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Gerakan masyarakat cinta sehat (Germacis) sebagai strategi mengendalikan

penyakit tidak menular: studi pada kampung di Yogyakarta

Heni Trisnowati, Utari Marlinawati, Naomi Nisari R.S. Fakultas Ilmu Kesehatan,
Universitas Respati Yogyakarta

Penyakit Tidak Menular (PTM) mendominasi penyebab kematian di Yogyakarta.


Kampung Jogokaryan di Kota Yogyakarta memiliki kasus hipertensi dan diabetes
melitus cukup tinggi. PTM dipicu oleh gaya hidup tidak sehat seperti kebiasaan
merokok, aktivitas fisik kurang, dan kegemaran makan gorengan. Di sisi lain, kampung
ini memiliki modal sosial seperti kebiasaan gotong royong, posyandu lansia, kelompok
arisan ibu-ibu dan bapak-bapak. Berdasarkan peluang tersebut, dilakukan Gerakan
Masyarakat Cinta Sehat (Germacis) untuk mengendalikan masalah PTM dan kebiasaan
merokok di Kampung Jogokaryan. Intervensi diawali dengan need assessment kepada
tokoh masyarakat dan kelompok PKK atau dasawisma diikuti sosialisasi program.
Kemudian, dilakukan perencanaan program bersama masyarakat. Terakhir, dilakukan
deklarasi Germacis. Lima tahapan Germacis terdiri dari: 1) Pengembangan inovasi:
merumuskan program bersama tokoh masyarakat; 2) Diseminasi Program: sosialisasi
program pada berbagai acara warga; 3) Adopsi Program: sasaran merespon program
dan menerima program; 4) Implementasi Program: program dilaksanakan secara
bertahap melalui edukasi dengan media promosi kesehatan, deteksi dini PTM, dan
partnership dengan tokoh masyarakat; 5) keberlangsungan dan pemeliharaan program:
dilakukan deklarasi Germacis kemudian disebarkan luaskan oleh stakeholder di setiap
pertemuan warga. Program Germacis dapat direplikasi pada wilayah lain dengan
memperhatikan karakteristik masyarakat setempat agar program berhasil.

Kata kunci: gerakan masyarakat cinta sehat (Germacis); penyakit tidak menular;
pengendalian
PROTECTOR JATEN (Program deteksi dini dan cegah penyakit oleh remaja
jaten) sebagai upaya peningkatan partisipasi remaja dalam posbindu PTM di
Dusun Jaten, Yogyakarta

Beauty Octavia, Ifa Najiyati, Yana Yulyana Departemen Perilaku Kesehatan,


Lingkungan, dan Kedokteran Sosial, Fakultas Kedokteran, Kesehatan Masyarakat dan
Keperawatan, Universitas Gadjah Mada

Saat ini sudah terbentuk Pos Pembinaan Terpadu Penyakit Tidak Menular (Posbindu
PTM) sebagai upaya pencegahan PTM di Dusun Jaten, Sleman, Yogyakarta. Namun,
partisipasi remaja setempat dalam kegiatan tersebut masih rendah. Program sekolah
kader bernama “PROTECTOR JATEN” (Program Deteksi Dini dan Cegah Penyakit
oleh Remaja Jaten) dirancang untuk membentuk dan membekali kader remaja setempat
dengan pengetahuan dan keterampilan dalam deteksi dan pencegahan PTM. Studi ini
bertujuan untuk menilai efektivitas program sekolah kader “PROTECTOR JATEN”
dalam meningkatkan pengetahuan dan keterampilan kader remaja di dusun Jaten.
Penelitian ini dilakukan dengan metode mixed method. Penilaian kuantitatif dilakukan
dengan desain studi pre-eksperimental one group pretest posttest kepada sebelas kader
remaja sedangkan penilaian kualitatif dilakukan dengan wawancara terhadap lima orang
kader remaja secara acak. Pasca pelaksanaan sekolah kader, didapatkan peningkatan
pengetahuan tentang PTM dan pelaksanaan Posbindu PTM pada kader remaja setempat.
Selain itu, juga didapatkan peningkatan keterampilan kader remaja dalam melaksanakan
sistem lima meja Posbindu PTM. Kegiatan sekolah kader dapat meningkatkan
pengetahuan kader remaja mengenai PTM dan keterampilan kader remaja dalam
melakukan pemeriksaan saat pelaksanaan Posbindu.

Kata kunci: posbindu ptm; kader remaja; pengetahuan; keterampilan


Empowering teenagers as health cadres to prevent non-communicable diseases in
dusun Jaten, Sleman, DI Yogyakarta

Melyza Perdana Department of Medical Surgical Nursing, FK-KMK, UGM

Global non-communicable diseases (NCDs) burden is increasing with the national


prevalence of some NCDs are highest in Yogyakarta. Dusun Jaten, as one of
practicum field for CFHC-IPE FK-KMK UGM also found the same problem. In 2017,
a program called POSBINDU PTM was initiated in Dusun Jaten in collaboration with
Puskesmas Mlati 1, RSA UGM, and Sleman Health District. This program aimed to
build awareness and increase the participation of teenagers to prevent NCDs. The step
is initiated by conducting a survey among Jaten residents related to POSBINDU
PTM. Interestingly, almost all of Jaten residents were not familiar with the program.
Thirty new health cadres were recruited (male and female) with 40% of them are
teenagers then followed by “Sekolah Kader” as a training program. An interview was
done among teenagers health cadre to evaluate their knowledge, skills, and willingness
in participating to POSBINDU PTM. Many of them were satisfied of the program and
they also made a good system in managing POSBINDU. Since it was launched in
February 2018, more than 75 residents attended POSBINDU program. This number is
increasing every month. It can be concluded that involving teenager health cadres
could be an important step to prevent NCDs by increasing the awareness of young
adult to participate in regular health check up at POSBINDU PTM.

Keywords: non-communicable diseases; posbindu ptm; teenager; health cadre


Posbindu PTM (Penyakit Tidak Menular) Berbasis Pasar Sebagai Upaya Promotif dan
Preventif pada Pra Lansia dan Lansia di Pasar.

Titih Huriah, Ena Septiningsih, Eka Safitri Sangadji, Anisa Ratnasari, Rafi Achmad
Rukhama. Masita Desi aryanti
Program Magister Keperawatan Universitas Muhammadiyah Yogyakarta

Pasar Bantul terletak di Bantul, Kecamatan Bantul, Bantul, Daerah Istimewa Yogyakarta.
Pasar Bantul memiliki beberapa fasilitas bagi pedagang pasar, salah satu diantaranya yaitu
Upaya Kesehatan Kerja (UKK), namun UKK tersebut sudah tidak aktif dan vakum sejak
tahun 2006. Pasar Bantul belum memiliki fasilitas seperti pemeriksaan kesehatan bagi
pedagang pasar, misalnya dalam bentuk posyandu maupun posbindu. Posyandu yang berada
di lingkungan tempat tinggal pedagang pasar jarang dikunjungi oleh lansia bahkan beberapa
diantara pedagang usia pra lansia dan lansia tidak mengikuti posyandu karena aktivitas
dipasar. Terbentuknya kegiatan yang disebut POSBINDU PTM (Penyakit Tidak Menular)
Berbasis Pasar Sebagai Upaya Promotif dan Preventif pada Pra Lansia dan Lansia di Pasar
bertujuan untuk meningkatkan derajat kesehatan pra lansia maupun lansia di pasar Bantul.
Kegiatan ini dilaksanakan sekali dalam 2 minggu selama 2 bulan. Sebelum dan sesudah
kegiatan dilakukan pre test dan post test menggunakan kuesioner QoL (Quality of Life).
Prosedur pelaksanaan menggunakan sistem 5 meja yang terdiri atas pendaftaran, wawancara
oleh anggota kelompok maupun kader, penimbangan berat badan, pengukuran tinggi badan
dan lingkar perut, pengukuran tekanan darah, pengecekan kadar gula darah sewaktu,
konseling, dan pemberian makanan tambahan. Selain itu, terdapat kegiatan pembentukan dan
pelatihan kader Posbindu. Data hasil pre-test menunjukan skor terendah mengenai kualitas
hidup lansia yaitu berada pada domain hubungan sosial (Mean 41,18). Sedangkan hasil post
test menunjukan peningkatan domain hubungan sosial (Mean 44,76). Selain domain tersebut,
seperti domain fisik, domain psikologis, dan lingkungan dalam batas normal baik pre-test
maupun post-test. Oleh karena itu, adanya kegiatan ini diharapkan pedagang pasar usia pra
lansia maupun lansia dapat memeriksa dan mengontrol kesehatannya secara rutin dan
langsung tanpa menyita banyak waktu karena lokasi Posbindu yang berada dipasar.

Kata kunci: derajat kesehatan, lansia, posbindu


Peningkatan Kompetensi Kader dalam Pelaksanaan ​Screening ​Penyakit Tidak Menular
di Pos Pembinaan Terpadu Wilayah Kabupaten Sleman di Yogyakarta

Sri Arini Winarti Rinawati

Penyakit Tidak Menular merupakan penyakit katastropik yang menimbulkan beban sosial
ekonomi besar bagi penderita, keluarga dan negara. Ketidaktahuan dan ketidakpedulian
masyarakat terhadap PTM, menjadi permasalahan yang mengakibatkan keterlambatan dalam
penanganan sehingga komplikasi dan kematian terjadi lebih dini. Oleh karena itu, diperlukan
partisipasi masyarakat sehingga dikembangkanlah suatu model pengendalian PTM yang
berbasis masyarakat dikenal dengan nama Posbindu PTM. Kegiatan Posbindu PTM
merupakan peran serta masyarakat dalam kegiatan deteksi dini, pemantauan dan tindak lanjut
dini faktor risiko PTM secara mandiri dan berkesinambungan. Tujuan penelitian ini untuk
mengetahui efektifitas pelatihan dalam meningkatkan Kompetensi Kader Dalam Pelaksanaan
Screening Penyakit Tidak Menular Di Pos Pembinaan Terpadu Wilayah Kabupaten Sleman
Di Yogyakarta. Jenis penelitian yang digunakan adalah kuasi eksperimen dengan “pre-post
test with control group design”. Sampel diambil secara non probabilitas sampling yaitu
mengambil 5 responden dalam satu Posbindu dan dianalisis dengan t test didapatkan
signifikansinya 0,001 (<0,05). Hasil penelitian menunjukkan bahwa perbedaan rerata
keterampilan sebelum dan sesudah pelaksanaan pelatihan menunjukkan hasil yang paling
tinggi selisihnya yaitu pada pemberian jenis simulasi yaitu sebelum perlakuan 71.05 dan
sesudah perlakuan 88,07 dengan selisih angka 7. Perubahan pengetahuan pada kelompok
Leaflet, Demonstrasi dan Simulasi hampir sama. Artinya tidak ada perbedaan yang signifikan
pada ketiga kelompok tersebut ditinjau dari pengetahuan kader mengenai screening penyakit
tidak menular (PTM). Sehingga tidak ada perubahan pengetahuan yang signifikan pada ketiga
kelompok tersebut. Pada kelompok perlakuan dengan simulasi didapatkan rerata yang lebih
tinggi dari kelompok leaflet dan demonstrasi. Peningkatan keterampilan responden yang
paling tinggi 17,0 atau paling tinggi di antara ketiga kelompok perlakuan. Sehingga bisa
diartikan bahwa kelompok pemberian pelatihan dengan simulasi akan memberikan dampak
peningkatan ketrampilan yang bagus bagi kader Posbindu. Kesimpulan adanya perbedaan
rerata keterampilan sebelum dan sesudah pelaksanaan pelatihan menunjukkan hasil yang
paling tinggi selisihnya yaitu pada pemberian jenis simulasi yaitu sebelum perlakuan 71.05
dan sesudah perlakuan 88,07 dengan selisih angka 7.

Kata Kunci: Kompetensi kader, screening penyakit tidak menular


.
Evaluasi Sistem Surveilans Faktor Risiko Penyakit Tidak Menular Berbasis Posbindu
di Kabupaten Sleman Tahun 2017

Erna Yati Renyaan​(1*)​, Theodola Baning Rahayujati​(2)​, Isa Dharmawidjaja​(3)


(1) Departemen Biostatistik, Epidemiologi dan Kesehatan Populasi, Fakultas Kedokteran,
Kesehatan Masyarakat, Universitas Gadjah Mada
(2) Dinas Kesehatan Kabupaten Kulonprogo
(3) Rumah Sakit Prambanan Yogyakarta

Latar belakang
WHO mencatat 36 juta jiwa per tahun (63%) penyebab kematian didunia adalah penyakit
tidak menular (PTM). Riset Kesehatan Dasar 2007 dan 2013 menunjukkan 61% dari total
kematian karena PTM. Profil Kabupaten Sleman tahun 2017 tercatat penyakit hipertensi
mencapai 83.000 kasus dan Diabetes Mellitus 33.987 kasus. Tujuan evaluasi untuk melihat
pelaksanaan sistem surveilans faktor risiko penyakit tidak menular (FR-PTM) berbasis Pos
Pembinaan Terpadu (Posbindu) di Kabupaten Sleman tahun 2017.
Metode
Desain penelitian adalah observasional. Dilaksanakan Januari-Februari 2018. Responden
adalah penanggungjawab surveilans PTM Posbindu di 17 puskesmas. Teknik pengambilan
sampel menggunakan purposive sampling. Evaluasi sistem surveilans terkait struktur sistem,
fungsi inti, fungsi pendukung dan kualitas surveilans berdasarkan pedoman WHO. Instrumen
menggunakan kuesioner terstruktur. Analisis data dilakukan secara deskriptif.
Hasil
136 posbindu yang tersebar di 17 puskesmas dan yang aktif melapor 95 posbindu. Dari
struktur sistem menunjukkan 82,38% belum mengetahui tentang legal aspek pelaksanaan
sistem surveilan PTM. Pada segi fungsi inti diketahui 76,47% deteksi kasus masih dilakukan
oleh kader dengan supervisi dokter karena keterbatasan tenaga. Sebanyak 82,35% tidak dapat
melakukan analisis dan interpretasi data FRPTM. Dari fungsi dukungan sebanyak 23,53
responden belum mengikuti pelatihan portal Web PPTM, sedangkan pada kualitas surveilans
diketahui 82,35% data tidak lengkap dan tidak tepat waktu.
Simpulan
Perlu penguatan pada penanggungjawab PTM Posbindu di puskesmas melalui sosialisasi
legal aspek, pembuatan format sederhana, pelatihan analisis dan interpretasi data serta
pelatihan portal Web PPTM untuk meningkatkan kualitas sistem pelaporan PTM.

