Daftar Nilai KMB Stikes Perdhaki

 

No	NIM	Nilai Akhir
1	300108107	96
2	300108122	95
3	300108129	92
4	300108147	91
5	300108160	88
6	300108163	88
7	300108105	85
8	300108109	85
9	300108166	85
10	300108164	83
11	300108104	82
12	300108126	81
13	300108119	80
14	300108153	80
15	300108120	80
16	300108159	78
17	300108141	78
18	300108167	77
19	300108128	77
20	300108162	77
21	300108135	76
22	300108136	76
23	300108123	76
24	300108158	75
25	300108125	74
26	300108130	74
27	300108132	74
28	300108148	74
29	300108117	72
30	300108161	71
31	300108152	69
32	300108116	69
33	300108137	68
34	300108144	67
35	300108155	67
36	300108134	66
37	300108111	66
38	300108138	66
39	300108150	65
40	300108118	65
41	300108106	64
42	300108127	64
43	300108143	64
44	300108154	64
45	300108146	63
46	300108157	63
47	300108131	63
48	300108142	62
49	300108165	59
50	300108108	58
51	300108112	57
52	300108124	57
53	300108121	56
54	300108145	55
55	300108110	54
56	300108139	52
57	300108149	52
58	300108151	51
59	300108140	-
60	300108115	48
61	300107100	41*
62	300107103	75
63	300107076	52
64	300107086	70
65	300107061	49

 * Tidak ikut UAS

 

Penguji,

Lukman

Vaksinasi sebagai Alat untuk Pencegahan Kanker

VACCINATION AS A TOOL FOR CANCER PREVENTION

Eric H. Raabe, MD, PhD; Julia M. Kim, MD, MPH; Miriam Alexander, MD, MPH

Abstract

Infectious agents, such as viruses and bacteria, are the causes of several common cancers. Infection with the bacterium Helicobacter pylori predisposes to gastric cancer. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are associated with liver cancer, and Epstein-Barr virus (EBV) is associated with lymphoma and nasopharyngeal cancer. Human papillomavirus (HPV) is a major cause of cervical, anal, penile, and oropharyngeal cancer. Together, infection-associated tumors make up nearly 20% of all cases of cancer worldwide, causing more than 2 million malignancies per year. Most of these cases occur in developing countries. Under normal circumstances, immune surveillance helps to keep many of these virus-associated cancers in check, but in immunocompromised persons, such as those with late-stage HIV infection, the incidence and aggressiveness of these cancers increase. HBV and HPV vaccines are effective and in use, and vaccines against other cancer-causing agents are in development. Because many virus-associated cancers occur in the developing world (such as EBV-associated Burkitt's lymphoma in Africa and HBV-associated hepatocellular carcinoma [HCC] in Asia), the development and deployment of vaccines to prevent infection with HPV, HBV, HCV, and EBV can serve as effective preventative tools to reduce the burden of cancer morbidity and mortality worldwide.

Introduction: Cancer-Causing Infections

In the developing world, cancer is estimated to afflict 10 million people per year. Worldwide efforts to prevent cancer have generally focused on behavioral changes, such as smoking cessation. Because infectious agents cause some of the more common human cancers, understanding the role of the immune system is necessary to maximize cancer prevention strategies. The immune system has an endogenous role in preventing some cancers and can be stimulated with vaccines to prevent infection with cancer-causing viruses.

One of the paradoxes of cancer biology is that a lack of immune surveillance (such as in HIV-infected individuals or immunosuppressed organ transplant recipients) can lead to cancer, and chronic inflammation due to persistent infection can also do so. Chronic inflammation as a result of HBV or HCV infection leads to HCC, usually after the patient progresses to cirrhosis. In gastric cancer, nearly 60% of all cases in developed countries and 75% of cases in developing countries are attributable to chronic infection with H pylori. It is likely that chronic inflammation due to H pylori leads to intestinal metaplasia of the gastric epithelium and eventually to gastric cancer. Long-term infection with HPV and EBV leads to transfer of oncogenes present in the viral genome to human cells, thereby promoting cancer development.

Harnessing the immune system to prevent or clear cancer is a major goal of cancer research. Vaccination campaigns have been enormously successful in reducing the global burden of infectious diseases. A worldwide infrastructure exists for the manufacture, distribution, and administration of vaccines in urban, suburban, and rural areas. The use of vaccines to prevent cancer caused by chronic infection with oncogenic agents has had a substantial benefit in the developed world and could have a major effect on cancer incidence in the developing world. This article will review the most common infection-related cancers and the role of vaccines for cancer prevention worldwide.

