Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Latar belakang: Untuk meningkatkan penemuan kasus dan diagnosis TB oleh dokter praktik swasta dilakukan melalui pendekatan Public Private Mix (PPM)-TB. Public Private Mix adalah keterlibatan semua penyedia layanan kesehatan publik dan swasta, formal dan non formal dalam penyediaan penanganan TB sesuai ISTC untuk pasien yang telah atau diduga memiliki penyakit TB. Pengalaman di beberapa negara terdapat peningkatan penemuan kasus TB oleh dokter praktik swasta yang terlibat dalam PPM-TB. Di Indonesia belum ada data tentang dokter spesialis paru praktik swasta yang terlibat PPM-TB dalam mendiagnosis TB sesuai dengan ISTC. Metode: Penelitian menggunakan desain potong lintang. Data yang digunakan diambil secara retrospektif melalui data sekunder (rekam medis &TB 01)pasien yang didiagnosis TB dalam kurun waktu Oktober-Desember 2010 yang berobat ke 18 rumah sakit/klinik swasta di Jakarta, tempat praktik 23 dokter spesialis paru yang terlibat dalam kegiatan PPM-TB. Hasil: Didapatkan 258 rekam medis pasien yang memenuhi kriteria dari 21 orang dokter spesialis paru di 16 rumah sakit/klinik swasta. Satu rumah sakit tidak diambil data karena tidak memenuhi kriteria dan satu orang dokter tidak bersedia diambil data pasiennya. Tercatat keluhan utama pasien adalah batuk tanpa keterangan waktu 148 (57,3%). Permintaan pemeriksaaan hapusan sputum BTA yang tercatat 160(62%). Dari 160 hasil pemeriksaan sputum BTA yang tercatat dilakukan pemeriksaan kultur 6 (2,7%), kultur dan resistensi 12 (5,5%). Permintaan pemeriksaaan foto toraks yang tercatat 248 (96,1%), tidak ada permintaan 5 (1,9%) dan tidak ada data 5 (1,9%). Didapatkan 219 kasus TB paru (84,9%) dan 39 TB ekstra paru (15,2%). Berdasarkan apusan BTA, terdapat 64 pasien BTA positif (40%), 94 BTA negatif (58,8%) dan 2 tidak ada data (1,2%). Diagnosis TB ditulis pada 252 rekam 6 lainnya tidak ada diagnosis. Empat belas dokter spesialis paru praktek swasta melakukan semua standar diagnosis 1-5 sesuai ISTC. Kesimpulan : Sebagian besar dokter spesialis paru praktek swasta sudah melaksanakan ISTC dalam menegakkan diagnosis TB. Pemeriksaan foto toraks lebih tinggi sebagai penunjang hasil apusan BTA yang lebih banyak negatif. Pemeriksaan kultur dan resistensi M.tb masih sangat rendah. ......Background: Tuberculosis (TB) remains a public health problem of global challenges. Indonesia is the first country with high burden TB problem in South East Asia to successfully achieve Millennium Development Goal (MDG) targets’ for TB in 2006 where 70% new case findingswith positive AFB and 85% recovery. However, TB management in many private hospitals and practices has not yet applied ISTC. To increase new case findings and TB diagnosis in private practice, the government conducted Public Private Mix (PPM)-TB approach. This study is intended to find out whether pulmonologistsin private practice has applied ISTC for TB diagnosis. Method: This is a cross sectional study. Retrospective secondary data from medical recoed and TB 01 forms of TB patients from October-December 2010 in 18 private hospitals in Jakarta (23 pulmonologists involved in PPM-TB program). Result:There were 258 patient’s medical records from 21 pulmonologist from 16 private hospital fulfilled the criteria. One pulmonologist did not meet the criteria and one other pulmonologist refused to participate in this study.Patients’ chief complaints were mostly cough without information of duration 148 (57.3%). The recorded demand for AFB sputum examination is found in 160 (62%). From 160 laboratory AFB sputum examination results, 6 was cultured(2.7%), 12 was cultured and examined for antituberculosis agent resistance (5.5%). Chest x-raywas asked in 248 patients (96.1%) but 5 without demand (1.9%) and no data in 5 patients (1.9%). Classification of TB anatomy found were pulmonary TB 219 (84.9%), extrapulmonary TB 39 (15.1%). Classification of TB based on AFB found were positive 64 (40%), negative 94 (58.8%) and no data 2 (1.2%). Written diagnosis of TB was found in 252 (97.7%) patients while 6 (1.3%) did not. Fourteen pulmonologist private practice had endorse ISTC all standar 1-5 to diagnosis tuberculosis. Conclusion: Diagnosis of TB by pulmonologist in private practices mostly has applied ISTC. High chest x-ray demand as a supporting diagnosis was found because most AFB sputum gave negative results. Examination of culture and resistance of antituberculosis agent are low.