Keywords: evaluasi; surveilans; faktor risiko PTM


BMC Public Health. 2013; 13: 1043.
Published online 2013 Nov 4. doi: 10.1186/1471-2458-13-1043

A community intervention for behaviour modification: an experience to control


cardiovascular diseases in Yogyakarta, Indonesia

Fatwa Sari Tetra Dewi, Hans Stenlund, V Utari Marlinawati, Ann Öhman, and Lars
Weinehall

Background
Non-communicable Disease (NCD) is increasingly burdening developing countries including
Indonesia. However only a few intervention studies on NCD control in developing countries
are reported. This study aims to report experiences from the development of a
community-based pilot intervention to prevent cardiovascular disease (CVD), as initial part
of a future extended PRORIVA program (Program to Reduce Cardiovascular Disease Risk
Factors in Yogyakarta, Indonesia) in an urban area within Jogjakarta, Indonesia.

Methods
The study is quasi-experimental and based on a mixed design involving both quantitative and
qualitative methods. Four communities were selected as intervention areas and one
community was selected as a referent area. A community-empowerment approach was
utilized to motivate community to develop health promotion activities. Data on knowledge
and attitudes with regard to CVD risk factors, smoking, physical inactivity, and fruit and
vegetable were collected using the WHO STEPwise questionnaire. 980 people in the
intervention areas and 151 people in the referent area participated in the pre-test. In the
post-test 883 respondents were re-measured from the intervention areas and 144 respondents
from the referent area. The qualitative data were collected using written meeting records (80),
facilitator reports (5), free-listing (112) and in-depth interviews (4). Those data were analysed
to contribute a deeper understanding of how the population perceived the intervention.

Results
Frequency and participation rates of activities were higher in the low socioeconomic status
(SES) communities than in the high SES communities (40 and 13 activities respectively). The
proportion of having high knowledge increased significantly from 56% to 70% among men in
the intervention communities. The qualitative study shows that respondents thought
PRORIVA improved their awareness of CVD and encouraged them to experiment healthier
behaviours. PRORIVA was perceived as a useful program and was expected for the
continuation. Citizens of low SES communities thought PRORIVA was a “cheerful”
program.

Conclusion
A community-empowerment approach can encourage community participation which in turn
may improve the citizen’s knowledge of the danger impact of CVD. Thus, a bottom-up
approach may improve citizens’ acceptance of a program, and be a feasible way to prevent
and control CVD in urban communities within a low income country.

Keywords: CVD prevention, Community-based intervention, Community-empowerment,


Primary prevention
Journal article - Media Kesehatan Masyarakat Indonesia Universitas Hasanuddin - March
2018

Pemberdayaan Masyarakat untuk Pencegahan Faktor Risiko Penyakit Tidak Menular


(Studi pada Pedesaan di YOGYAKARTA)

Heni Trisnowati

Abstract
Penyakit Tidak Menular (PTM) merupakan penyebab utama kematian di dunia. PTM juga
mendominasi penyebab kematian di Indonesia terutama di Yogyakarta. Penelitian ini
bertujuan menginisiasi program intervensi masyarakat melalui pemberdayaan masyarakat
untuk mengendalikan faktor risiko PTM di Indonesia, khususnya pada daerah pedesaan di
Yogyakarta. Penelitian ini menggunakan metode kualitatif. Pengumpulan data dilakukan
melalui Focus Group Discussion dan wawancara mendalam. Informan penelitian adalah
tokoh masyarakat dan kader kesehatan sejumlah 23 orang. Analisis data menggunakan
metode tematik content analysis. Proses promosi keehatan melalui pemberdayaan mayarakat
untuk pencegehan PTM di Dusun Modinan adalah sebagai berikut : 1) membangun
kepercayaan masyarakat melalui pertemuan dengan tokoh masyarakat membahas tentang
PTM; 2) meningkatkan kesadaran masyarakat melalui pertemuan kader kesehatan dan
melakukan FGD; 3) mengembangkan program promosi kesehatan; 4) mengorganisasikan
kegiatan promosi kesehatan tentang “Perilaku Cerdik” meliputi : cek kesehatan secara rutin,
enyahkan asap rokok, rajin aktivitas fisik, diet seimbang, istirahat cukup dan kelola stres; 5)
inisisasi untuk pemeliharaan program. Kesimpulannya promosi kesehatan melalui
pemberdayaan masyarakat merupakan salah satu strategi untuk mencegah faktor risiko PTM.
Adanya keterlibatan tokoh masyarakat, persepsi dan pengetahuan yang positif tentang PTM
dari kader kesehatan menentukan keberhasilan program.
Analisis Implementasi Program Pos Pembinaan Terpadu Penyakit Tidak Menular
(Posbindu Ptm) Di Kecamatan Banguntapan Kabupaten Bantul
Lutfy Laksita Pranandari, Septo Pawelas Arso, Eka Yunila Fatmasari

Abstract

Banguntapan is the highest number of program target of Posbindu PTM in Bantul, that is
82.728 people. The coverage of PTM Posbindu activities is 0.52% including the red category
(less than 10%) and the proportion of measurement of abdominal circumference by 60%
including the red category. The objective of this research was analyze implementation of
Posbindu PTM program in Banguntapan District, Bantul Regency. The type of research is
qualitative descriptive with in-depth interview and observation. The research informants were
head of kader, target of Posbindu PTM, programmer staff of infectious diseases, head of
primary healthcare center, and staff of controlling infectious diseases sub unit mental health
in Semarang District Health Office. The result of the research show that the implementation
of Posbindu PTM program in Banguntapan sub-district has not been optimal yet because it
has not been routinely done yet, the partnership still had limited, the implementation of the
service stage still has not optimum in interview stage, measurement, examination and
identification of PTM risk factors and counseling. It was influenced by communication,
resources, disposition, and bureaucracy structure. In communication to the target and
cross-sector was still lacking, the kader were not understand the calculation of IMT. In
resources, from the aspect of human resources the number of cadres has not been sufficient
and the facilities of the provision of inspection strips were not sufficient. In disposition,
response, commitment, and motivation of the implementer was good, but the commitment of
primary healthcare center in assistance less. In the variable of bureaucracy structure,
organizational structure has not been written yet, decree formation of Posbindu PTM had not
been made, job division still has not optimum in service of PTM risk factor identification and
counseling, and supervision have not done optimally. Suggestions from this research were
socialization to the target, establishing partnership, refreshing kader about IMT, making
decree, and monitoring of periodic evaluation.

Keywords: Program implementation, Posbindu PTM


FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEJADIAN HIPERTENSI
PADA PEKERJA SEKTOR INFORMAL DI PASAR BERINGHARJO KOTA
YOGYAKARTA

Dwi Lestari Ratna Ningsih, Indriani

Latar Belakang: Asia menyumbang 54% kematian global akibat hipertensi. Tingginya angka
kematian hipertensi diakibatkan perkembangan sosial ekonomi yang pesat, globalisasi, dan
urbanisasi yang menyebabkan perubahan perilaku atau gaya hidup tidak sehat sehingga
kurangnya mengkonsumsi sayuran, buah, biji-bijian, dan berbagai sumber protein, dan
mudahnya akses makanan cepat saji Dampak dari penyakit hipertensi diantaranya adalah
penyakit serangan jantung, penyakit stroke, gangguan pernafasan kronis seperti penyakit paru
obstruktif kronik dan asma, kanker dan penyakit diabetes melitus. Tujuan : untuk mengetahui
faktor-faktor yang berhubungan dengan kejadian Hipertensi pada Pekerja Sektor Informal di
Pasar Beringharjo Kota Yogyakarta 2017. Metode Penelitian: Penelitian ini menggunakan
desain penelitian Survey Analitik dengan pendekatan Cross sectional, metode pengambilan
sampel menggunakan Accidental Sampling . Jumlah responden sebanyak 320 responden dan
alat pengumpulan data yang digunakan kuesioner. Dan data antropometri diambil dengan
menggunakan timbangan injak, pengukur tinggi badan, Sphygmomanometer dan Stetoskop
digunakan untuk mengukur tekanan darah. Hasil: Hasil Angka kejadian hipertensi pada
pekerja sektor informal di Pasar Beringharjo di Kota Yogyakarta sebanyak 180 responden
(56,3%). Rata-rata Usia responden mayoritas ≥40 tahun yaitu 297 responden (92,5%), Jenis
Kelamin mayoritas perempuan sebanyak 226 (70,6%), Pendidikan paling banyak dalam
kelompok rendah 206 (64,4%), Jenis Pekerjaan responden mayoritas pemilik kios 167
responden (52,2%), Asal tempat tinggal rata-rata Kota Yogyakarta 105 (32,8%). Penghasilan
responden terbanyak rendah yaitu 175 (54,4%), mayoritas responden tidak menyukai
makanan asin yaitu 171 (53,2%), dan tidak menyukai makanan berlemak 163 responden
(50,3%), responden rata-rata tidak mengkonsumsi alkohol yaitu 315 ( (98,4%), tidak
mengkonsumsi rokok sebanyak 240 (75%), aktivitas fisik kurang sebanyak 137 responden
(43,8%) akses layanan kesehatan > 60 menit yaitu 165 responden (51,6%) dan rata-rata
responden memiliki pengetahuan yang rendah yaitu 152 responden (47,5%). Faktor-faktor
yang berhubungan dengan kejadian hipertensi pada pekerja sektor usia (p=0,000), jenis
kelamin (p=0,003), pekerjaan (p=0,001), pendapatan (p=0,000), pendidikan (p=0,000),
riwayat hipertensi keluarga (p=0,000), akses pelayanan kesehatan (p=0,030), pola konsumsi
makanan asin (p=0,000), pola konsumsi makanan berlemak (p=0,000), pola aktivitas fisik
(p=0,000),pengetahuan (p=0,011) dan faktor-faktor yang tidak berhubungan dengan kejadian
hipertensi yaitu asal (p=0,825), konsumsi alkohol (p=0,70). Simpulan dan Saran :
Faktor-faktor yang berhubungan dengan kejadian hipertensi pada pekerja sektor informal di
Pasar Beringharjo Kota Yogyakarta diantaranya usia, jenis kelamin, pekerjaan, pendapatan,
pendidikan, riwayat hipertensi keluarga, akses pelayanan kesehatan, pola konsumsi makanan
asin, pola konsumsi makanan berlemak, pola aktivitas fisik, pengetahuan, konsumsi alkohol
dan asal tempat tinggal tidak berhubungan dengan kejadian hipertensi. Diharapkan agar
pemerintah (Puskesmas) untuk melakukan intervensi hipertensi pada kelompok masyarakat
Pasar yang ada di Indonesia, karena Pasar merupakan komunitas yang cukup besar, sehingga
bisa berkoordinasi antar instansi kesehatan dengan petugas pasar atau universitas
ANALISIS TERHADAP IMPLEMENTASI PERATURAN MENTERI KESEHATAN
NOMOR 71 TAHUN 2015 TENTANG PENANGGULANGAN PENYAKIT TIDAK
MENULAR (PTM) (Studi Kasus: Penanggulangan PTM Berbasis Posbindu PTM Di
Kabupaten Bantul Tahun 2015-2016)

Agreani Diasti Ningrum

Angka kematian akibat Penyakit Tidak Menular (PTM) di Indonesia mengalami peningkatan.
Dari 49,9% di tahun 2001 menjadi 59,5% pada kurun waktu 2007. Kabupaten Bantul adalah
salah satu kabupaten yang ada di Indonesia merupakan penyumbang kematian akibat
penyakit tidak menular. Dari data yang telah ada penyakit tidak menular di Kabupaten Bantul
mengalami kenaikan per tahunnya. Sesuai dengan pembahasan penulis melakukan penelitian
dengan judul Analisis Implementasi Terhadap Peraturan Menteri Kesehatan Nomor 71 Tahun
2015 Tentang Penanggulangan Penyakit Tidak Menular (PTM), dengan studi kasus
Penyelenggaraan Penanggulangan Penyakit Tidak Menular Berbasis Posbindu PTM di
Kabupaten Bantul Tahun 2015-2016, dan dengan rumusan masalah terkait penerapan
implementasi tersebut. Dalam penelitian ini penulis melakukan observasi melalui Dinas
Kesehatan Kabupaten Bantul sebagai salah satu wadah utama dalam melaksanakan
implementasi terkait penyelenggaraan penanggulangan penyakit tidak menular. Selain itu
penulis melakukan observasi langsung kepada masyarakat terkait pelaksanaan dan
pengetahuan mereka terhadap faktor risiko penyakit tidak menular khususnya tentang
kegiatan pelaksanaan Posbindu PTM. Metode penelitian dalam menyelesaikan penelitian ini
penulis menggunakan metode penelitian kualitatif dan menggunakan metode deskriptif
kualitatif yaitu penelitian dengan cara melibatkan kerja lapangan, dimana peneliti biasanya
melakukan observasi terhadap orang-orang, keadaan, atau institusi dalam setting yang
alamiah. Melalui metode kualitatif pula data yang penulis sajikan dalam penelitian ini berupa
data primer yang dihasilkan dari hasil wawancara dan data sekunder yang dihasilkan dari
hasil dokumentasi dan observasi. Pada penelitian ini penulis mendapatkan hasil berupa
adanya kegiatan penyelenggaraan penanggulangan penyakit tidak menular yaitu berupa
adanya pelaksanaan Pos Pembinaan Terpadu Penyakit Tidak Menular atau Posbindu PTM
sesuai dengan isi kebijakan Peraturan Menteri Kesehatan Nomor 71 Tahun 2015 Tentang
Penanggulangan Penyakit Tidak Menular. Posbindu PTM merupakan wujud peran serta
masyarakat dalam melakukan kegiatan deteksi dini dan monitoring faktor risiko PTM serta
tindak lanjutnya yang dilaksanakan secara terpadu, rutin, dan periodik. Masyarakat diberikan
fasilitas dan bimbingan untuk ikut berpartisipasi dalam pengendalian faktor risiko PTM
dengan dibekali pengetahuan dan keterampilan untuk melakukan deteksi dini. Namun pada
pelaksanaannya penerapan implementasi kebijakan tersebut belum berjalan secara maksimal.
Faktor-faktor seperti komunikasi, sumberdaya, disposisi, dan struktur birokrasi perlu lebih
diperhatikan dan ditingkatkan untuk mengoptimalkan pelaksanaan implementasi kebijakan
tersebut. Tetapi walaupun belum berjalan secara maksimal, penerapan implementasi terkait
penyelenggaraan penanggulangan penyakit tidak menular berbasis Posbindu PTM di
Kabupaten Bantul Tahun 2015-2016 berhasil mengurangi angka kematian akibat penyakit
tidak menular di Kabupaten Bantul. Diharapkan dengan adanya kegiatan Posbindu PTM di
Kabupaten Bantul, masalah mengenai faktor risiko terkena penyakit tidak menular yang
membayangi masyarakat dapat diminimalisir dan meningkatkan derajat kesejahteraan
masyarakat khususnya pada bidang kesehatan di Kabupaten Bantul dan untuk tahun
berikutnya diharapkan pelaksanaan implementasi kebijakan kesehatan terkait
penanggulangan penyakit tidak menular dapat lebih ditingkatkan.

