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"Infeksi HIV terus bertambah. Angka kesakitan dan angka kematian infeksi HIV dapat dihambat dengan terapi ARV. Terapi ARV efektif menekan viral load namun dapat menimbulkan dampak ketidaknyamanan. Kenyamanan spiritual merupakan aspek sentral untuk kesehatan. Pengkajian kenyamanan spiritual digunakan untuk menentukan masalah keperawatan. Penelitian ini ditujukan untuk membentuk instrumen kenyamanan spiritual pada pasien HIV positif. Metode penelitian menggunakan mixed methode. Hasil penelitian kenyamanan spiritual pasien HIV terdapat tiga faktor kenyamanan spiritual yaitu intrapersonal, interpersonal dan transpersonal. Instrumen kenyamanan spiritual pasien HIV positif valid dan reliabel untuk digunakan. Hasil respon regulator tekanan darah sistolik dan denyut jantung berhubungan dengan kenyamanan spiritual dengan tekanan darah sistolik dapat mendeteksi kenyamanan spiritual pada faktor intrapersonal (sensitivitas 70,8%), faktor interpersonal (spesivisitas 70,4%) dan faktor transpersonal (spesivisitas 81,5%). Uji diagnostik perubahan denyut jantung dapat mendeteksi kenyamanan spiritual pada faktor intrapersonal (sensitivitas 60%), faktor interpersonal (spesivisitas 61,5%) dan faktor transpersonal (spesivisitas 80,8%).

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The infection of HIV increases continuously with morbidity and mortality rates can be inhibited through the provision of ARV therapy. Giving ARV therapy suppresses effectively the viral load even though it has an impact on patients' discomfort. However, spiritual comfort is a central aspect in health care. Therefore, spiritual comfort needs to be determine nursing problems. This research intended to produce a spiritual comfort instrument to patients with HIV positive. The research used a mixed-method. The HIV patients' spiritual comfort consisted of three factors which are intrapersonal, interpersonal and transpersonal. The instrument of spiritual comfort for patients with HIV positive valid and reliable to use.  The regulator response of systolic blood pressure and heart rate related to the spiritual comfort. The systolic blood pressure detect the spiritual comfort for intrapersonal factor 70.8% sensitivity, interpersonal factor 70.4% specificity, and transpersonal factor 81.5% specificity. The heart rate changes in diagnostic test detect spiritual comfort in intrapersonal factor 60% sensitivity, interpersonal factor 61.5% specificity, and transpersonal factor 80.8% specificity."

"Studi ekologi ini mengembangkan suatu model manajemen demam berdarah dengue berdasarkan dinamika transmisi, kondisi lingkungan dan kependudukan di wilayah tsunami berat, tsunami ringan, dan tidak tsunami. Pemanfaatan data citra satelit Landsat-5 TM dan klimatologi melalui analisis spasial menemukan bentuk pola sebaran dan tingkat konektivitas antar titik kasus. Ditemukan model manajemen yang berbeda pada simpul 2 media transmisi dan simpul 3 perilaku pemajanan antar wilayah, sehingga dalam memodifikasi kondisi lingkungan dan intervensi perubahan perilaku harus berdasarkan manajemen demam berdarah dengue berbasis wilayah.

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Ecological study is to develop a management model of dengue hemorrhagic fever based on transmission dynamics, environmental conditions and population risk factors in the severe tsunami, the light tsunami, and areas not affected by tsunami. The using satellite imagery Landsat-5 TM and climatological data through spatial analysis were found a form of distribution patterns and levels of connectivity between case points. Management model was found different on node 2 transmission media and node 3 exposure behavior between regions, so that in modifying environmental conditions and behavior change intervention should be refer to the management of dengue hemorrhagic fever based on the region."