Abstrak :
Metode Penelitian: Penelitian ini menggunakan metode deskriptif studi potong lintang secara consecutive sampling. Mengggunakan data sekunder dari penelitian induk pada bulan Mei 2020. Subjek merupakan dokter spesialis paru dan dokter residen paru anggota Perhimpunan Dokter Paru Indonesia wilayah Jakarta. Hasil Penelitian: Pada penelitian ini didapatkan subjek penelitian adalah 134 subjek yang masuk dalam kriteria inklusi, dengan 53 subjek dari kelompok spesialis paru dan 81 subjek dari kelompok residen paru .Jenis kelamin paling banyak adalah perempuan sebanyak 87 orang (65%), rerata usia 38,36 (±9,54) tahun dan paling banyak berdomisili di Jakarta timur yaitu 52 subjek (39%). Lama kerja subjek penelitian rata-rata lima jam sehari di zona merah. Kekerapan kejadian COVID-19 pada seluruh total subjek penelitian adalah 9 subjek (6,7%) dengan luaran derajat ringan. Komorbid paling banyak asma yaitu 17 subjek (13%). Ditemukan hubungan bermakna antara penggunaan alat trasportasi umum berupa taksi online dengan kejadian COVID-19 pada subjek penelitian. Kesimpulan: Kekerapan kejadian COVID-19 pada dokter spesialis paru dan residen paru anggota Perhimpunan Dokter Paru Indonesia wilayah Jakarta adalah sebanyak 6,7% dengan luaran mayoritas derajat ringan. Ditemukan hubungan bermakna antara penggunaan alat trasportasi umum berupa taksi online dengan kejadian COVID-19 pada subjek penelitian. ......Background: Coronavirus disease 2019 (COVID-19) is an infection by severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) with a high transmission rate in Indonesia. We concern that transmission rate of COVID-19 among healthcare worker whose contact with COVID-19 patients is high, about 3.8% occurred in China in February 2020. Data in Indonesia from the Indonesian Doctors Association recorded about 80 specialist doctors transmitted with COVID-19 from their patients in April 2020. High transmission can occur due to close contact and several other things that affecting such as variations in immunity status of each individual. Proper preventive procedures are needed in an effort to prevent COVID-19 transmission, especially among healthcare worker. Methods: This study uses descriptive study cross-sectional methods with consecutive sampling. Using secondary data from the main study in May 2020. The subjects are pulmonologist and pulmonology resident member of The Indonesia Society of Respirology in Jakarta. Results: The study with 134 subjects suitable with inclusion criteria, with 53 subjects from the pulmonologist group and 81 subjects from the pulmonology resident group. Women are the most common 87 subjects (65%), the mean age was 38,36 (±9,54) years and most of them live in east Jakarta 52 subjects (39%). Median of working duration in red zone was five hours in a day. The frequency of COVID-19 incidence in all total subjects was 9 subjects (6.7%) with majority mild outcome in degrees severity. Asthma is the most comorbid in 17 subjects (13%). There is a relationship between using of public transportation in the setting of online taxis and the incidence of COVID-19 in the study subjects. Conclusion: The frequency of COVID-19 incidence in pulmonologist and pulmonology residents members of The Indonesia Society of Respirology in Jakarta is 6.7% with a majority mild outcome in degrees severity. There is a relationship between using of public transportation in the setting of online taxis and the incidence of COVID-19 in the study subjects.