Kata Kunci: Implementasi Kebijakan, Kebijakan Kesehatan Kesehatan, Pos Pembinaan


Terpadu Penyakit Tidak Menular (Posbindu PTM).
HUBUNGAN TINGKAT PENGETAHUAN LANSIA TENTANG POSBINDU
DENGAN MOTIVASI LANSIA MENGUNJUNGI POSBINDU

Leli Marlina1 , Arneliwati2 , Rismadefi Woferst3

This study aims to determine the relationship of the knowledge level elderly visiting the
elderly posbindu with motivation posbindu. This research is quantitative research design used
was a descriptive cross sectional correlation approach. The elderly study sample registered a
posbindu existing members in the working area health center inpatient Tenayan Pekanbaru
highway taken by purposive sampling technique as many as 73 people. Measuring instrument
used was a questionnaire designed by the researchers and have been validity and reliability.
Analysis was performed using univariate and bivariate frequency distributions using the chi-
square test. The results showed that there is a significant relationship between the level of
knowledge about the elderly posbindu by visiting posbindu motivation in the work area
inpatient clinic Tenayan Pekanbaru highway (p-value 0.038 <α 0.05). Results of this study
recommends to health professionals to always support the implementation of activities
posbindu both in terms of facilities and training of cadres related duties and responsibilities as
well as the cadre posbindu provide information to families, communities and social
organization in which the elderly live on the importance of visiting posbindu for seniors to
improve their health status.

Keywords: Elderly, knowledge, motivation, posbindu


Impact of Training by Family Doctor on Cadre Performance in Counseling at
Posbindu Dusun Tahunan of Gunungkidul Regency

T. Herjuna Hadiyanta​(1*)​, Wahyudi Istiono​(2)​, I Dewa Putu Pramantara​(3)


(1) Puskesmas Paliyan (Community and Primary Health Care Center), Gunungkidul,
Yogyakarta
(2) Department of Family and Community Medicine, Faculty of Medicine Universitas Gadjah
Mada
(3) Departement of Internal Medicine, Dr. Sardjito Central Public Hospital, Yogyakarta

Background: Increasing cases of non-communicable diseases (NCDs) are becoming a


serious public health threat because they dominate the top 10 global causes of death. The
government is trying to control it by way of early detection of NCDs risk factors through
Posbindu​(Integrated Coaching Groups) activities. At this time ​Posbindu programs are not
running optimally because the volunteers called cadres (​Kader)​ are not confident in doing
counseling. Cadres find it difficult to read and understand the modules by themselves, while
special training on counseling has not been prioritized. Optimally, family doctors as
community oriented care providers need to train cadres to be skilled in counseling so that risk
factors can be controlled as early as possible.
Objectives: The purpose of this study was to assess whether the impact of role playing
training by family physicians can improve the volunteer cadres’ performance in providing
counseling compared with those who rely on only reading the modules.
Methods: The design of this study was a quasi-experimental research with a sample size of
50 participants. The treatment was provided in the form of counseling to 11 volunteers
(cadres) who were specially trained. Analysis of pre and post-test data used a variety of tests
(t-test).
Results: Cadres who were trained by family physicians showed a significant increase in
mean knowledge level (​p ​value 0.007) of 22.9. An average increase 4 weeks after training
showed no significant difference (​p ​value 0.346) when compared to results immediately after
the training. Knowledge of cadres only reading the module showed no significant mean
difference (​p v​ alue 0.6871). There was a significant difference of mean knowledge between
the trained cadres which was higher than the cadres who only read the modules (​p ​value
0.005). There was also a significant increase in the average knowledge of participants after
receiving counseling by trained cadres (​p ​value 0.001) of 22.28.
Conclusion: There was a significant increase in cadre knowledge about NCDs risk factors
after being specially trained by family physicians. Knowledge of cadres before and after
being given modules without training showed no significant change. There was also a
significant increase in participants’ knowledge after receiving counseling by trained cadres.
Training of cadres with role playing methods was demonstrated to increase participants’
knowledge significantly and can be considered a determinant of success in improving cadre
performance in counseling.

Keywords​: education and counseling; non-communicable diseases (NCDs); Posbindu


 
 
   
SOCIAL CAPITAL DALAM PENCEGAHAN DAN PENGENDALIAN FAKTOR
RISIKO PENYAKIT TIDAK MENULAR DI KOTA YOGYAKARTA PROVINSI
DAERAH ISTIMEWA YOGYAKARTA

Penulis: Supriyati
Pembimbing: Prof. dr. Adi Utarini, M.Sc., MPH., Ph.D.; Dra. Yayi Suryo Prabandari, M.Si.,
Ph.D.; DR. M. Najib Azca, M.A

Penelitian ini bertujuan untuk mendeskripsikan promosi kesehatan untuk pencegahan dan
pengendalian faktor risiko penyakit tidak menular (PTM) di Kota Yogyakarta;
mengeksplorasi social capital di Kota Yogyakarta, serta memformulasikan mekanisme
interaksi promosi kesehatan dan social capital beserta konsekuensinya (partisipasi
masyarakat, efikasi kelompok, dan tindakan kolektif) dalam pencegahan dan pengendalian
faktor risiko PTM. Penelitian grounded theory ini dilakukan dengan informan masyarakat
Kota Yogyakarta yang terlibat dalam berbagai kegiatan pencegahan dan pengendalian faktor
risiko PTM, tokoh masyarakat, serta pengelola dan pelaksana promosi kesehatan. Sebanyak
42 informan dipilih secara purposif. Data dikumpulkan melalui observasi, wawancara, dan
diskusi kelompok terarah. Selanjutnya, data dianalisis secara grounded theory dengan
menggunakan software Open Code 3.6. Trustworthiness dilakukan dengan peer debriefing,
prolonged engagement, thick description, negative case analysis, dan triangulasi. Adanya
kepercayaan dan pemimpin lokal yang siap berkorban telah menstimulasi hubungan timbal
balik yang memungkinkan kesuksesan promosi kesehatan. Kepercayaan tersebut diperlukan
pada tingkat provider dan masyarakat. Saat ini, kepercayaan di tingkat provider masih lemah,
sehingga kerja sama dan koordinasi untuk pelaksanaan promosi kesehatan sangat terbatas.
Kondisi tersebut berdampak pada belum maksimalnya partisipasi masyarakat, efikasi
kelompok, dan tindakan kolektif dalam melakukan pencegahan dan pengendalian faktor
risiko PTM. Temuan lain penelitian ini adalah bahwa bonding social capital dan bridging
social capital mensyaratkan interaksi anggota masyarakat atau lingkungan sosial yang
mendukung. Lingkungan sosial Kota Yogyakarta sangat mendukung. Sementara itu, linking
social capital menjadi social capital tambahan yang hanya dimiliki oleh individu yang
memiliki keterampilan sebagai pemimpin dan memiliki jejaring. Partisipasi masyarakat, dan
tindakan kolektif dapat ditumbuhkan (baik pada promosi kesehatan yang dilakukan secara
community centered program maupun provider centered program) selama (1) pesannya
dikemas sesuai dengan felt need masyarakat, (2) masyarakat dapat merasakan manfaat
program, (3) terdapat pengalaman tentang keberhasilan program. Community centered
program lebih memungkinkan untuk tumbuhnya efikasi kelompok yang memicu tindakan
kolektif dalam mengatasi masalah yang dihadapi dan lebih mendukung keberlangsungan
program. Lingkungan sosial masyarakat Kota Yogyakarta yang ditengarai dengan hubungan
timbal balik, kepercayaan sosial, serta didukung dengan keberadaan pemimpin yang siap
berkorban sangat kondusif untuk promosi pencegahan dan pengendalian faktor risiko PTM.
Lingkungan sosial yang kondusif semestinya diimbangi dengan adanya kepercayaan pada
tingkat provider yang dapat meningkatkan koordinasi dan kerja sama untuk promosi
kesehatan tersebut.

Kata kunci: social capital – faktor risiko penyakit tidak menular – promosi kesehatan –
grounded theory
Exploring community empowerment to support non-communicable disease prevention
in a middle-income country

Fatwa Sari Tetra Dewi 2013


Department of Public Health and Clinical Medicine Epidemiology and Global Health
Umeå University, Sweden

Background: Non communicable diseases (NCD) are recognized as a major burden of human
health globally, especially in low and middle-income countries including Indonesia. This
thesis addresses a community intervention program utilizing a community empowerment
approach to study whether this is a reasonable strategy to control NCD.
Objective: To explore possible opportunities, common pitfalls, and barriers in the process of
developing a pilot community intervention program to prevent NCD in an urban area of a
middle-income country.
Methods: The study was conducted in Yogyakarta Municipality. The baseline risk factor
survey in 2004 (n=3205) describes the pattern of NCD risk factors (smoking, physical
inactivity and low fruit and vegetable intake) and demographic characteristics using
STEPwise instrument. A qualitative study was conducted in order to illustrate peoples’
perceptions about NCD risk factors and how NCD might be prevented. A pilot intervention
was developed based on the baseline survey and the qualitative data. The pilot intervention
was conducted in four intervention communities while one community served as the referent
area. The intervention was evaluated using quantitative and qualitative approaches. Finally, a
second cross-sectional survey was conducted in 2009 (n= 2467) to measure NCD risk factor
changes during the five year period.
Results: Baseline qualitative data showed that people in the high SES (Socio Economic
Status) group preferred individual activities, whereas people in the low SES group preferred
collective activities. Baseline survey data showed that the prevalence of all NCD risk factors
were high. The community intervention was designed to promote passive smoking protection,
promote healthy diet and physical activity, improve people’s knowledge of NCD, and provide
a supporting environment. A mutual understanding between the Proriva team and community
leadership was bargained. Several interactive group discussions were performed to increase
NCD awareness. A working team was assigned to set goals and develop programs, and the
programs were delivered to the community. There were more frequent activities and higher
participation rates in the low SES group than in high SES group. The repeated cross-sectional
surveys showed that the percentage of men predicted to be at high risk of getting an NCD
event had significantly increased in 2009 compared to 2004.
Conclusion: The community empowerment model was a feasible choice as a “moderate”
strategy to accommodate with people’s need when implementing a community intervention
that also interacts with the service provided by the existing health system. A community
empowerment approach may improve program acceptance among the people.
Keywords: NCD, cardiovascular disease, community intervention, prevention, community
empowerment, middle-income countries
Pengembangan konsep worksite health and wellness programs di kantor pemerintahan
kota yogyakarta sebagai upaya pencegahan penyakit tidak menular bagi karyawan
perkantoran.

Mohammad Fikri, Departemen Perilaku Kesehatan, Lingkungan dan Kedokteran Kesehatan,


Fakultas Kedokteran, Kesehatan Masyarakat dan Keperawatan, Universitas Gadjah Mada

Abstract
Data Badan Penelitian dan Pengembangan Kesehatan (2013), PTM DI Yogyakarta meliputi
PPOK (3,1%), Asma (6,9%), penyakit jantung (0,6%), kanker (4,1%), diabetes (2,6%),
hipertensi (12,8%) dan beberapa PTM lain yang jumlah kasusnya masih tergolong tinggi
pada usia produktif yang bekerja di perusahaan/perkantoran. Mengatasi masalah kesehatan
tersebut, program-program baru pun coba dirancang mencegah, mengurangi atau paling tidak
mengontrol angka kejadian PTM khususnya bagi para karyawan formal dan informal. Salah
satu program yang coba dirancang adalah Worksite Health and Wellness Programs. WHWPs
merupakan program kesehatan yang telah banyak diterapkan di eropa dan Asia Tenggara
yang memberikan efek positif menanggulangi penyakit tidak menular pada karyawan.
Tujuan penelitian ini adalah untuk melihat seberapa efektif program WHPWs diterapkan di
Kantor Pemerintahan Kota Yogyakarta sebagai strategi pencegahan PTM bagi para
karyawan. Berdasarkan hasil-hasil penelitian terkait, program WHWPs diterapkan
perusahaan di berbagai negara Eropa, Amerika bahkan Asia Tenggara. Salah satunya
Perusahaan J&J merasakan manfaat dari program tersebut dengan hasil yang menunjukkan
adanya penurunan risiko kesehatan bagi karyawannya dari 87,5% berisiko sakit menjadi 78%
pada periode 5 tahun penerapanya. Selain itu, lewat program WHWPs juga mengurangi
persentase perilaku sedentary dari 39% menjadi 21 %, mengurangi perilaku merokok dari
12% menjadi 3,6%, hipertensi dari 14% menjadi 6.4%, dan risiko kolesterol dari 19%
menjadi 6,2%. Kesimpulannya, program WHWPs sangat baik diterapkan di tempat kerja
guna mencegah dan menurunkan risiko PTM bagi karyawan dan biaya pengobatan PTM
dapat ditekan. Oleh karena itu perlu adanya kerja sama lintas sektor untuk mencapai tujuan
positif dari program WHWPs.