"Sistem informasi keperawatan adalah salah satu elemen penting dalam pelaksanaan asuhan keperawatan. Sistem informasi keperawatan di Indonesia saat ini masih belum optimal dan umumnya masih bersifat manual. Riset dimulai dengan mengidentifikasi dan dilanjutkan pengembangan model sistem informasi manajemen keperawatan oleh Roro ("SIMPRO") yang disesuaikan dengan kondisi rumah sakit. Model "SIMPRO" yang telah dicustomization diujicobakan di dua rumah sakit dengan karakteristik yang berbeda yaitu rumah sakit swasta dan rumah sakit pemerintah. Setelah implementasi, dilaksanakan evaluasi dengan desain pre- post test without control group. Jumlah sampel dokumentasi yang digunakan untuk mengevaluasi kinerja "SIMPRO" adalah 219 dokumentasi dari setiap kelompok rumah sakit. Hasil riset menyampaikan ada perbedaan kinerja sebelum dan sesudah menggunakan "SIMPRO" yang diidentifikasikan dari perbedaan kualitas, kelengkapan, kesinambungan, bukti aspek legal dan fungsi membantu membuat keputusan (p=0.001). Ada perbedaan efisiensi waktu: baik di Rumah Sakit Ibu dan Anak Bunda Jakarta dan RS. Fatmawati (p= 0.01). Setelah menggunakan "SIMPRO" waktu yang diperlukan untuk melaksanakan dokumentasi di RS Fatmawati adalah 40.29 menit atau 25.27% dari total waktu dalam satu shift, sedangkan di RS Ibu dan Anak Bunda Jakarta membutuhkan waktu 24.62 menit atau 9.60% dari total waktu dalam satu shift. "SIMPRO" juga mempengaruhi efisiensi biaya, dimana dengan "SIMPRO" dokumentasi tidak setiap waktu harus dicetak. "SIMPRO" menjamin continuity of care dari asuhan keperawatan, sebagai bukti aspek legal, membantu mengambil keputusan dan meningkatkan keselamatan pasien. "SIMPRO" mengefisiensikan waktu dokumentasi sehingga waktu perawatan langsung ke pasien lebih optimal. "SIMPRO" juga meningkatkan edukasi kesehatan kepada pasien dan keluarga."Pada riset ini "SIMPRO" juga dapat meningkatkan peran manajer keperawatan dalam melaksanakan fungsi manajemen terutama pada peran pemberiaan motivasi, pengarahan, evaluasi dan monitoring terhadap pelaksanaan asuhan keperawatan. Dukungan aspek perawat, aspek manajemen dan teknik dapat mengoptimalkan kinerja "SIMPRO" sehingga dapat meningkatkan kualitas pelayanan keperawatan. Berdasarkan manfaat dari "SIMPRO", maka sistem ini dapat direkomendasikan untuk digunakan di setiap Rumah Sakit serta dapat mendukung peningkatan kualitas mutu pelayanan keperawatan dan kesehatan.

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Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects.;Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects."

"Sistem informasi keperawatan adalah salah satu elemen penting dalam pelaksanaan asuhan keperawatan. Sistem informasi keperawatan di Indonesia saat ini masih belum optimal dan umumnya masih bersifat manual. Riset dimulai dengan mengidentifikasi dan dilanjutkan pengembangan model sistem informasi manajemen keperawatan oleh Roro ("SIMPRO") yang disesuaikan dengan kondisi rumah sakit. Model "SIMPRO" yang telah dicustomization diujicobakan di dua rumah sakit dengan karakteristik yang berbeda yaitu rumah sakit swasta dan rumah sakit pemerintah. Setelah implementasi, dilaksanakan evaluasi dengan desain prepost test without control group. Jumlah sampel dokumentasi yang digunakan untuk mengevaluasi kinerja "SIMPRO" adalah 219 dokumentasi dari setiap kelompok rumah sakit. Hasil riset menyampaikan ada perbedaan kinerja sebelum dan sesudah menggunakan "SIMPRO" yang diidentifikasikan dari perbedaan kualitas, kelengkapan, kesinambungan, bukti aspek legal dan fungsi membantu membuat keputusan (p=0.001). Ada perbedaan efisiensi waktu: baik di Rumah Sakit Ibu dan Anak Bunda Jakarta dan RS. Fatmawati (p= 0.01). Setelah menggunakan "SIMPRO" waktu yang diperlukan untuk melaksanakan dokumentasi di RS Fatmawati adalah 40.29 menit atau 25.27% dari total waktu dalam satu shift, sedangkan di RS Ibu dan Anak Bunda Jakarta membutuhkan waktu 24.62 menit atau 9.60% dari total waktu dalam satu shift. "SIMPRO" juga mempengaruhi efisiensi biaya, dimana dengan "SIMPRO" dokumentasi tidak setiap waktu harus dicetak. "SIMPRO" menjamin continuity of care dari asuhan keperawatan, sebagai bukti aspek legal, membantu mengambil keputusan dan meningkatkan keselamatan pasien. "SIMPRO" mengefisiensikan waktu dokumentasi sehingga waktu perawatan langsung ke pasien lebih optimal. "SIMPRO" juga meningkatkan edukasi kesehatan kepada pasien dan keluarga.?Pada riset ini "SIMPRO" juga dapat meningkatkan peran manajer keperawatan dalam melaksanakan fungsi manajemen terutama pada peran pemberiaan motivasi, pengarahan, evaluasi dan monitoring terhadap pelaksanaan asuhan keperawatan. Dukungan aspek perawat, aspek manajemen dan teknik dapat mengoptimalkan kinerja "SIMPRO" sehingga dapat meningkatkan kualitas pelayanan keperawatan. Berdasarkan manfaat dari "SIMPRO", maka sistem ini dapat direkomendasikan untuk digunakan di setiap Rumah Sakit serta dapat mendukung peningkatan kualitas mutu pelayanan keperawatan dan kesehatan.