Abstrak :
Latar Belakang: Pandemi Corona Virus Disease 2019 (COVID-19) di Indonesia mengakibatkan masalah psikologis, termasuk kecemasan, depresi dan distress psikologis pada tenaga kesehatan khususnya dokter spesialis paru dan peserta Pendidikan Program Dokter Spesialis (PPDS) paru. Tujuan dari penelitian ini adalah untuk mengetahui prevalens, derajat risiko distress dan faktor-faktor yang memengaruhi derajat risiko distress psikologis pada dokter spesialis paru dan PPDS paru di Jakarta. Metode: Peneliti menggunakan metode studi deskriptif potong lintang terhadap dokter spesialis paru dan PPDS paru di Jakarta, Indonesia secara consecutive sampling pada bulan Mei 2020. Peneliti menggunakan alat ukur yaitu Distress Thermometer (DT) dan problem list yang telah divalidasi secara transkultural dan pengisiannya dilakukan mandiri oleh subjek secara daring. Hasil: Sebanyak 134 subjek yang masuk dalam penelitian ini diantaranya 81 orang peserta PPDS paru dan 53 orang dokter spesialis paru dengan dominasi subjek perempuan sebanyak 66,4%, rerata usia 38,36 (±9,54) tahun dan rerata lama pengalaman kerja adalah 3 (1-27) tahun. Seluruh subjek memiliki risiko distress psikologis dengan perbandingannya berturut-turut pada kelompok PPDS adalah ringan, sedang, berat (44,4%, 50,6%, 4,9%) dan pada dokter spesialis paru (47,2%, 45,3%, 7,5%). Pada analisis subgrup ditemukan bahwa kelompok dokter spesialis paru lebih banyak mengalami masalah yang memengaruhi risiko distress psikologis dibandingkan kelompok PPDS. Pada kelompok dokter spesialis paru ditemukan masalah-masalah yang memengaruhi tingkat risiko distress diantaranya adalah usia (56,0%, p=0,003), masalah mengasuh anak (50,0%, p=0,037), mengurus rumah (45,5%, p=0,040), masalah dengan kerabat (75,0%, p=0,035), depresi (100%, p=0,011), ketakutan (50,0%, p=0,040), gugup (100%, p=0,011), sedih (41,7%, p=0,010), hilang minat pada aktivitas rutin (50,0%, p=0,005), diare (100%, p=0,011), kelelahan (62,5%, p=0,037), demam (66,7%, p=0,011), gangguan pencernaan (50,0%, p=0,008), gangguan konsentrasi (37,5%, p=0,033), mual (42,9%, p=0,008), hidung kering (60%, p=0,001), kulit kering dan gatal (50,0%, p=0,004), gangguan tidur (72,7%, p=0,004) serta kesemutan (57,1%, p=0,024). Faktor-faktor yang memengaruhi tingkat risiko distress pada PPDS paru diantaranya adalah depresi (80,0%, p=0,040), ketakutan (68,4%, p<0,001), gugup (62,5%, p=0,031) dan kelelahan (70,8%, p=0,023). Kesimpulan: Prevalens risiko distress psikologis pada dokter spesialis paru dan PPDS paru saat pandemi COVID-19 di Jakarta tinggi. Faktor-faktor yang memengaruhi tingkat risiko distress pada dokter spesialis paru diantaranya adalah usia, masalah teknis, keluarga, emosional dan fisis, sedangkan pada PPDS paru diantaranya adalah masalah emosional dan fisis. ......Background: Corona Virus Disease 2019 (COVID-19) pandemic in Indonesia causes psychological problems, including anxiety, depression and psychological distress in health workers, especially pulmonologist and pulmonology resident. The purpose of this study was to find out the prevalence, distress levels and factors that affect the risk psychological distress of pulmonologist and pulmonology resident in Jakarta. Methods: Researchers used a descriptive study cross-sectional method on pulmonologist and pulmonology resident in Jakarta, Indonesia using consecutive sampling in May 2020. We used Distress Thermometer as a measurement tools and problem list that was transculturally validated and filled out online and independently by subjects. Results: A total of 134 subjects were included in this study including 81 pulmonology residents and 53 pulmonologists dominated by women (66.4%), mean age 38.36 (± 9.54) years and median length of work was 3 (1-27) years. All subjects had a risk of psychological distress with the ratios in resident group are mild, moderate, severe (44.4%, 50.6%, 4.9%) and pulmonologist (47.2%, 45.3%, 7.5%). In subgroup analysis, it was found that the pulmonologist group experienced more problems that affect the risk of psychological distress than the resident group. In the pulmonologist group, problems that assosciated with the level of distress risk are age (56.0%, p=0.003), parenting problems (50.0%, p=0.037), house problem (45.5%, p= 0.040), problems with relatives (75.0%, p=0.035), depression (100%, p=0.011), fear (50.0%, p=0.040), nervous (100%, p=0.011), sadness (41.7%, p=0.010), loss of interest in routine activities (50.0%, p=0.005), diarrhea (100%, p=0.011), fatigue (62.5%, p=0.037), fever (66.7%, p=0.011), indigestion (50.0%, p=0.008), concentration (37.5%, p=0.033), nausea (42.9%, p=0.008), nasal dry (60%, p=0.001), dry and itchy skin (50.0%, p=0.004), sleep (72.7%, p=0.004) and tingling (57.1%, p=0.024). Factors that assosciated with the level of distress risk in residents are depression (80.0%, p=0.040), fear (68.4%, p<0.001), nervousness (62.5%, p=0.031) and fatigue (70.8%, p=0.023). Conclusion: Prevalens psychological distress risk in pulmonologist and pulmonology resident during the COVID-19 pandemic in Jakarta is high. Factors that assosciated with the level of psychological distress risk in pulmonologist are age, technical, family, emotional and physical problems. Factors that assosciated with the level of psychological distress risk in pulmonology resident are emotional and physical problems.