Keywords: ​karyawan; penyakit tidak menular; workplace health wellness program


Acceptability and adoption of health-facility based NCD surveillance in Kulon Progo
district, Yogyakarta
Theodola Baning Rahayujati, Dinas Kesehatan Kabupaten Kulonprogo

Abstract
Background: Non-communicable diseases (NCD) have been recognized as the new
disease pandemic to the developing world in recent years. In 2020, it is estimated that
70% of NCD-related deaths will occur in developing countries. The most prevalent NCD
such as coronary heart diseases, cancer, respiratory diseases and diabetes mellitus. Since
2012 Indonesia MOH was established two main surveillance system i.e. health facility-
and community-based surveillance systems. MOH report on 2015 showed those reporting
from PHC less than 25%. The front-line of health facility-based surveillance is the
primary health centers (PHC). Data should undergo validity and quality check by the
District and Provincial Health Office before being sent to the central reporting
system.This study aim to evaluate the implementation of health-facility based NCD
surveillance and develops recommendations for increasing coverage NCD surveillance in
Kulon Progo District. Method: We used RE-AIM (only Reach and Adoption) framework
for evaluating the surveillance system. The Reach variables are coverage, knowledge,
acceptance, constraint, infrastructure and feasibility. 76 NCD team at PHC and District
Health office included doctor, nurse, program manager and laboratory staffs were
interviewed and observed using a standardize questionnaire and checked list. Secondary
data on NCD surveillance reports were collected and reviewed. Qualitative study were
conducted through semi structured interviews and FGDs to evaluate acceptance,
constraints and barriers of implementation. Descriptive analysis was used to analyze
quantitative data and content analysis was performed on the qualitative data. Result: This
study found that most of the health officer involving in the non-communicable program
was having fair knowledge on web based NCD surveillance, and only 5% of the
respondent has a good understanding on it. There are 19 Puskesmas was assessed on the
completeness of the data entry on web based NCD surveillance.

Keywords: surveillance; non-communicable disease; acceptability; adoption; health


facility base
A Community Health Worker–Based Program for Elderly People With
Hypertension in Indonesia: A Qualitative Study, 2013
Riana Rahmawati, MH and Beata Bajorek, PhD

Abstract
Introduction
Hypertension is prevalent in the elderly, but treatment is often inadequate, particularly in
developing countries. The objective of this study was to explore the role of a
community-based program in supporting patients with hypertension in an Indonesian rural
community.
Methods
A qualitative study comprising observation and in-depth interviews was conducted in an
Integrated Health Service Post for the Elderly (IHSP-Elderly) program in Bantul district
(Yogyakarta province). Eleven members of IHSP-Elderly program (ie, hypertensive
patients), 3 community health workers (CHWs), and 1 district health staff member were
interviewed to obtain their views about the role of the IHSP-Elderly program in
hypertension management. Data were analyzed using thematic analysis.
Results
CHWs played a prominent role as the gatekeepers of health care in the rural community.
In supporting hypertension management, CHWs served members of the IHSP-Elderly
program by facilitating blood pressure checks and physical exercise and providing health
education. Members reported various benefits, such as a healthier feeling overall, peer
support, and access to affordable health care. Members felt that IHSP-Elderly program
could do more to provide routine blood pressure screening and improve the process of
referral to other health care services.
Conclusion
CHWs have the potential to liaise between rural communities and the wider health care
system. Their role needs to be strengthened through targeted organizational support that
aims to improve delivery of, and referral to, care. Further study is needed to identify the
key factors for effective CHW-based programs in rural communities and the incorporation
of these programs into the health care system.
Counseling and Motivational Short Text Messages Increase Adherence and Behavioral
Changes in Patient with Hypertension
Ginanjar Zukhruf Saputri • Akrom Akrom • Endang Darmawan

Abstract
Background: Patients with hypertension often fail to achieve treatment goals of
controlling their blood pressure, hence they fall onto the condition of uncontrolled
hypertension. In addition to counseling and patient-education programme, an enhanced
methods of intervention is needed by pharmacist to increase patient adherence and
commitment in taking antihypertension medicine. Motivational intervention has not been
widely used by pharmacist in conducting pharmaceutical care to patients. Objective: This
research is aimed to understand the effect of motivational counseling and short text
messages (SMS) with adherence and behavioral changes in outpatient with hypertension
at PKU Muhammadiyah Hospital Bantul, Yogyakarta. Methods: Sixty patients who meet
the inclusion criteria was divided into two groups, which were experimental group (n=30)
who received motivational counseling and SMS, and control group (n=30) who received
usual care. Data was collected by interviews, behavioral questionaire, adherence
questionaire using Morisky Medication Adherence Scale (MMAS), and blood pressure
measurement according to the medical record. Results: Trans theoretical model (TTM)
was used in this research. Stages of behavioral changes were divided into
pre-contemplation, contemplation, preparation, and action. Result showed that pharmacist
intervention, using motivational counseling and SMS as reminder, contribute to an
increase of patient adherence and action stage of behavioral changes in the experimental
group by 50% compared to 20% in the control group (p=0,035). Increase of adherence as
much as 83,33% was seen in experimental group (p=0,000). A bigger decrease of systolic
and diastolic blood pressure (SBP/DBP) was also seen in the experimental group
compared to control group (SBP=15,37 vs 1,27mmHg), (DBP=6,73 vs 0,43 mmHg) on
their second visits. Conclusion: Based on these results, it can be concluded that
motivational counseling with SMS as a reminder and motivation by pharmacists in
hypertensive patients give a positive influence on behavioral changes that improve
adherence, and increase of systolic and diastolic blood pressure control.
Pengaruh Pemberian Informasi Obat Antihipertensi Terhadap Kepatuhan Pasien
Hipertensi Di Puskesmas Umbulharjo Yogyakarta Periode November 2014

Aulia Kurniapuri, Woro Supadmi

Abstract

Hipertensi merupakan salah satu penyakit dengan prevalensi tinggi. Pengobatan hipertensi
bertujuan untuk mengontrol tekanan darah dan mencegah penyakit komplikasi. Kepatuhan
untuk mencapai keberhasilan pengobatan dapat ditingkatkan dengan pemberian informasi
obat (PIO) untuk meningkatkan pemahaman instruksi pengobatan. Penelitian ini bertujuan
untuk mengetahui pengaruh PIO antihipertensi terhadap kepatuhan pasien hipertensi di
Puskesmas Umbulharjo I Yogyakarta. Penelitian ini menggunakan metode eksperimen
dengan rancangan kelompok statis, sehingga terdiri dari dua kelompok yaitu tanpa PIO
dan dengan PIO. Data diperoleh dari rekam medik/resep dan kuesioner MMAS-8.
Pengambilan sampel dilakukan secara purposive sampling berdasarkan kriteria inklusi dan
eksklusi selama November 2014 dan dianalisis menggunakan uji chi square. Sampel yang
diperoleh sebanyak 45 orang terdiri dari 23 orang dengan PIO dan 22 orang tanpa PIO.
Hasil penelitian menunjukkan bahwa antihipertensi yang paling banyak digunakan adalah
antihipertensi tunggal amlodipin (51,1%) dan antihipertensi kombinasi amlodipin dan
hidroklorotiazid (26,7%). Persentase pasien patuh dengan PIO adalah kepatuhan rendah
8,9%, kepatuhan sedang 11,1%, dan kepatuhan tinggi 31,1%. Persentase pasien patuh
tanpa PIO adalah kepatuhan rendah 24,4%, kepatuhan sedang 11,1%, dan kepatuhan
tinggi 13,3%. Berdasarkan analisis chi square nilai p=0,040 (< α=0,050) sehingga PIO
berpengaruh terhadap kepatuhan. Pemberian informasi obat antihipertensi berpengaruh
signifikan terhadap kepatuhan pasien hipertensi di Puskesmas Umbulharjo I Yogyakarta.

Keywords

Hipertensi; Informasi Obat; Kepatuhan


Mobilising a disadvantaged community for a cardiovascular intervention: designing
PRORIVA in Yogyakarta, Indonesia

Fatwa S.T. Dewi​, ​Hans Stenlund​, ​Ann Öhman​, ​Mohammad Hakimi​, and ​Lars Weinehall

Abstract
Introduction
Cardiovascular disease (CVD) is a burden for developing countries, yet few CVD
intervention studies have been conducted in developing countries such as Indonesia. This
paper outlines the process of designing a community intervention programme to reduce CVD
risk factors, and discusses experiences with regard to design issues for a small-scale
intervention.
Design process
The design process for the present community intervention consisted of six stages: (1) a
baseline risk factor survey, (2) design of a small-scale intervention by using both baseline
survey and qualitative data, (3) implementation of the small-scale intervention, (4) evaluation
of the small-scale intervention and design of a broader CVD intervention in the Yogyakarta
municipality, (5) implementation of the broader intervention and (6) evaluation of the broader
CVD intervention. According to the baseline survey, 60% of the men were smokers, more
than 30% of the population had insufficient fruit and vegetable intake and more than 30% of
the population were physically inactive, this is why a small-scale population intervention
approach was chosen, guided both by the findings in the quantitative and the qualitative
study.
Experiences
A quasi-experimental study was designed with a control group and pre- and post-testing. In
the small-scale intervention, two sub-districts were selected and randomly assigned as
intervention and control areas. Within them, six intervention settings (two sub-villages, two
schools and two workplaces) and three control settings (a sub-village, a school and a
workplace) were selected. Health promotion activities targeting the whole community were
implemented in the intervention area. During the evaluation, more activities were performed
in the low socioeconomic status sub-village and at the civil workplace.
Keywords: ​cardiovascular disease, design intervention, community intervention, urban
community, developing countries
KEGIATAN POSYANDU PENYAKIT TIDAK MENULAR (PTM) – DM
TERHADAP KEPATUHAN PENGELOLAAN DM DI RUMAH PADA
PENYANDANG DM TIPE II

Rosa Delima Ekwantini Harmilah


Jurusan Keperawatan, Poltekkes Kemenkes, Yogyakarta, Indonesia

ABSTRAK
WHO memperkirakan prevalensi global DM tipe II akan meningkat dari 171 juta orang
pada tahun 2000 menjadi 366 juta orang di tahun 2030, dan Indonesia menduduki urutan
keempat (Soegondo, 2007). Menurut catatan di Puskesmas Gamping II bahwa jumlah
penyandang DM di wilayah kerjanya pada tahun 2014 ada sekitar 400 orang, kunjungan rata
– rata 106 orang untuk kontrol gula darah dengan sebagian besar kadar gula darah sewaktu
di atas normal (> 200 mg/dl). Upaya pemerintah yang telah dilakukan untuk menanggulangi
penyakit tersebut adalah memberikan pelayanan di tingkat rumah sakit s.d Puskesmas.
Pelayanan yang dekat dengan masyarakat dibutuhkan untuk menyadarkan mereka agar
melakukan pengelolaan penyakit di rumah secara baik sehingga komplikasi dapat ditunda
atau dicegah. Tujuan penelitian ini untuk mengetahui pengaruh Kegiatan Posyandu PTM -
DM terhadap kepatuhan pengelolaan DM di rumah pada penyandang DM tipe II di wilayah
kerja Puskesmas Gamping II. Jenis Penelitian ini adalah Quasi eksperiment dengan
rancangan pre test-post test design with control group. Jumlah sampel dalam penelitian ini
sebanyak 64 responden pada dua Posyandu yang terbagi dalam 32 responden kelompok
perlakuan dan 32 responden sebagai kelompok pembanding. Pengambilan sampel secara
consecutive sampling. Analisa data menggunakan uji Mc Nemar dan Chi square. Pada
kelompok perlakuan, kepatuhan pengelolaan DM di rumah sebelum kegiatan Posyandu
PTM-DM patuh dan sesudah kegiatan dengan kepatuhan patuh ada 18 responden, sebelum
kegiatan patuh setelahnya tidak patuh 2, sebelum kegiatan tidak patuh dan setelah kegiatan
patuh 10 responden, sebelum kegiatan Posyandu tidak patuh sesudahnya tidak patuh 2 Hasil
uji Mc Nemar diperoleh α 0,039 < 0,05. Responden dengan kepatuhan pengelolaan DM di
rumah setelah kegiatan Posyandu PTM-DM patuh pada kelompok perlakuan ada 28
responden dan kelompok pembanding 20 responden . Responden dengan kepatuhan setelah
kegiatan Posyandu PTM-DM tidak patuh pada kelompok perlakuan ada 4 responden,
kelompok pembanding 12 responden. Hasil uji Chi square diperoleh α 0,021 < 0,05.
Kegiatan Posyandu PTM – DM berpengaruh terhadap kepatuhan pengelolaan DM dirumah.