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Nursing Information System is an important element in nursing process. Current nursing system in Indonesia is still manual and less optimal. However, manual system has weaknesses, such as data slip or even lost, which may potentially lead a nurse in the legal risk. This research was an operational research. It was started by problem identification in order to identify needs for development of nursing information system. The second stage was Sistem Informasi Manajemen Keperawatan oleh Roro ("SIMPRO"), in other words, Development of Nursing Management Information System by Roro. "SIMPRO" has been adjusted and customized with the conditions of the hospitals. Coordination of management, human resources, and infrastructure as well as trainings and assistance were conducted prior to trial of "SIMPRO". Then, trial of "SIMPRO" was conducted at two hospitals, which represent the characteristics of both public and private hospitals. Pretest and posttest without control were done after the implementation. Numbers of nursing documentation as samples were 219 documentations from each hospital group. It was used to evaluate the effectiveness of system performance before and after the implementation of "SIMPRO". Result of the research was difference of performance before and after the implementation of "SIMPRO", which was identified by differences on quality, completeness, continuity, aspect legal function and decision support system (p=0.001). Hospital with good management and infrastructure supports demonstrated higher level of effectiveness than another one. There was difference on time effectiveness before and after the implementation of "SIMPRO", both at Bunda Hospital (p=0.010) and Fatmawati General Hospital (p=0.010). Duration of documentation at Fatmawati General Hospital was 40.29 minutes or about 25.27 percent of total duration in one shift. Meanwhile, duration of documentation at Bunda Hospital was 24.62 minutes or about 9.60 percent of total duration in one shift. "SIMPRO" affected cost effectiveness since no printed documentation produced. In addition, "SIMPRO" guaranteed the continuity of nursing process. Thus, it guaranteed legal aspect and enhanced patient safety as well. This research implicated to the enhancement of quality, completeness, relevance, aspect legal function and decision support system. It also implicated to time efficiency on documentation, thus direct care to patients can be more optimal. "SIMPRO" can enhance the quality of nursing care by supports of nurses, management and technical aspects."

