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"Pemberian ASI pada bayi terpajan HIV merupakan keputusan yang masih menjadi perdebatan karena berisiko menimbulkan penularan HIV dari ibu ke anak. Penelitian ini bertujuan untuk mengeksplorasi proses pengambilan keputusan ibu tentang pemberian ASI pada bayi terpajan HIV, menggunakan metode kualitatif dengan pendekatan grounded theory. Sebanyak 23 partisipan terdiri dari 13 partisipan ibu, 10 partisipan pendamping ibu direkrut menggunakan teknik purposive sampling, snowball sampling dan theoretical sampling. Domisili partisipan meliputi wilayah Jakarta, Jawa Barat, Banten, Yogyakarta dan Lombok. Pengumpulan data dilakukan dengan wawancara mendalam secara online. Data hasil wawancara, studi dokumen dan literatur, dianalisis melalui tahap open coding, axial coding, selective coding, hingga pengembangan kerangka teori menggunakan pendekatan Strauss dan Corbin. Hasil penelitian mendapatkan proses pengambilan keputusan pemberian ASI meliputi penghadapan dilema, penempuhan jalan menuju hasil terbaik, perolehan dampak dan penyelesaian program. Terdapat beberapa faktor yang memengaruhi pengambilan keputusan yaitu faktor internal meliputi aspek fisik, psikologis, perilaku dan sosial ibu; dan faktor eksternal meliputi dukungan menyusui, kebijakan kesehatan dan kondisi sosial. Penelitian ini mengungkapkan tahapan dalam pengambilan keputusan pemberian ASI pada bayi terpajan HIV, yang dapat menjadi masukan bagi tenaga kesehatan dalam memberikan pendampingan kepada ibu pengidap HIV untuk memutuskan pemberian makan bagi bayinya.

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Breastfeeding HIV-exposed babies is a controversial decision because it risks transmitting HIV from mother to child. This study aims to explore the process of maternal decision-making about breastfeeding in HIV-exposed babies, using a qualitative method with a grounded theory approach. A total of 23 participants, comprising 13 maternal participants and 10 maternal companion participants, were recruited using purposive sampling, snowball sampling, and theoretical sampling techniques. The domicile of the participants covers the areas of Jakarta, West Java, Banten, Yogyakarta and Lombok. Data collection was conducted through in-depth online interviews. Data from interviews, document studies, and literature were analysed through the stages of open coding, axial coding, and selective coding to develop a theoretical framework using the Strauss and Corbin approach. The research results revealed the decision-making process of breastfeeding, including encountering dilemmas, treading the way to the best results, acquiring the impact, and completing the program. Several factors influence decision-making, including internal factors such as physical, psychological, behavioural, and social aspects of the mother, as well as external factors like breastfeeding support, health policies, and social conditions. This study reveals the stages in making decisions about breastfeeding in HIV-exposed babies, which can be an input for health care providers in assisting mothers with HIV to decide on feeding for their babies."

"Latar Belakang: Kompetensi IPCN berpengaruh terhadap keselamatan pasien dan kualitas pelayanan. Kondisi di pelayanan, belum ada standar kompetensi sebagai dasar pengembangan karier IPCN. Tujuan: Terbentuk model pengembangan karier IPCN untuk menggambarkan jenjang kompetensi IPCN di Indonesia. Metode: Mix Method melalui tiga tahap penelitian yaitu Descriptive Explorative untuk mengidentifikasi masalah, penyusunan model pengembangan karier IPCN, serta Descriptive Crossectional untuk mengetahui jenjang kompetensi serta korelasi masa kerja, pendidikan, dan CPD dengan kompetensi IPCN. FGD melibatkan 30 IPCN, dan In Depth Interview melibatkan 16 manajer rumah sakit. Proses Delphi dilakukan tiga putaran dan konsultasi pakar untuk merumuskan Model Pengembangan Karier dan Kompetensi serta Evaluasi Diri IPCN valid dan reliable. Kuesioner diterapkan pada 384 IPCN pada 24 wilayah Indonesia. Hasil: Teridentifikasi lima tema yaitu peran dan tanggungjawab IPCN, kendala yang dihadapi, upaya yang dilakukan, penerapan jenjang karier Perawat Klinis, dan harapan tersusun model pengembangan karier IPCN. Gambaran jenjang karier IPCN di Indonesia adalah IPCN Muda 24,2%; IPCN Madya 68,8%; dan IPCN Ahli 7%. Terdapat korelasi hubungan signifikan antara masa kerja, pendidikan, dan Continuing Professional Development dengan kompetensi. Kesimpulan: Model Pengembangan Karier dan Kompetensi IPCN dapat memberikan gambaran jenjang karier IPCN di Indonesia, sebagai acuan rekruitmen, pengembangan profesional berkelanjutan, dan evaluasi kinerja IPCN secara periodik

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Background: IPCN competency affects patient safety and service quality. Conditions in the service, there is no competency standard as a basis for IPCN career development. Objective: An IPCN career development model was formed to describe the IPCN competency level in Indonesia. Method: Mix Method through three stages of research, namely Descriptive Explorative to identify problems, preparation of IPCN career development model, and Descriptive Crosssectional to determine the competency level and correlation of work period, education, and CPD with IPCN competency. FGD involved 30 IPCN, and In Depth Interview involved 16 hospital managers. The Delphi process was carried out in three rounds and expert consultation to formulate a valid and reliable IPCN Career and Competency Development Model and Self-Evaluation. The questionnaire was applied to 384 IPCN in 24 regions of Indonesia. Results: Five themes were identified, namely the role and responsibilities of IPCN, obstacles faced, efforts made, implementation of Clinical Nurse career levels, and expectations of the IPCN career development model. The description of IPCN career levels in Indonesia is Young IPCN 24.2%; IPCN Madya 68.8%; and IPCN Ahli 7%. There is a significant correlation between length of service, education, and Continuing Professional Development with competence. Conclusion: The IPCN Career Development and Competence Model can provide an overview of IPCN career levels in Indonesia, as a reference for recruitment, continuous professional development, and periodic IPCN performance evaluation."