Kata Kunci​: diabetus mellitus, kepatuhan, pengelolaan

Evaluasi kualitatif program penyakit tidak menular berbasis posbindu di


wilayah kerja Puskesmas Muara Bungo I

grace sicilia dhany​(1*)

(1) Universitas Gadjah Mada


(*) Corresponding Author
Abstract
Latar belakang​: penderita penyakit tidak menular (PTM) pada umumnya datang ke fasilitas
pelayanan kesehatan sudah dalam kondisi lanjut dan sulit untuk sembuh total. Masyarakat
yang berdaya dan tangguh merupakan modal sosial yang luar biasa besar dibanding sumber
daya lainnya yang berasal dari luar masyarakat. Posbindu PTM merupakan salah satu solusi
peningkatan potensi dan partisipasi masyarakat dalam upaya pengendalian faktor risiko PTM
melalui kegiatan deteksi dini dan pemantauan faktor risiko PTM utama. Posbindu PTM di
wilayah kerja Puskesmas Muara Bungo I efektif berjalan sejak tahun 2015. Penelitian ini
bertujuan mendeskripsikan pelaksanaan program pengendalian penyakit tidak menular
berbasis posbindu PTM di wilayah kerja Puskesmas Muara Bungo I.
Metode​: penelitian ini adalah penelitian kualitatif dengan rancangan studi kasus. Subjek
penelitian berjumlah 38 orang diambil dengan menggunakan teknik ​purposive. Menggunakan
teknik wawancara mendalam, FGD, observasi lapangan dan pengambilan data sekunder.
Hasil​: Posbindu PTM di wilayah kerja Puskesmas Muara Bungo I berjalan dari tahun 2015
dan rutin dilaksanakan setiap bulan serta berkembang dari 6 menjadi 9 posbindu pada Tahun
2017. Terdapat kebutuhan akan keberadaan posbindu di masyarakat, kader dan tokoh
masyarakat menganggap posbindu penting untuk menjaga kesehatan masyarakat dan
berharap program tetap dijaga keberlajutannya. Terdapat potensi besar dari masyarakat yang
diwakili oleh kader dan tokoh masyarakat yang perlu dikembangkan lebih baik lagi. Masih
terdapat kekurangan jumlah petugas kesehatan sebagai pengelola P2PTM menurut informan,
pemahaman konsep posbindu belum sesuai dengan pedoman yang berlaku dan keterbatasan
pembiayaaan dan sarana prasarana. Kader posbindu selalu konsisten menjalankan Posbindu
PTM dengan ataupun tanpa pelatihan tentang posbindu PTM. Peran kader dan tokoh
masyarakat merupakan modal utama dalam pelaksanaan kegiatan ini. Masih terdapat
pandangan masyarakat bahwa di mana ada pemeriksaan kesehatan di situ ada pengobatan.
Beberapa kendala tersebut menjadikan capaian kunjungan posbindu di wilayah kerja
Puskesmas Muara Bungo I tahun 2017 sebesar 5,7% (standar SPM 100%).
Kesimpulan​: Posbindu PTM rutin dilakukan setiap bulan. Berdasarkan evaluasi
menggunakan metode CIPP bahwa pelaksanaan Posbindu PTM di wilayah kerja Puskesas
Muara Bungo I belum optimal. Diperlukan perhatian dan campurtangan lintas sektor yang
diprakarsai langsung oleh Bupati Bungo.
Kata kunci​: e​ valuasi program; penyakit tidak menular; posbindu PTM

Efektivitas sekolah kader protector Jaten terhadap peningkatan pengetahuan


dan keterampilan kader remaja di dusun Jaten, Sendangadi, Mlati, Sleman,
Yogyakarta

Beauty Octavia​(1*)​, Ifa Najiyati​(2)​, Yana Yulyana​(3)

(1) "Gadjah Mada University"


(2)
(3)
(*) Corresponding Author

Abstract

Latar Belakang: Berdasarkan data ​Community and Family Health Care ​(CFHC) FKKMK
UGM tahun 2018, sebanyak 32,6% keluarga di Jaten memiliki anggota keluarga yang
menderita hipertensi. Salah satu upaya pengendalian PTM dilakukan dengan pembentukkan
Pos Pembinaan Terpadu (Posbindu) PTM. Posbindu PTM di Dusun Jaten telah dibentuk
sejak bulan April 2018 namun partisipasi remaja dalam pelaksanaan kegiatan tersebut masih
rendah. Dirancang ​“PROTECTOR JATEN” (Program Deteksi Dini dan Cegah Penyakit oleh
Remaja Jaten) untuk mendekatkan akses pelayanan kesehatan remaja yang dimulai dengan
pembentukan kader remaja dan dilanjutkan dengan kegiatan Sekolah Kader untuk membekali
kader remaja pengetahuan dan keterampilan.​Tujuan: Penelitian ini bertujuan untuk
meningkatkan pengetahuan dan keterampilan kader remaja di dusun Jaten mengenai sistem
lima meja dalam pelaksanaan Posbindu PTM.​Metode: Penelitian ini dilakukan dengan
metode ​mixed method​. Pendekatan kuantitatif dilakukan dengan menggunakan rancangan
pre-eksperimental dengan ​one group pretest posttest design kepada 11 orang kader remaja.
Pendekatan kualitatif dilakukan dengan wawancara semi struktural terhadap 5 orang kader
remaja yang dipilih secara acak.​Hasil: Terdapat peningkatan pengetahuan tentang PTM dan
pelaksanaan Posbindu PTM yang signifikan setelah dilakukan Sekolah Kader (p= 0,003)
dengan nilai rata-rata pretest 6,646 dan nilai rata-rata posttest 8,573. Terdapat peningkatan
keterampilan kader remaja dalam melaksanakan sistem lima meja Posbindu PTM yang dinilai
dengan observasi langsung pada saat pendampingan kegiatan Posbindu PTM. ​Kesimpulan:
Kegiatan Sekolah Kader dapat meningkatkan pengetahuan kader remaja mengenai PTM dan
pelaksanaan Posbindu PTM; Kegiatan Sekolah Kader dapat meningkatkan keterampilan
kader remaja dalam melaksanakan pemeriksaan dalam pelaksanaan Posbindu PTM.

PEMANFAATAN POS PEMBINAAN TERPADU PENYAKIT TIDAK MENULAR


(POSBINDU PTM) OLEH WANITA LANSIA DALAM RANGKA MENCEGAH
PENYAKIT TIDAK MENULAR DI WILAYAH KERJA PUSKESMAS CILONGOK 1
Fauzia Purdiyani
BagianPendidikan Kesehatan dan Ilmu Perilaku, FakultasKesehatanMasyarakat
UniversitasDiponegoro
Email: Fauziapurdiyani@gmail.com

Abstract :Based Buletin jendela data Informasi kesehata lansia, in Indonesia in 2010 there
were 18.1 million elderly people.WHO data show that 36 million deaths of elderly people due
to non-communicable diseases. Posbindu PTM launched a program for the early detection of
disease is not contagious but the fact these facilities are utilized by risk groups (elderly
women). The main purpose of this research is to analyzeefactors related to the utilization
factor Posbindu PTM by elderly women. The method used quantitative with cross sectional
approach. The total population of 398 elderly women with a total sample of 82 women using
proportional stratified random sampling techniques. The analysis of the data using analysis of
univariate statistical tests with bivariat and Chi Square (0.05 significant levels). Results of the
study showed no relationship between age (0,913),eduacation stage (0,155) and accessibility
(0,052), while the jobs respondents (p=0,025 ), status of the treatment of the respondent
(p=0,021), health status, knowledge, attitude, support health cadres (p=0,000), support health
care personnel and peers (p=0,002 ), family support (p=0,003), the perception of pain
(p=0,004 ) and needs Posbindu PTM (p=0,001) has value pvalue (0.05) so that it can be
concluded that there is a relationship between variables with the utilization of elderly women
by Posbindu PTM. The advice of this research is to carry out monitoring and evaluation of
the implementation of the PTM Posbindu each month towards the performance of the health
workforce and health cadre, make colobaration between Posyandu lansia program and
Posbindu PTM.
Keywords :Elderly women, Non communicable disease, Posbindu PTM

Evaluasi sistem surveilans faktor risiko penyakit tidak menular berbasis


Posbindu di kabupaten Sleman

Erna Yati Renyaan​(1*)​, Theodola Baning Rahayujati​(2)​, Isa Dharmawidjaja​(3)

(1) Departemen Biostatistik, Epidemiologi dan Kesehatan Populasi, Fakultas Kedokteran,


Kesehatan Masyarakat, Universitas Gadjah Mada
(2) Dinas Kesehatan Kabupaten Kulonprogo
(3) Rumah Sakit Prambanan Yogyakarta
(*) Corresponding Author
Abstract
Latar belakang
WHO mencatat 36 juta jiwa pertahun (63%) penyebab kematian didunia adalah penyakit
tidak menular (PTM). Riset Kesehatan Dasar 2007 dan 2013 menunjukkan 61% dari total
kematian karena PTM. Profil Kabupaten Sleman tahun 2017 tercatat penyakit hipertensi
mencapai 83.000 kasus dan Diabetes Mellitus 33.987 kasus. Tujuan evaluasi untuk melihat
pelaksanaan sistem surveilans faktor risiko penyakit tidak menular (FR-PTM) berbasis Pos
Pembinaan Terpadu (Posbindu) di Kabupaten Sleman tahun 2017.
Metode
Desain penelitian adalah observasional. Dilaksanakan Januari-Februari 2018. Responden
adalah penanggungjawab surveilans PTM Posbindu di 17 puskesmas. Teknik pengambilan
sampel menggunakan purposive sampling. Evaluasi sistem surveilans terkait struktur sistem,
fungsi inti, fungsi pendukung dan kualitas surveilans berdasarkan pedoman WHO. Instrumen
menggunakan kuesioner terstruktur. Analisis data dilakukan secara deskriptif.
Hasil
136 posbindu yang tersebar di 17 puskesmas dan yang aktif melapor 95 posbindu. Dari
struktur sistem menunjukkan 82,38% belum mengetahui tentang legal aspek pelaksanaan
sistem surveilan PTM. Pada segi fungsi inti diketahui 76,47% deteksi kasus masih dilakukan
oleh kader dengan supervisi dokter karena keterbatasan tenaga. Sebanyak 82,35% tidak dapat
melakukan analisis dan interpretasi data FRPTM. Dari fungsi dukungan sebanyak 23,53
responden belum mengikuti pelatihan portal Web PPTM, sedangkan pada kualitas surveilans
diketahui 82,35% data tidak lengkap dan tidak tepat waktu.
Simpulan
Perlu penguatan pada penanggungjawab PTM Posbindu di puskesmas melalui sosialisasi
legal aspek, pembuatan format sederhana, pelatihan analisis dan interpretasi data serta
pelatihan portal Web PPTM untuk meningkatkan kualitas sistem pelaporan PTM.

Keywords

evaluasi; surveilans; faktor risiko PTM; posbindu

PEMBERDAYAAN KADER DENGAN MENINGKATKAN PENGETAHUANDAN


KETERAMPILAN KADER DALAM PELAYANAN POSBINDU DIWILAYAH KERJA
PUSKESMAS BAYAT

ABSTRAK
Peran kader Posbindu dalam pelaksanaan kegiatan sangat dominan karena tenaga
kesehatan hanya sebagai pendamping dan penerima rujukan, sehingga pengetahun
dan ketrampilan kader perlu ditingkatkan. Tujuan penelitian untuk mengetahui
apakah ada peningkatan pengetahuan dan ketrampilan kader dalam pelayanan
Posbindu setelah diberikan pemberdayaan kader. Metode penelitiaan kuantitatif
dengan jenis quasi eksperiment design. Desain penelitian yang digunakan pretest
and posttest control group design. Populasi sekaligus sampel seluruh kader
kesehatan di Wilayah Puskesmas Bayat, Klaten sebanyak 60 orang dengan 30
orang pada kelompok perlakuan dan 30 orang kelompok kontrol dengan teknik total
sampling. Variabel independen berupa pemberdayaan kader sedangkan
variabeldependen pengetahuan dan keterampilan, instrumen yang digunakan
dengan kuesioner. Teknik analisis data paired simple test danindependen paired
simple t-test. Hasil penelitian menunjukkan pengetahuan kelompok eksperimen dan
kelompok kontrol sebelum diberikan pemberdayaan kader dalam pelayanan
Posbindu pada kategori cukup (77,8% dan 82,4%) dan pengetahuan kelompok
eksperimen dan kelompok kontrol sesudah diberikan pemberdayaan kader dalam
pelayanan Posbindu pada kategori cukup (55,6% dan 70,6%),
keterampilanresponden kelompok eksperimen dan kelompok kontrol sebelum
diberikan pemberdayaan kader kategori terampil (72,2% dan 82,4%) dan
keterampilan responden kelompok eksperimen dan kelompok kontrol sesudah
diberikan pemberdayaan kader kategori terampil (61,1% dan 70,6%), dan terdapat
pengaruh pemberdayaan kader dalam pelayanan Posbindu terhadap pengetahuan
dan keterampilan kader dalam pelayanan Posbindu di wilayah kerja Puskesmas
Bayat (p=0,014, p=0,019).Disarankan bagi kader, setelah dilakukan pemberdayaan,
dapat menambah keterampilan agar tidak mengalami kemunduran dalam pelayanan
Posbindu.
Kata kunci: Pemberdayaan kader, Pengetahuan, Keterampilan, Pelayanan Posbindu

Status Partisipasi dan Kualitas Hidup Peserta Pos Pelayanan Terpadu Lanjut Usia
Syamsumin Kurnia Dewi1, Hari Kusnanto2, I Dewa Putu Pramantara3, Theodola
Baning Rahayujati4
1Akademi Fisioterapi, “YAB” Yogyakarta, Indonesia
2Jurusan Biostatistika, Epidemiologi, dan Kesehatan Populasi, Fakultas Kedokteran,
Universitas Gadjah Mada, Yogyakarta, Indonesia
3Sub Bagian Geriatri, Bagian Penyakit Dalam, Fakultas Kedokteran/RS Sardjito,
Universitas Gadjah Mada, Yogyakarta, Indonesia
4Dinas Kesehatan Kulon Progo, Daerah Istimewa Yogyakarta, Indonesia
E-mail: dikdewik@yahoo.com, drdewik@gmail.com, ​harikusnanto@yahoo.com
Received: 30/09/2016; published:27/02/2017
Abstract
Background: Demographic and epidemiologic transition now occurred in the District
of Bantulcould be followed by decreasing quality of life in elderly. Community elderly
care service (CECS) is a primary service for elderly with potential to support
increasing quality of life in elderly. Based on previous study, utilization of CECS was
high (73.30%) at subdistrict of Bambanglipuro, Bantul. To know the relationship
between participation status and quality of life in CECS participants at subdistrict of
Bambanglipuro. Method: A cross-sectional study was conducted from April to May
2012. Samples were selected with consecutive sampling technique. Data were
collected from 8 CECSs at subdistrict of Bambanglipuro. Quality of life was
measured with short form 36 (SF-36) Health Survey, including physical component
summary (PCS) and mental component summary (MCS). Data then were analyzed
with descriptive and analytic methods using Chi-square test and multiple logistic
regression. Results: Of 238 subjects investigated, 186 (78.20%) were good in PCS
and 194 (81.50%) were good in MCS. Multivariate analysis showedthat active in
physical exercise of CECS program, absence of hypertension, and better economic
status were related to better PCS (aPR: 5.31, 95%CI: 2.52-11.20; aPR: 3.41, 95%CI:
1.31-5.47; aPR: 2.68; 95%CI: 1.31-5.47) and better MCS (aPR: 3.97, 95%CI:
1.83-8.64; aPR: 3.08, 95%CI: 1.39-6.82; aPR: 6.38; 95%CI: 2.62-15.53). Conclusion:
Dominant factors that related to better quality of life in CECS participants were:
active in physical exercise program of CECS, absence of hypertension and better
economic status.Keywords: community elderly care service, elderly, participation
status, quality of life.
Faktor Yang Mempengaruhi Pemanfaatan Posyandu Lansia di Imogiri
Kabupaten Bantul