"ABSTRAKFatigue atau kelelahan pada anak dengan kanker masih menjadi permasalahan utama dalam penanganan efek terapi dan efek samping terapi modalitas kanker. Peran keluarga khususnya ibu sangat penting dalam mengelola fatigue kanker secara efektif. Tujuan penelitian adalah memperoleh model yang efektif manajemen fatigue berfokus pada efikasi diri ibu yang memiliki anak dengan kanker. Penelitian menggunakan desain riset operasional dengan tiga tahap penelitian. Tahap 1 mengidentifikasi masalah dan aktifitas ibu merawat anak dengan kanker yang mengalami fatigue melalui penelitian kualitatif dengan desain deskriptif eksploratif menggunakan wawancara semi terstruktur. Tahap 2 dihasilkannya model manajemen kelelahan (fatigue) yang merupakan hasil integrasi dari studi tahap 1, studi literatur dan konsultasi pakar. Tahap 3 validasi model menggunakan desain kuasi eksperimen pre-post test dengan kontrol.Tehnik sampling cara konsekutif digunakan untuk merekrut sampel 40 ibu di kelompok perlakuan dan 38 ibu di kelompok kontrol, dilakukan di tiga rumah sakit pemerintah di Jakarta dan Bandung. Hasil riset tahap 1, diperoleh 6 tema. Tahap 2 dihasilkan rancangan model manajemen fatigue dengan pendukung 7 buku saku manajemen kelelahan, buku saku tanya jawab, dan buku rancangan pelatihan untuk ibu.Hasil penelitian tahap 3 didapatkan perbedaan bermakna antara stres dan efikasi diri pada ibu, fatigue multidimensi, status fungsional, kualitas hidup kanker dan kualitas hidup generik pada anak dengan kanker pada empat kali pengukuran. Kesimpulan, model manajemen fatigue berfokus efikasi diri ibu yang memiliki anak kanker efektif dalam menurunkan stres, meningkatkan efikasi diri ibu serta menurunkan fatigue multi dimensi, meningkatkan status fungsional, kualitas hidup kanker dan kualitas hidup generik pada anak dengan kanker.Rekomendasi: replikasi model manajemen fatigue di seluruh wilayah Indonesia dengan mengintegrasikan model manajemen fatigue di ruang perawatan anak dengan kanker, penelitian lanjut mengenai pengujian model manajemen fatigue dengan desain RCT, membandingkan efikasi diri ayah dan ibu dari anak dengan kanker dan efektifitas manajemen fatigue terhadap efikasi dan kualitas hidup remaja dengan kanker."

"[ABSTRAKTujuan penelitian ini yaitu mengembangkan intervensi model adaptasi paska stroke serta mengidentifikasi efektifitasnya terhadap perilaku adaptasi dan kualitas hidup pasien paska stroke. Penelitian ini secara keseluruhan dilakukan dalam dua tahap. Tahap satu yaitu pengembangan model intervensi yang diawali dengan penelitian kualitatif menggunakan pendekatan fenomenologi deskriptif tentang pengalaman pasien beradaptasi paska stroke. Model intervensi kemudian dikembangkan dengan cara mengintegrasikan tema hasil penelitian kualitatif, studi literatur, dan konsultasi pakar. Tahap kedua yaitu uji coba intervensi model untuk menentukan efektifitasnya terhadap respon adaptasi dan kualitas hidup pasien paska stroke. Penelitian tahap dua merupakan penelitian kuasi eksperimen menggunakan desain post test control group. Metode sampling yang digunakan dalam penelitian tahap dua yaitu consecutive sampling dengan jumlah sampel 65 orang (32 orang kelompok intervensi dan 33 orang kelompok kontrol). Pembagian sampel ke dalam kelompok intervensi dan kontrol dilakukan dengan matching rumah sakit. Hasil penelitian tahap satu teridentifikasi 9 tema yang dinyatakan partisipan dan dihasilkan intervensi model adaptasi paska stroke (IMAPS) beserta perangkatnya meliputi buku panduan intervensi model, modul untuk perawat pelaksana, dan booklet untuk pasien dan keluarga. Hasil penelitian tahap dua membuktikan adanya perbedaan respon adaptasi fisiologis, adaptasi psikososial, dan kualitas hidup yang bermakna antara pengukuran 3 bulan dengan 4 bulan sesudah intervensi diantara kelompok intervensi dan kontrol. Kesimpulan hasil penelitian yaitu intervensi model adaptasi paska stroke efektif meningkatkan respon adaptasi fisiologis, adaptasi psikososial dan kualitas hidup paska stroke.;

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ABSTRACTThe purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke;The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke, The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke]"