"Latar belakang: Diagnosis tuberkulosis (TB) pada anak sulit ditegakkan karena gejala tidak khas dan sulit memperoleh sampel sputum. Pemeriksaan antigen lipoarabinomannan (LAM) urin telah direkomendasikan oleh WHO. Namun, penelitian pada anak tanpa HIV di Indonesia masih sangat terbatas. Mengingat kesulitan dalam mendapatkan sampel sputum pada anak tanpa HIV, diperlukan metode diagnostik non-sputum yang mudah dilakukan, memberikan hasil cepat, serta dapat diterapkan langsung di lokasi pasien (point-of-care testing atau POCT). Tujuan: Menilai dan membandingkan akurasi diagnostik dua alat deteksi LAM urin yaitu Abbott Determine TB LAMAg TM (Abbott LAM) dan Fujifilm SILVAMP TB LAM TM (Fuji LAM) untuk mendiagnosis TB pada anak.Metode: Penelitian ini merupakan studi potong lintang yang melibatkan anak berusia 0 - 18 tahun dengan dugaan TB di tiga rumah sakit rujukan nasional. Data dikumpulkan melalui anamnesis, pemeriksaan fisis, serta pengambilan sampel urin menggunakan metode midstream atau urine collector. Sampel urin kemudian diperiksa menggunakan Abbott LAM dan Fuji LAM, lalu dibandingkan dengan standar diagnosis TB menurut Pedoman Kemenkes RI 2023 (TB klinis dan TB terkonfirmasi bakteriologis) serta standar pemeriksaan bakteriologis (GeneXpert®).Hasil: Pada periode Oktober hingga Desember 2024, sebanyak 77 pasien dianalisis, dengan 18 pasien terkonfirmasi bakteriologis dan 22 pasien didiagnosis TB secara klinis.Dibandingkan dengan alur diagnosis Kemenkes RI 2023 sebagai standar: Abbott LAM memiliki sensitivitas 52% dan spesifisitas 48,6%, Fuji LAM memiliki sensitivitas 22,5% dan spesifisitas 97,3%. Dibandingkan dengan pemeriksaan bakteriologis sebagai standar: Sensitivitas dan spesifisitas Abbott LAM menurun menjadi 47,1% dan 42,5%, sensitivitas dan spesifisitas Fuji LAM meningkat menjadi 47% dan 97,5%.Kesimpulan: Kedua alat memiliki sensitivitas yang lebih rendah dari standar minimal WHO (65%), sehingga tidak direkomendasikan untuk skrining atau diagnosis awal TB pada anak. Namun, Fuji LAM menunjukkan spesifisitas tinggi dan berpotensi menjadi alat diagnostik penguat dalam mendeteksi TB pada anak yang menunjukkan gejala, terutama bagi anak yang mengalami kesulitan dalam memperoleh sampel untuk pemeriksaan bakteriologis

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Background: Diagnosing tuberculosis (TB) in children is challenging due to non-specific symptoms and difficulties in obtaining sputum samples. The World Health Organization (WHO) has recommended urinary lipoarabinomannan (LAM) antigen testing for TB detection. However, studies on HIV-negative children in Indonesia remain very limited. Given the challenges in obtaining sputum samples from HIV-negative children, a non-sputum diagnostic method that is easy to perform, provides rapid results, and can be implemented at the point of care (POCT) is needed.

Objective: To evaluate and compare the diagnostic accuracy of two urinary LAM detection tests, Abbott Determine TB LAM Ag™ (Abbott LAM) and Fujifilm SILVAMP TB LAM™ (Fuji LAM), for diagnosing TB in children.

Methods: This cross-sectional study involved children aged 0–18 years with suspected TB from three national referral hospitals. Data collection included medical history, physical examination, and urine sample collection using either the midstream method or a urine collector. Urine samples were tested using Abbott LAM and Fuji LAM, and results were compared with the 2023 Indonesian Ministry of Health TB diagnostic guidelines (clinical TB and bacteriologically confirmed TB) as well as the bacteriological testing standard (GeneXpert®).

Results: Between October and December 2024, a total of 77 patients were analyzed, including 18 bacteriologically confirmed TB cases and 22 clinically diagnosed TB cases. When compared to the 2023 Indonesian Ministry of Health TB diagnostic algorithm, Abbott LAM showed a sensitivity of 52% and specificity of 48.6%, while Fuji LAM had a sensitivity of 22.5% and specificity of 97.3%. When using bacteriological testing (GeneXpert®) as the reference standard, the sensitivity and specificity of Abbott LAM decreased to 47.1% and 42.5%, respectively, whereas Fuji LAM demonstrated improved performance with a sensitivity of 47% and specificity of 97.5%.

Conclusion: Both tests demonstrated lower sensitivity than the WHO-recommended minimum standard (65%), making them unsuitable for screening or initial TB diagnosis in children. However, Fuji LAM exhibited high specificity, suggesting that it may serve as a valuable additional diagnostic tool for children with TB symptoms who face challenges in providing sputum samples for bacteriological confirmation."