Abstrak
Posyandu lansia adalah salah satu cara untuk mengantisipasi perubahan
degeneratif yang terjadi pada lansia. Jumlah kunjungan ke posyandu lansia di Dusun
Karangkulon 2010, rata-rata 60 lansia dari 160 lansia yang terdaftar. Penelitian
observasional dengan disain cross sectional ini bertujuan untuk mengetahui faktor
yang berpengaruh terhadap pemanfaatan posyandu lansia. Sampel diambil dengan
teknik total sampling pada 160 populasi lansia di Dusun Karangkulon. Pengambilan
data menggunakan kuesioner dan wawancara. Analisis menggunakan uji chi square
dan regresi logistik. Hasil uji chi square menujukkan variabel jenis kelamin (0,000),
status perkawinan (p=0,018), persepsi sehat sakit (p=0,000), persepsi kualitas
pelayanan (p=0,000) ada pengaruh terhadap pemanfaatan posyandu lansia.
Sedangkan variabel umur (0,774), pendidikan (p=0,059), pekerjaan (p=1), dukungan
refrence group (0,865) tidak ada pengaruh terhadap pemanfaatan posyandu lansia.
Hasil uji Regresi logistik menunjukkan bahwa variabel yang paling dominan
(p=0,025) berpengaruh terhadap pemanfaatan posyandu lansia adalah persepsi
kualitas pelayanan posyandu. Kesimpulan: Ada pengaruh signifikan jenis kelamin,
status perkawinan, persepsi sehat sakit dan persepsi kualitas pelayanan terhadap
pemanfaatan posyandu lansia. Disarankan kader dan petugas kesehatan untuk
meningkatkan kualitas pelayanan dan penyuluhan posyandu lansia.

PARTISIPASI LANJUT USIA DALAM POSYANDU LANSIA “WIRA


WERDHA” DI RW 14 KELURAHAN WIROGUNAN KECAMATAN
MERGANGSAN KOTA YOGYAKARTA

Deasy Wiji Wulandari


Abstract

Penelitian ini bertujuan untuk mendekripsikan : (1) Partisipasi lanjut usia dalam
posyandu lansia (2) Faktor pendukung dan penghambat lanjut usia dalam
berpartisipasi pada kegiatan Posyandu Lansia Wira Werdha. Penelitian ini
merupakan penelitian deskriptif dengan menggunakan pendekatan kualitatif.
Penentuan subjek penelitian dalam penelitian ini menggunakan ​purposive sampling.​
Subjek penelitian adalah kader, lanjut usia, dan tokoh masyarakat. Pengumpulan
data dilakukan dengan teknik wawancara, observasi, dan dokumentasi. Teknik yang
digunakan dalam analisis data adalah reduksi data, ​display data, dan penarikan
kesimpulan. Trianggulasi yang digunakan untuk menjelaskan keabsahan data
menggunakan sumber data. Hasil penelitian menunjukan bahwa: (1) Partisipasi
lanjut usia dalam posyandu lansia yaitu partisipasi tenaga, dana dan material. Pada
partisipasi tenaga adalah keikutsertaan dalam kehadiran di posyandu lansia,
melakukan kegiatan-kegiatan yang dilaksanakan posyandu lansia seperti senam,
pemeriksaan kesehatan, dan rekreasi, sedangkan partisipasi dana yaitu
keikutsertaan dalam memberikan sumbangan secara sukarela di setiap pertemuan,
dan partisipasi material yaitu keikutsertaan dalam bentuk sumbangan yang
dipergunakan untuk umum seperti menjenguk orang sakit dan melayat. (2) Faktor
pendukung dan penghambat dalam posyandu lansia, faktor pendukung: a) Faktor
internal: lanjut usia banyak yang masih aktif dan bersemangat dalam mengikuti
kegiatan ini dan adanya keinginan untuk mengetahui kesehatan dan banyak
kegiatan positif b) Faktor Eksternal: banyak teman, serta kader-kader juga perhatian
dengan lansia, adanya dukungan dari tokoh masyarakat serta kader yang selalu
ingin memajukan Posyandu Lansia, teman-temannya yang masih aktif dalam
mengikuti kegiatan di posyandu lansia serta pengurus-pengurus di RW maupun RT
sangat mendukung dan merespon postif adanya Posyandu Lansia ini, peran dari
Puskesmas dalam pelayanan kesehatan dan bantuan dari tokoh masyarakat dalam
menyediakan sarana dan prasarana. Faktor penghambat: a) Faktor Internal: Kondisi
lansia yang sudah lemah yang terkadang tidak dapat memungkinkan untuk ikuserta
dalam Posyandu Lansia dan ada sebagian pihak keluarga yang tidak mendukung
lanjut usia untuk ikut serta dalam Posyandu Lansia b) Faktor Eksternal: kondisi
cuaca yang kadang tidak menentu seperti ujan dan alat-alat kesehatan di Posyandu
Lansia kurang lengkap untuk mengecek kesehatan lanjut usia.

Sekolah Kader : Sebagai Upaya Peningkatan Pengetahuan dan Keterampilan Kader


Remaja Posbindu PTM Di Dusun Jaten, Yogyakarta
AIM / OBJECTIVE
Berdasarkan data Community and Family Health Care (CFHC) FKKMK UGM tahun
2018, sebanyak 32,6% keluarga di Jaten memiliki anggota keluarga yang menderita
hipertensi. Remaja menjadi kelompok yang rentan, karena remaja masih berada
dalam fase perkembangan dan mulai mencari kebebasan dari pantauan orang tua¹.
Berdasarkan hasil diskusi yang dilakukan dengan remaja mengenai pola hidup
sehari-hari, didapatkan bahwa lebih dari 50% remaja di Dusun Jaten adalah perokok
aktif. Selain itu, remaja menyatakan bahwa mereka kurang mengonsumsi sayur dan
buah. Kedua perilaku tersebut merupakan faktor risiko terjadinya penyakit tidak
menular (PTM). Salah satu upaya pengendalian PTM dilakukan dengan
pembentukkan Pos Pembinaan Terpadu (Posbindu) PTM². Posbindu PTM di Dusun
Jaten telah dibentuk sejak bulan April 2018 namun partisipasi remaja dalam
pelaksanaan kegiatan tersebut masih rendah, yakni hanya 5 orang remaja yang
hadir. disebabkan karena kesadaran yang rendah, remaja merasa sehat sehingga
tidak perlu untuk memeriksakan kesehatannya. Selain itu, kegiatan posbindu
diadakan di hari sabtu. Terdapat beberapa remaja yang bekerja dan masih
bersekolah.
Salah satu cara efektif untuk meningkatkan partisipasi remaja dalam mengakses
fasilitas kesehatan untuk melakukan pemeriksaan kesehatan yaitu dengan
mendekatkan akses pelayanan kesehatan ke tempat yang mudah dan sering
dijangkau oleh remaja³.
Dirancang “PROTECTOR JATEN” (Program Deteksi Dini dan Cegah Penyakit oleh
Remaja Jaten) untuk mendekatkan akses pelayanan kesehatan remaja yang dimulai
dengan pembentukan kader remaja dan dilanjutkan dengan kegiatan Sekolah Kader
untuk membekali kader remaja pengetahuan dan keterampilan.
Penelitian ini bertujuan untuk menilai dan mengeksplorasi sekolah kader sebagai
upaya peningkatan pengetahuan dan keterampilan kader remaja di dusun Jaten
mengenai sistem lima meja dalam pelaksanaan Posbindu PTM

FAKTOR – FAKTOR YANG MEMPENGARUHI KEAKTIFAN KUNJUNGAN POS


PEMBINAAN TERPADU PENYAKIT TIDAK MENULAR DI DESA
(Factors That Influence The Activity Of Visited Integrated Posting Most Of Diseases
In The Village)
(Submited : 4 Januari 2018, Accepted : 27 Februari 2018)
Ivong Rusdiyanti
Politeknik Unggulan Kalimantan
ngovipersadha@gmail.com
ABSTRAK
Menigkatnya kasus Penyakit Tidak Menular merupakan salah satu masalah yang
dihadapi oleh masyarakat. Berbagai upaya telah dilakukan pemerintah untuk
mengatasi masalah tersebut, Salah satu program yang dicanangkan oleh
pemerintah adalah Pos Pembinaa Terpadu penyakit tidak menular, program tersebut
digalakkan guna peningkatan mutu dan derajat kesehatan serta pelayanan
kesehatan. Peran masyarakat secara mandiri dan berkesinambungan sangat
diperlukan untuk mengendalikan factor resiko penyebaran Penyakit Tidak Menular.,
dengan pencegahan faktor risiko penyakit tidak menular dapat dilakukan sejak dini
dan kejadian penyakit tidak menular di masyarakat dapat diminimalkan.Tujuan dari
penelitian ini adalah untuk mengetahui faktor-faktor yang mempengaruhi keaktifan
kunjungan ke pos pembinaa terpadu penyakit tidak menular Di Desa Bulupitu.
Desain penelitian menggunakan studi deskriptif. Populasi penelitian adalah seluruh
sasaran pembinaa terpadu penyakit tidak menular sejumlah 3426 orang. Sampel
diambil dengan menggunakan tehnik sampling random atau acak sebanyak 97
orang. Data primer menggunakan kuesioner. Data yang diperoleh selanjutnya
dianalisis dengan pendekatan statistik deskriptif dan non-parametrik.Uji statistic yang
dignakan dalam penelitian ini yaitu menggunakan uji non –parametrik yaitu analisis
Chi-Kuadrat. Hasil analisa data menunjukkan bahwa faktor jenis kelamin,
pengetahuan, pekerjaan, penghasilan, jarak, dan peran kader mempunyai korelasi
dengan keaktifan kunjungan pembinaan terpadu penyakit tidak menular setiap
bulan, sedangkan Pendidikan, dukungan keluarga seseorang tidak mempunyai
korelasi dengan keaktifan kunjungan pembinaan terpadu penyakit tidak menular.
Kata Kunci : Keaktifan kunjungan, penyakit tidak menular

Community Empowerment to Prevent Risk Factors of Non Communicable


Diseases (Case in A Rural Communities of Yogyakarta)
Heni Trisnowati
Prodi Kesehatan Masyarakat, Fakultas Ilmu Kesehatan, Universitas Respati
Yogyakarta
(hentris27@gmail.com)
ABSTRAK
Non-Communicable Diseases (NCDs) are the leading cause of death in the world.
NCDs dominated cause of death in Indonesia, mainly in Yogyakarta. This study aim
to initiate a community intervention program through community empowerment to
control risk factors for NCDs in Indonesia, especially in a rural area of Yogyakarta.
This study used qualitative methods where data were collected by focus group
discussions and in-depth interviews. There were 23 informants of community leaders
and health workers. Tematik content analysis was used to analyse data. The
process of community empowerment for the prevention and control of NCDs in
Modinan are as follows: 1) building public trust through meetings with community
leaders to discuss about NCDs; 2) raising public awareness through health cadre
meetings and conducting FGD; 3) developing health promotion programs; 4)
organising health promotion activities on “CERDIK Behavior” includes : routine
medical chek up, not smoking doing physical activity, a balanced diet, adequate rest
and manage stress; 5) initiation to maintenance program. In Summary,
Empowerment is one of health promotion strategies to prevent risk factors for NCDs.
The involvement of community leaders, positive perception and knowledge about
NCDs of health cadres determine the success of the program.
Keywords : Community empowerment, risk factors, non-communicable diseases
Access to Medicines for Hypertension: A Survey in Rural Yogyakarta Province,
Indonesia

AUTHORS
Riana Rahmawati PhD *
Beata V Bajorek PhD, A/Prof
CORRESPONDENCE
*Dr Riana Rahmawati riana.rahmawati@uii.ac.id
AFFILIATIONS
Pharmacology Department, Faculty of Medicine, Islamic University of Indonesia,
Yogyakarta, Indonesia and Graduate
School of Health, University of Technology Sydney, NSW, Australia
Graduate School of Health, University of Technology Sydney, NSW, Australia
PUBLISHED
15 August 2018 Volume 18 Issue 3
HISTORY
RECEIVED: 26 February 2017
REVISED: 3 August 2017
ACCEPTED: 20 August 2017
CITATION
Rahmawati R, Bajorek BV. Access to medicines for hypertension: a survey in rural
Yogyakarta province, Indonesia.
Rural and Remote Health 2018; 18: 4393. https://doi.org/10.22605/RRH4393
Except where otherwise noted, this work is licensed under a Creative Commons
Attribution 4.0 International Licence

ABSTRACT
Introduction: Obtaining an adequate supply of medicines is an important step in
facilitating medication adherence. This study aimed to determine (1) how people with
hypertension in rural villages in Indonesia obtain their supply of anti-hypertensive
medications, (2) the type of hypertension medication taken and (3) factors
associated with where and how people obtain their medicines supplies.
Method: Data pertaining to people with hypertension (age ≥45 years) were collected
from eight rural villages in the Bantul district, Yogyakarta province, Indonesia, using
a researcher-administered questionnaire.
Results: Of 384 participants, 203 (52.9%) obtained anti-hypertensive medications
from public or private healthcare services. The most common way was by
purchasing these medicines without prescription in community pharmacies (n=64,
17%). The medicines obtained this way included captopril, amlodipine, nifedipine,
and bisoprolol. One-hundred and nineteen (15%) participants obtained their
medicines at no cost by visiting public healthcare services such as community health
centres (n=51), the Integrated Health Service Post for the Elderly (n=53), and the
public hospitals (n=15). Direct dispensing from clinicians was reported by
participants who visited a doctor (n=15), midwife (n=23) or nurse (n=21). Having
access to an adequate medication supply (ie for an entire 30 days) was reported by
40 (10.4%) participants, who obtained the medication from a community health
centre (n=18), public hospital (n=4), community pharmacy (n=5), private hospital
(n=2), or multiple sources (n=11). A higher formal education level was associated
with obtaining medicines from multiple sources rather than from the public or private
provider only. Living near a community health centre and having government
insurance were associated with obtaining medicines from the public health service.
Age, gender, employment, presence of other chronic diseases, and knowledge about
hypertension were not significantly associated with how participants obtained their
medications.
Conclusion: These Indonesian participants obtained their anti-hypertensive
medications from various sources; however, the inadequate supplies found in this
study could compromise both short- and long-term management of hypertension.
Direct dispensing, non-doctor prescribing, and self-medication with anti-hypertensive
medications indicate the current complex healthcare system in Indonesia. This study
also shows some challenges involved in managing patients with chronic diseases
such as hypertension in resource-poor settings. It provides important findings for
quality improvement practices that should be considered to improve the health
lifespan in populous countries such as Indonesia.
KEYWORDS: ​anti-hypertensive agents, direct dispensing, Indonesia, Posyandu
lansia, Prolanis, self-medication