"Tuberkulosis masih merupakan masalah kesehatan masyarakat yang utama di dunia, termasuk di Indonesia. Menemukan dan menyembuhkan pasien merupakan cara terbaik dalam upaya pencegahan penularan TB, dengan menerapkan strategi DOTS. Sejalan dengan kebijakan pembangunan nasional, pelaksanaan strategi pengendalian TB nasional diprioritaskan pada daerah terpencil, perbatasan dan kepulauan terutama yang belum memenuhi target penemuan kasus dan keberhasilan pengobatan. Terdapat lima provinsi dengan TB paru tertinggi dan dua tertinggi yaitu Provinsi Jawa Barat (0.7%), Papua (0.6%). Akses pelayanan kesehatan pasien TB menunjukan ketidakmerataan, dimana hanya ada di wilayah perkotaan dan berada pada ekonomi tinggi. Permasalahan dalam penelitian ini adalah masih ditemukan pasien TB yang tidak mendapatkan akses pelayanan kesehatan. Keterbatasan akses pelayanan kesehatan pasien TB dapat disebabkan oleh kondisi individu yang berbeda-beda serta adanya perbedaan kondisi fisik (geografis). Tujuan penelitian ini adalah mendapatkan model spasial akses pelayanan kesehatan di provinsi Jawa Barat dan Papua.Penelitian ini menggunakan desain potong lintang dan menggunakan data yang berasal dari Riset Kesehatan Dasar 2013. Lokasi penelitian di 2 provinsi yaitu di provinsi Jawa Barat dan provinsi Papua. Analisis penelitian dengan menggunakan regresi logistik untuk melihat pengaruh karakteristik individu terhadap akses pelayanan kesehatan dan analisis spasial statistik menggunakan Geographically Weighted Regression (GWR) untuk melihat spasial akses pelayanan kesehatan. Akses pelayanan kesehatan adalah pasien TB yang melakukan pemeriksaan dahak, foto rontgen dan mendapatkan obat anti TB.Akses pelayanan kesehatan pasien TB di provinsi Papua masih rendah. Karakteristik individu yang mempengaruhi akses pelayanan kesehatan adalah asuransi kesehatan, pekerjaan, menikah, mengetahui ketersediaan fasilitas kesehatan. Model spasial akses pelayanan kesehatan menghasilkan dua jenis variabel pembentuknya, yaitu adanya variabel lokal dan variabel global. Variabel lokal adalah variabel yang mempunyai pengaruh unsur kewilayahannya terhadap akses pelayanan kesehatan, sedangkan variabel global merupakan variabel yang berpengaruh di tingkat provinsi.Masih rendahnya pasien TB yang melakukan akses pelayanan dapat disebabkan oleh sulitnya pasien TB dalam mencapai fasilitas kesehatan, terutama di wilayah dengan perbedaan geografis. Sehingga perlunya ada kebijakan dalam menyiapkan sarana dan prasarana kesehatan pasien TB, yaitu dengan mulai memasukan tenaga kesehatan terlatih di bidang tuberkulosis pada seluruh fasilitas pelayanan kesehatan.

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Tuberculosis is a major public health problem in the world, including in Indonesia. Finding and curing the patients are the best way of preventing transmission of TB by implementing the DOTS strategy. Implementation of the national TB control strategy prioritized in remote, border and island especially TB patients who do not meet the target case detection and treatment success. There are two of provinces with the highest and second highest TB namely west Java province (0.7%) and Papua (0.6%). Accessibility to health services of TB patients showed inequality, which only exist in urban areas and at high economic status. The problem in this research is find the of TB patients who do not get accessibility to health services. Limited accessibility to health services of TB patients could be caused by conditions different individuals as well as differences in physical conditions (geographic). The purpose of this study is to setup a spatial model of accessibility to health services in the province of West Java and Papua.

This study used a cross-sectional design and data derived from the Basic Health Research in 2013 (RISKESDAS). Research sites in the provinces of West Java and Papua. Research analysis applied logistic regression to determine the effect of individual characteristics of accessibility to health services and statistical spatial analysis using the Geographically Weighted Regression (GWR) for a model of spatial accessibility to health services.

Accessibility to health care is the patient of TB sputum examination, x-rays and getting anti-TB. Accessibility to health services of TB patients in the province of Papua remains low. Individual characteristics that affect accessibility to health care are health insurance, employment, marriage, the availability of health facilities. Spatial models of accessibility to health services generate two types of constituent variables, the local variables and global variables. Local variables are variables that influence the spatial element of accessibility to health services, while global variables are variables that influence at the provincial level.

The low TB patients who do accessibility services may be caused by the difficulty in the of TB patients to health facilities, especially in the areas with geographical differences. Thus the need for a policy in preparing health facilities TB patients, i.e. to start entering trained health personnel in the field of tuberculosis in the entire health care facility."