan dianalisis secara tematik. Hasil penelitian menunjukkan semua penderita kusta menjalani pengobatan selama 12 bulan. Mayoritas penderita konsisten dalam pengobatan meskipun menghadapi efek samping dan motivasi yang rendah. Semua penderita menerima dukungan sosial berupa dukungan emosional, instrumental, informasi, penghargaan, dan jaringan sosial, baik dari keluarga, petugas Puskesmas dan pengelola program kusta Dinas Kesehatan Kota Pariaman. Dukungan emosional meningkatkan motivasi penderita, sementara dukungan instrumental dari keluarga seperti bantuan finansial berperan dalam memfasilitasi proses pengobatan. Puskesmas dan Dinas Kesehatan memberikan dukungan melalui penyuluhan tentang kusta dan deteksi dini ketika melakukan kunjungan rumah dan pengantaran obat. Dinas Kesehatan juga berkoordinasi dengan Dinas Sosial untuk memberikan bantuan materi kepada penderita. Penelitian ini juga menemukan bahwa penderita tetap aktif dalam kegiatan sosial meskipun cenderung menyembunyikan kondisinya. Untuk itu, Kota Pariaman dapat membentuk komunitas khusus bagi penderita kusta sebagai upaya membangun jaringan dukungan yang lebih terstruktur dan menjadi forum pertukaran informasi dan sumber dukungan bagi penderita.

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Leprosy can cause permanent disabilities and affect the social and economic aspects of the patients' lives. In the city of Pariaman, the percentage of leprosy patients completing their treatment has decreased in recent years. This study aims to analyze the forms of social support received by leprosy patients during treatment based on the Social Support Theory for Health, using a qualitative method with a case study design. The research informants consisted of eight leprosy patients, seven public health center officers, one leprosy program officer at the Health Office, and eight family members of the patients. Data were collected through in-depth interviews and Focus Group Discussions conducted in March-April 2024 and analyzed thematically. The results of the study showed that all leprosy patients underwent treatment for 12 months. The majority of patients remained consistent in their treatment despite facing side effects and low motivation. All patients received social support in the form of emotional, instrumental, informational, appraisal, and social network support from family, Puskesmas staff, and the leprosy program managers at the Pariaman Health Office. Emotional support helped increase the patients' motivation, while instrumental support from family, such as financial assistance, facilitated the treatment process. The Puskesmas and Health Office provided support through leprosy education and early detection during home visits and medication deliveries. The Health Office also coordinated with the Social Service to provide material assistance to the patients. The study also found that patients remained active in social activities, although they tended to hide their condition. Therefore, it is recommended that the city of Pariaman establish a special community for leprosy patients as an effort to build a more structured support network and become a forum for information exchange and support for the patients."

"Kecacatan merupakan salah satu indikator beban penyakit kusta. Risiko kecacatan akibat kusta tidak hanya terjadi pada kasus baru kusta, tetapi juga selama pengobatan dan setelah selesai pengobatan. Metode pengamatan berperan untuk mengendalikan tingkat cacat pada penderita yang telah selesai pengobatan. Metode pengamatan pasif diterapkan di Indonesia sejak tahun 1982. Pada tahun 2009, metode pengamatan semi aktif diterapkan di Kabupaten Pasuruan. Belum diketahui metode pengamatan yang lebih efektif biaya. Penelitian ini bertujuan untuk menganalisis efektivitas biaya antara metode pengamatan pasif dan metode pengamatan semi aktif setelah selesai pengobatan kusta dalam pengendalian tingkat cacat. Efektivitas dan biaya pada masingmasing metode dihitung dan dilihat berapa rasio efektivitas biaya dalam pengendalian tingkat cacat. Hubungan faktor-faktor seperti umur, tingkat pendidikan, tingkat pengetahuan, tingkat ekonomi, tipe kusta, riwayat reaksi, pencegahan cacat, perawatan diri dengan pengendalian tingkat cacat serta faktor apa yang paling dominan juga diteliti. Desain penelitian adalah cross sectional. Hasil penelitian menunjukkan metode pengamatan semi aktif lebih efektif biaya dibandingkan dengan metode pengamatan pasif. Berdasarkan hasil analisis bivariat, terdapat hubungan antara pencegahan cacat dan perawatan diri dengan pengendalian tingkat cacat. Sedangkan hasil multivariat menyatakan perawatan diri sebagai faktor yang mempengaruhi.

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Disability is one of indicator of the leprosy burden. The risk of disability due to leprosy, not only in new cases of leprosy, but also during treatment and after release from treatment. Surveillance is one of method to control level of disability in patients who had completed treatment. Passive surveillance implemented in Indonesia since 1982. In 2009, the semi-active surveillance applied in Pasuruan. Not yet known which surveillance is more cost-effective.

This study aims to analyze the cost-effectiveness of the passive and semiactive surveillance after release from leprosy treatment in controlling the level of disability. The effectiveness and cost of each method was calculated and seen the cost-effectiveness ratio to the control of the level of disability. Relationship of factors such as age, education level, knowledge level, economic level, type of leprosy, history of reactions, defect prevention, self-care by controlling the level of disability and what is the most dominant factor is also studied. The study design was cross-sectional.

The results showed semi active surveillance more cost-effective than passive surveillance. Based on the results of the bivariate analysis, there is a relationship between defect prevention and self-care by controlling the level of disability. While the results of the multivariate declared self-care as a affected factor."