AKTIVITAS FISIK PADA REMAJA SLTP KOTA YOGYAKARTA DAN


KABUPATEN BANTUL,SERTA HUBUNGANNYA DENGAN KEJADIAN
OBESITAS

Emy Huriyati, Hamam Hadi, Madarina Julia

ABSTRACT
BACKGROUND: ​The prevalence of Obesity is markedly increasing, both in
developed and developing countries. Whether physical activity contributes to the
obesity in Indonesian adolescents is still unknown
OBJECTIVE: ​To assess whether physical activity is associated with obesity in junior
high school adolesecents in Yogyakarta
METHODS: ​A case control study was conducted in Yogyakrta Province in 2003.
Subjects were 140 obese and 140 non-obese junior high school adolescents in
Yogyakarta and Bantul, randomly chosen from an obesity survey perfomed
previously. Pattern and duration of activiy were assessed using IPAQ modified
questionnaire. The activities were than sorted into light (sedentary), moderate and
vigorous activities
RESULTS: ​There was significant difference in the distribution sedentary activity
between adolescents of Yogyakarta and Bantul (​p<0,0001). ​The mean duration of
sedentary activity in Yogyakarta was 12.4 hours/day while in Bantul was 11.0
hours/day. Obese adolescents (​p=0.002). ​The odds of being obese in adolescents
whose sedentary activity was longer than 13 hours/day were almost doubled.
CONCLUSIONS: ​Urban adolescents spent more time for sedentary activities than
rural adolescents, so were obese adolescents. The association of sedentary
activities to obesity is independent from other factors such as calorie intake and
parental obesity status.

Key Words: ​adolescents obesity, sedentary, physical activity

Early Implementation of Universal Health Coverage Among


Hypertension Subjects in Sleman District of Yogyakarta

Rita Suhadi, Yunita Linawati, Dita M. Virginia, Christianus H. Setiawan


Faculty of Pharmacy, Sanata Dharma University, Yogyakarta, Indonesia
Correspondence mail:
Campus 3, Sanata Dharma University. Paingan Maguwoharjo, Sleman, Yogyakarta,
Indonesia. email: ritasuhadi@
usd.ac.id, ​ritasuhadi.rs@gmail.com​.

ABSTRAK
Tujuan: untuk mengevaluasi angka partisipasi jaminan kesehatan nasional (JKN)
dan dampaknya terhadap subyek hipertensi di daerah pedesaan Kabupaten
Sleman-Yogyakarta pada tahap implementasi awal.
Metode: survei epidemiologi terkait implementasi JKN merupakan suatu studi
potong lintang analitik cluster random sampling. Kriteria subyek umur 30-85 tahun,
tidak sedang hamil, dan menandatangani informed-consent. Subyek dikelompokkan
berdasarkan adanya jaminan kesehatan dan dianalisis menggunakan chi-square
statistik untuk prevalensi, kesadaran, terapi, dan pengendalian hipertensi. Variabel
tambahan BMI, pendidikan, pekerjaan, penghasilan, merokok, pengaturan diet,
aktivitas fisik, dan fasilitas kesehatan dikelompokan menjadi data binomial dan
dianalisis dengan chi-square berdasarkan adanya jaminan kesehatan.
Hasil: dari 926 subyek sebanyak 602 (65,0%) memiliki jaminan kesehatan termasuk
9,2% JKN-BPJS. Kelompok dengan dan tanpa jaminan kesehatan tidak berbeda
secara signifikan dalam prevalensi hipertensi, profil umur, tekanan darah, dan
proporsi variabel tambahan (p>0,05) kecuali pada merokok dan aktivitas fisik. Pada
subyek dengan tekanan darah tinggi (n=446), subyek tanpa jaminan kesehatan
memiliki kesadaran dan terapi yang lebih rendah berturut-turut: p<0,02; OR:0,60
(CI95%:0,39-0,91): p<:0,03; OR:0,50 (CI95%:0,27-0,94): tetapi tidak berbeda dalam
pengendalian tekanan darah (p>0,05).
Kesimpulan: angka partisipasi JKN relatif rendah sebesar 9,2%. Pada
sub-kelompok dengan tekanan darah ≥140/90mmHg, subyek tanpa JKN cenderung
memiliki proporsi kesadaran dan terapi yang lebih rendah dibandingkan dengan
yang memiliki JKN (p<0,05).

Kata kunci:​ jaminan kesehatan nasional, hipertensi, kesadaran, terapi.

AN INCREASE IN RISK FACTORS FOR CARDIOVASCULAR DISEASE IN


YOGYAKARTA, INDONESIA: A COMPARISON OF TWO CROSS-SECTIONAL
SURVEYS

FST Dewi1,2, H Stenlund2,3, M Hakimi4 and L Weinehall2,3


1Public Health Division, Faculty of Medicine, Gadjah Mada University,
Yogyakarta, Indonesia; 2Epidemiology and Global Health, Department of
Public Health and Clinical Medicine, Umeå University, Umeå; 3Umeå Center for
Global Health Research, Umeå University, Umeå, Sweden; 4Center for Health
and Nutrition Research Laboratory, Faculty of Medicine, Gadjah Mada
University, Yogyakarta, Indonesia

Abstract.​ This paper aims to describe changes in risk factors for cardiovascular
disease (CVD) over a five year period in urban Indonesia. In 2004 (n=3,205) and
2009 (n=2,467) we conducted cross-sectional surveys of residents in Yogjakarta
City, Indonesia evaluating risk factors for CVD. Smoking habits, fruit and vegetable
intake, physical activity, blood pressure, weight, and height were recorded. The
results of these 2 surveys conducted 5 years apart were then compared. The risk for
having a CVD event was also calculated. Behavioral CVD risk factors were more
common among men. The predicted risk of having a CVD event increased from
8.4% to 11.3% among men between 2004 and 2009. Effective measures need to be
taken to change these behaviors among men in Yogyakarta, Indonesia.
Keywords: ​non-communicable diseases, chronic diseases, smoking, risk factor,
Indonesia

Level of Family Knowledge on Diabetes Mellitus Diet in Yogyakarta


Fahni Haris∗ and Aulia Ayu Nugraheni
School of Nursing, Faculty of Medicine and Health Sciences, Universitas
Muhammadiyah Yogyakarta 55183, Indonesia

An unhealthy diet contributes to the incident rate of people with type 2 diabetes
mellitus (T2DM) in the world. The key to diet success is influenced by many factors
and one of them is the level of family knowledge. This study aimed to assess the
level of family knowledge on DM diet. The descriptive-analytic method was used by
involving 45 respondents of the clustering system (sampling) with a total population
of 276 people. The result of research is 53.3% of respondents were in poor
knowledge. Family with age range 30–60 years had poor knowledge (37.8%), a vast
of family were women (55.6%), level of education was graduated from high school
(40%). Most respondents are unemployed (55.6%) and they had never known about
the diabetes mellitus diet before (60%). The conclusion of the study is the family of
DM patients in Kasihan, Yogyakarta had poor knowledge on DM diet. The healthcare
professionals should provide more information in detail particularly on DM diet
toward the family members of DM patients.
Keywords:​ Diabetes Mellitus, Diet, Family Knowledge Level.

Prevention of Risk Factors for Non-Communicable Diseases


through Community Empowerment (Case In A Rural Communities
of Yogyakarta)
*Heni Trisnowati, Rodiyah, V. Utari Marlinawati
Public Health Department, Faculty of Health Sciences, University Respati
Yogyakarta
*Correspondence: hentris80@yahoo.com
ABSTRACT
Background: Non-Communicable Diseases (NCDs) are the leading cause of death
in the world. NCDs dominated cause of death in Indonesia, mainly in Yogyakarta.
This study aim to initiate a community intervention program through community
empowerment to control risk factors for NCDs in Indonesia, especially in a rural area
of Yogyakarta.
Methods: This study used mixed methods with concurrent nested strategy. Data
were collected by focus group discussions, in-depth interviews, observation, and
questionare. There were 23 informants of community leaders and health workers.
The data from two methods are mixed during the analysis phase.
Results: The process of community empowerment for the prevention and control of
NCDs in Modinan are as follows: 1) building public trust through meetings with
community leaders to discuss about NCDs; 2) raising public awareness through
health cadre meetings and conducting FGD; 3) developing health promotion
programs; 4) organising health promotion activities on "CERDIK Behavior" includes:
routine medical chek up, not smoking doing physical activity, a balanced diet,
adequate rest and manage stress 5) initiation to maintenance program.
Conclusion: Empowerment is one of health promotion strategies to prevent risk
factors for NCDs. The involvement of community leaders, positive perception and
knowledge about NCDs of health cadres determine the success of the program.
Keywords: Risk factors for non-communicable diseases, health promotion,
community empowerment

THE PREVALENCE AND RISK FACTORS OF HYPERTENSION OF RURAL


POPULATION IN YOGYAKARTA, INDONESIA: A CROSS SECTIONAL STUDY
Ayyu Sandhi, Vivi Leona Amalia, Nurul Maiki Rayun Ittaqa
School of nursing, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta,
Indonesia
Email: ​ayyu_sandhi@yahoo.com

ABSTRACT
BACKGROUND: ​Hypertension is an important global public health challengen since
it is major risk factor for cardiovascular burden and mortaluty. More than half of
Indonesian population lives in rural areas, resulting in poorer access to healthcare
facilities than in urban areas. The aims of this study were to identify the prevalence
and risk factors of hypertension of rural population in Yogyakarta, indonesia.
MATERIAL AND METHODS: ​A cross sectional study was conducted amongst 117
residents of rural ​dukuh i​ n Yogyakarta, Indonesia. All participants were interviewed
and data were related to the sociodemographics of the individuals, family history of
hypertension, dietary habits, exercise, alcohol consumption, tobacco use, caffein use
and BMI. Blood pressure and aanthropometric data was recorded.
RESULT: ​Hypertension (stage I and II) was present in 38 of the 48 males (79.2%)
and 55 of the 69 females (79.9%). Risk factors of hypertension which significantly
associated in this study were level of school education, family history of
hypertension, smoking, caffein consumption, salt use, and BMI.
CONCLUSION: ​The prevalence of hypertension in the rural community under this
study is 4.5%, and is should be compared to other populations in Indonesia. All the
risk factors identified were modifiable
Keywords:​ hypertensio, risk factors, rural population

Pengelolaan penyakit pada pasien diabetes


melitus: akses layanan informasi pola konsumsi
dan komplikasi gigi-mulut
Disease management in people with diabetes melitus: access to information service
consumption patterns and dental-mouth complications
Normalita Sulistyanawati & Retna Siwi Padmawati

Abstract
Purpose: This study aimed to determine the effect of the availability of information
services related to diet and dental-mouth complications against diabetes melitus
disease management.
Methods: This research was a descriptive analytic study with a cross sectional
design, using quantitative research methods. The population was all patients with
diabetes mellitus who were recorded in Yogyakarta. Research sample counted 336
people at four health centers in Yogyakarta, namely Tegalrejo, Kotagede I,
Mantrijeron, and Wirobrajan health centers.
Results: This research indicated that there was no significant correlation between
availability of consumption pattern information service and management behavior in
diabetes melitus indicated by p >0.25 ( p =0.763). There were significant correlations
in the information of consumption pattern ( p =0.003), information of oral dental
complication ( p =0.149), and family support ( p =0.148) with management behavior
in diabetes melitus indicated by p <0.25.
Conclusions: Primary health care services to diabetic patients in Yogyakarta are
generally good but still less concerned with the oral and dental health in diabetics.
Primary health care needs to provide more oral health information to people with
diabetes melitus. Moreover, education programs need innovation in delivering
information to patients, especially patients with longer duration of diabetes.
Keywords: availability of service information; patterns of consumption; oral health;
diabetes melitus

Social support, self-efficacy and psychological stress responses among


outpatients with diabetes in Yogyakarta, Indonesia.
Kanbara S1, Taniguchi H, Sakaue M, Wang DH, Takaki J, Yajima Y, Naruse F, Kojima S, Sauriasari
R, Ogino K.

Abstract
We attempted to study whether social support promotes self-efficacy and reduces
stress responses of patients with diabetes in Yogyakarta, Indonesia. Diabetic
outpatients at Dr. Sardjito Hospital voluntarily participated in a questionnaire survey.
Data from 125 patients were subjected to analysis. The questionnaires included the
scales and subscales of social support, self-efficacy, psychological stress response,
and demographic measure. Data were analyzed by Spearman's rank correlation test
to examine the relationships between parameters, Mann-Whitney U-test and
Kruskal-Wallis test to compare the scales by characteristics, and structural equation
modeling to explore the best-fit model. This study was performed in September
2003. It was found that augmentation of emotional support to patients significantly
increased the 'active coping for the disease' and 'controllability of health', and that
'helplessness' was reduced significantly. Behavioral support affected only
'controllably of health'. Self-efficacy reduced stress response of the patients. It was
also found that subjects who received support from their children significantly scored
higher in perceived availability of social support than those without support from their
children. To know their behavioral support better as well as emotional support may
be one area to focus on in improving the health status of people with diabetes in
Yogyakarta.

GIVING OF ORAL COUNSELING BY PHARMACISTS IMPROVE QUALITY OF


LIFE OF HYPERTENSIVE PATIENTS IN RURAL PRIVATE HOSPITAL IN
BANTUL DISTRICT YOGYAKARTA
Riza Alfian, Riza (2014) ​Giving Of Oral Counseling By Pharmacists Improve Quality Of Life Of
Hypertensive Patients In Rural Private Hospital In Bantul District Yogyakarta. Prosiding, Akademi Farmasi
ISFI Banjarmasin.

ABSTRAK 

Background: The hypertension prevalence in Indonesia in 2007 is 32,2%. High blood

pressure can damage arteries and blood vessels. It can also cause coronary artery
disease, kidney failure and stroke. It is expected that the appropriate counseling can

improve the quality of life hypertensive patients. Objective: This study aim to

evaluate the quality of life after giving brief oral counseling by a pharmacist.

Methods: This study were conducted with quasi-experimental design. The

ambulatory hypertension patients data were collected prospectively during the period

of January until April 2013. A total samples of 60 patients were divided into 2 groups,

30 (50%) patients were received counseling (intervension group) and 30-50%)

patients were not received counseling (control group). Exclusion criteria were a deaf

and pregnant patients. Data collection were conducted by doing interview and

completion of SF-36 questionnaire. Outcome measured : Quality of life domain in

hypertension patients Results : The results showed that oral counseling intervension

by pharmacist could increased quality of life of hipertensive patients. The SF-36

parameters that have higher in intervention group are physical functioning (p=0,002),

emotional functioning (p=0,001), social functioning (p=0,013), general health

(p=0,008), physical status (p=0,157), pain (p=0,014) and fatigue (p=0,001) in


comparison to the control group. Conclusion : To sum up, the pharmacist

intervension by oral counseling can increase the quality of life of hipertensive

patients. Key words : quality of life, hypertension, brief oral counseling, rural hospital.

Improving type 2 diabetes patients' quality of life by using a community based


interactive approach – diabetes mellitus strategy in Yogyakarta, Indonesia

Titien S. Hartayu, Mohamed I. Mohamed Izham, Sri Suryawati

Abstract 

Objective  The  aim  of  this  study  was  to  improve  diabetes  patients'  quality  of  life 
(QOL)  by  using  a  community  based  interactive  approach  –  diabetes  mellitus 
(CBIA-DM) strategy. 

Methods  This  study  was  a  time-series  pre  and  post  quasi-experimental  with 
control  groups  design.  Inclusion  criteria  were  adults  with  type  2 diabetes 
mellitus  (DM),  had  not  attended  a  diabetes  education  programme  in  the  last  2 
years,  were  literate  and  had  completed  all  activities  required  over  the  6-month 
study  period.  The  intervention  group  was  CBIA-DM  and the control groups were 
DM  club  and  normal  care.  Data  were  collected  pre, immediately after, 1, 3 and 6 
months'  post  intervention  using  the  World  Health  Organization  QOL–bref 
(Bahasa  Indonesia  version)  and  scored  as  good,  fair  and  poor.  Improvement  of 
QOL  was  assessed  by  how  much  the  number  of  participants  at  the  ‘good’  level 
increased and was sustained until 6 months' post intervention. 

Key  finding  The  QOL  of  diabetes  patients  with  can  be  improved  using  CBIA-DM 
strategy (​P​ < 0.05). 

Conclusion  Given  the  WHOQOL–bref  usage,  such  an  approach  can  also  be 
applied for other chronic diseases. 

 
‘Maintaining  balance  and  harmony’:  Javanese  perceptions  of  health  and 
cardiovascular disease 
FatwaS.T. Dewi​,Lars Weinehall & Ann Öhman

Abstract

Community intervention programmes to reduce cardiovascular disease (CVD) 


risk factors within urban communities in developing countries are rare. One 
possible explanation is the difficulty of designing an intervention that 
corresponds to the local context and culture. 

Objectives:​ To understand people's perceptions of health and CVD, and how 


people prevent CVD in an urban setting in Yogyakarta, Indonesia. 

Methods:​ A qualitative study was performed through focus group discussions 


and individual research interviews. Participants were selected purposively in 
terms of socio-economic status (SES), lay people, community leaders and 
government officers. Data were analysed by using content analysis. 

Results:​ Seven categories were identified: (1) heart disease is dangerous, (2) the 
cause of heart disease, (3) men have no time for health, (4) women are 
caretakers for health, (5) different information-seeking patterns, (6) the role of 
community leaders and (7) patterns of lay people's action. Each category 
consists of sub-categories according to the SES of participants. The main theme 
that emerged was one of balance and harmony, indicating the necessity of 
assuring a balance between ‘good’ and ‘bad’ habits. 

Conclusions:​ The basic concepts of balance and harmony, which differ between 
low and high SES groups, must be understood when tailoring community 
interventions to reduce CVD risk factors. 

Keywords:​health perception, Javanese philosophy, qualitative content analysis, 


cardiovascular disease, community intervention 

Multilevel  Analysis  on  the  Social  Determinants  of  Cervical 


Cancer in Yogyakarta 

Heni Elmiani Sari, Ambar Mudigdo, Argyo Demartoto 

Abstract 

Background​: There are 527.600 new cases of invasive cervical cancer. Cervical 
cancer is caused by infection with the Human Papilloma Virus (HPV) 16 and 18 
study was conducted in the city of Yogyakarta. This study aimed to analyze the 
social determinants on cervical cancer by multilevel analysis in Yogyakarta. 

Subjects and Methods​: This was an observational analytic study with case 
control design. This was conducted on March 31 to May 4, 2016. A total of 120 
samples were selected by fixed disease sampling with a ratio 1:3. The data 
collected was using a questionnaire and analyzed with Logistic Regression. 

Results​: The risk of cervical cancer with a positive effect on family income (OR = 
3.45 95% CI = 0.26 to 45.45 p = 0.346), age of first sexual intercourse (OR = 8.54 
95% CI = 1.17 to 62.41 p = 0.034), number of sexual partners (OR = 14.60 95% CI = 
2.93-72.66 p = 0.001), oral contraÂ​ceptives (OR = 1.85 95% CI = 0:37 to 9:20 p = 
0452), nutritional status (OR = 5.69 95% CI = 1.36 to 23.82 p = 0.017), hygiene 
genitalia (OR = 9:23 95% CI = 1.76 to 48.35 p = 0.009), and an effect reversed by 
education (OR = 0:14 95% CI = 0:09 to 2:08, p = 0.155). ICC value of 40.68% 
indicating the risk of cervical cancer in women varies and a variation of 40.68% 
at the level of environmental sanitation home. 

Conclusion​: There is a positive effect of family income, age of first sexual 


intercourse, number of sexual partners, nutritional status, hygiene genitalia, and 
sanitary home environment, on the risk of cervical cancer. There is an inverse 
effect of education on the risk of cervical cancer. The society  is expected to be 
aware of cervical cancer. 

Keywords​: multilevel analysis, social determinants, cervical cancer 

Impact of organophosphate exposure on farmers’ health in Kulon


Progo, Yogyakarta: Perspectives of physical, emotional and
social health

Dyah Aryani Perwitasari​, ​Dian Prasasti​, ​Woro Supadmi​, ​Sonia Amelia Dewi Jaikishin​, ​Idha
Arfianti Wiraagni

Abstract
Objective:
The exposure of organophosphate could be caused by the absorption in some parts
of the body like skin and breath. Toxicity may cause nausea, vomiting and dizziness
which are not too specific related with the pesticide toxicity. The purpose of this
study is to understand the association between organophosphate exposure and
farmers’ health in Kulon Progo County from the perspectives of physical, emotional
and social health.

Methods:
This study was conducted using descriptive observational design. The blood sample
was collected during harvesting periods in 2016. The inclusion criterion of farmers
was using organophosphate-contained pesticide during the planting period of red
onion. The farmers who had renal disease, liver disease and cancer were excluded.
The organophosphate exposure parameters were the duration and frequency of
pesticide application, width of the area, serum cholinesterase activity and the
completeness of personal protective equipment.

Results:
Among 84 farmers, most of them were male (85.7%), and the mean age was 49.1
(standard deviation: 12.5) years; 71.4% of the subjects experienced tremor, 17.86%
experienced dizziness and 8.33% subjects experienced nausea–vomiting after
pesticide application. According to the pesticide application, in average, subjects
used pesticide 1.4 h/day with the area of 1.285 m​2​. The frequency of pesticide used
is three times per week. Around 97.6% subjects used incomplete personal protective
equipment. The average of serum cholinesterase activity in subjects with tremor is
higher than subjects without tremor (p > 0.05). There is a significant association
between serum cholinesterase activity and creatinine content (p < 0.05). The
farmers’ quality-of-life domain scores are lower than the scores of the normal
population in Yogyakarta.

Conclusion:
Organophosphate exposure may affect the farmers’ physical health and quality of
life.

Health-related Quality of Life Among Smokers in Yogyakarta Province,


Indonesia

Susi Ari Kristina1*, Dwi Endarti1, Anna Wahyuni Widayanti1, Mentari Widiastuti2

ABSTRACT
Background: Smoking is considered as the leading cause of many diseases and has
detrimental effects on health. However, little is known about impairment of health related
quality of life associated with smoking and level of nicotine dependence in Indonesian
population. Methods. Data obtained from questionnaire survey among Yogyakarta city and
Sleman district population. A number of 561 male respondents was selected by convenience
sampling. WHO-QoL BREF consisted of 26 questions with 4 dimensions was delivered by
trained interviewer. Nicotine dependence was measured using Fagerstorm scale consisted of
6 items. Age, education level, job status, physical activity was also being asked to
respondents. Data was analyzed descriptively and association between smoking status,
nicotine dependence level, and sociodemographic factors with health-related quality of life
was investigated. Results. Overall, an estimated 58.1% of adults aged >15 years were current
smokers and 41.9% were non-smokers. Current smokers had significantly poorer HRQoL than
those who never smoked. Additionally, those who had high nicotine dependence were had
more impaired HRQoL compared to low and moderate level of nicotine dependence.
Respondents with low education, not employed, and physically inactive reported poorer
HRQoL than their counterparts. Conclusions. There are relationships between smoking and
HRQoL impairment. Lower HRQoL also reported among those who had high nicotine
dependence, and others sociodemograhic factor. Awareness among health professionals
about smoking as health risk behavior needed to be raised and smoking cessation
interventions should be provided as potential efforts of tobacco control.
Keywords: Health-related quality of life, smokers, nicotine dependence, Indonesia

The Communication Effectivity of Health Elucidator Officer in Increasing


Healthy Lifestyle Awareness of The City Society (Case Study in
Mergangsan Sub-district, Yogyakarta, Indonesia)

UTAMI, Yenni Sri (2011) ​The Communication Effectivity of Health Elucidator Officer in Increasing Healthy
Lifestyle Awareness of The City Society (Case Study in Mergangsan Sub-district, Yogyakarta, Indonesia).
In: The 1st ACIKITA International Conference of Science and Technology, July 25-27, 2011, Jakarta,
Indonesia.

Abstract

The effectiveness of elucidation communication performed by health elucidation officers, in order to


implement healthy lifestyle can be seen from the increasing health quality in the society. An unhealthy
lifestyle could cause the emerge of degenerative disease cases, such as heart attack, diabetes,
hypertension, atherosclerosis, stroke, various kinds of cancers and many more, that have the tendency to
increase, it would even grow to a larger scale in the future. One’s healthy lifestyle behavior is influenced by
their knowledge. Relating to that matter, a research has been conducted to find out how the affectivity level
of communication done by the health elucidators is, when explaining to the society about degenerative
diseases and the knowledge about healthy lifestyle, and also, to know the extend of how society live their
healthy lifestyle. Therefore, a descriptive qualitative survey research is carried out, to find out the exact fact
and figure concerning with that matter. In data collection, the process used here, are questionnaires and
interview guide to gather the primary data needed, and the secondary data was also collected in the
research area, in Sub-district Yogyakarta, Indonesia. From the research results, it could be concluded that
people in the research area are very much aware about the information relating to degenerative diseases,
and healthy lifestyle is also very much well known among them, but the awareness to implement a healthy
lifestyle behavior is not seen yet. This is proven by the larger amount of people who are still smoking in
public places, and many people are ill, caused by degenerative diseases. The source of this phenomenon
is derived from the ineffective approaches of communication forms which are used, either in media or in the
message arrangements.
A SOCIAL ECOLOGICAL PERSPECTIVE ON THE INDONESIAN MATERNAL
MORTALITY PROBLEM; AN ANNOTATED BIBLIOGRAPHY

Inraini, Fitria Syah (2017) ​A SOCIAL ECOLOGICAL PERSPECTIVE ON THE INDONESIAN MATERNAL
MORTALITY PROBLEM; AN ANNOTATED BIBLIOGRAPHY. In: THE 4th INTERNATIONAL
CONFERENCE ON HEALTH SCIENCE 2017 “The Optimization of Adolescent Health in The Era of SDGs”,
INNA GARUDA HOTEL YOGYAKARTA, INDONESIA.

Abstract

The Indonesian government has attempted to reduce maternal mortality, including the placement of
midwives in the villages, infrastructure development, and the provision of health insurance to the poor.
However, the maternal mortality rate is still astonishingly high, with over 15,000 women per year dying from
complications of pregnancy and childbirth. The purpose of this study is to use a social ecological
perspective – which systematically considers influences at multiple levels from individual and interpersonal,
up through community, institutional, and policy – to understand the root of the maternal mortality problem in
Indonesia. The study is a literature review structured around the social ecological model, presenting
findings at each level. The researches were obtained from variety of publish literature in 2009 until 2015.
They were taken from several databases like Pub Med, Google Scholar, and Science Direct. Result: In
intrapersonal level; culture, customs, stigma, and belief are the root of causes.In the interpersonal level, in
addition to her husband and family, midwives and dukun have an important role in this stage. In the
community level, several programs that have been taken by the government seem have good impact,
although many things need to be repaired. Conclusion: In every level of social ecological perspective, there
are problems that need to be addressed. The collaboration from individual, community and government is
important to reduce the maternal mortality problem in Indonesia. Keywords: Indonesia, maternal mortality,
social ecological perspective.