HPV and Cancers of the Anogenital Tract and Oropharynx

HPVs are commonly spread through sexual contact. These viruses are the cause of genital warts, and subtypes 16, 18, 31, 33, and 35 are the major subtypes that cause cervical, anal, and head and neck cancer. HPV infection is associated with 100% of cases of cervical cancer. The incidence of infection with HPV is far higher than the incidence of cancer, because the immune system clears most infections. However, more than 500,000 new cases of cervical cancer are estimated to occur worldwide in 2010. Routine Papanicolaou smears can monitor for early signs of cervical cancer, but many at-risk women in the United States and elsewhere do not receive appropriate gynecologic care. These women are more likely to be from nonwhite, lower-income, and immigrant groups, and they are more likely to develop and die of cervical cancer.

During the past 30 years, the incidence of aggressive serotype HPV-associated squamous-cell carcinoma of the anus has increased. This increase largely began in men who have sex with men, but increases in women have also been observed. HPV is also associated with cancer of the vagina, vulva, and penis, although these are much less common than cervical cancer.

Squamous-cell carcinoma of the oropharynx and head and neck is associated with tobacco and alcohol use, but HPV serotypes 16 and 18 are commonly observed in a subset of persons with this cancer. Of interest, the percentage of HPV-positive oral cancers is reported to be increasing in several countries. This increase is attributed to changing sexual practices, suggesting that HPV-associated oral cancer, like HPV-associated anal and cervical cancer, can be considered a sexually transmitted infection.

Hepatitis B and C Viruses and HCC

Chronic HBV infection is highly prevalent throughout the developing world, particularly in Asia and Africa, where some countries have a prevalence rate as high as 12% of the total population. It is estimated to cause more than 1 million annual deaths worldwide, with one third of these deaths caused by HCC and the remainder by cirrhosis. Chronic HBV infection confers a 20 times increased risk for HCC. HBV vaccination is now included in the standard childhood vaccination series in the United States, but immigrant and older populations can have high HBV carrier rates. Intrapartum transmission is a major cause of transmission of HBV to children. To prevent HBV infection, hepatitis B immune globulin, along with hepatitis B vaccine, must be given to neonates of HBV-positive mothers (see "Key Recommendations for Healthcare Providers to Prevent Cancers Caused by Infectious Disease").

HCV infection is another a major cause of HCC. Whereas the carrier rate of HCV in the United States was estimated at 1.6% in 2002, in Africa the prevalence ranged from more than 8% in Northern Africa to less than 2% in Southern Africa. Vaccines for HCV are in development, but for patients who have already contracted HCV, a regimen involving 6 months of pegylated interferon alpha and ribavirin can lead to eradication in up 60% to 80% of patients. Active surveillance for HCV and aggressive attempts at eradication can therefore reduce the subsequent risk for cancer in populations at risk.

EBV-Associated Cancers

EBV is the primary cause of infectious mononucleosis, a typically benign disease of adolescence and young adulthood. However, the virus is also a causative agent in many aggressive neoplasms, including 20% of cases of Hodgkin's lymphoma (one of the most common lymphomas of adolescence), nasopharyngeal carcinoma, and a subtype of Burkitt's lymphoma. Nasopharyngeal cancer affects approximately 80,000 people each year, predominantly in less developed countries. Most of these cases are attributable to EBV infection. Although this cancer is curable with intensive chemotherapy and radiation therapy, most of the people affected by this cancer do not have access to these treatments.

More than 28,000 worldwide cases of Hodgkin's lymphoma are attributed to EBV infection. Like nasopharyngeal cancer, Hodgkin's lymphoma is highly treatable. More than half of Hodgkin's lymphoma cases occur in less developed countries, however, and curative treatment is often not available. The iconic image of a sub-Saharan African child with a very large facial or neck mass is an easily recognizable sign of endemic Burkitt's lymphoma caused by EBV infection. As many as 6800 cases of Burkitt's lymphoma caused by EBV occur every year, with more than 90% of these infections occurring in less developed countries. EBV-associated non-Hodgkin's lymphoma is particularly common in patients with advanced HIV infection. An estimated 68,000 cases of EBV-associated non-Hodgkin's lymphoma occur annually, and two thirds occur in developing countries.

H Pylori-Associated Gastric Cancer and Mucosa-Associated Lymphoid Tissue Lymphoma

The causative infectious agent for peptic ulcer disease, H pylori, is also a known cancer-causing agent. Chronic infection with this pathogen predisposes to stomach cancer and to gut mucosa-associated lymphoid tissue (MALT) lymphoma. Gastric cancer accounts for nearly 10% of all cases of cancer worldwide, and the causative agent in more than 60% of these cases is estimated to be H pylori (other risk factors include diet and excessive alcohol intake). In 2002, it was estimated that H pylori caused as many as 600,000 cases of gastric cancer per year worldwide. Eradication of H pylori can be accomplished with antibiotic therapy; however, the very high burden of infection in many countries (for example, in sub-Saharan Africa, more than 75% of adults are infected with H pylori) and the relative ease of reinfection make treatment of asymptomatic carriers unfeasible. Because the infection first occurs in young children, H pylori seems to be an amenable target for vaccine development to prevent colonization and subsequent stomach cancer and gut-associated MALT lymphoma. Until a vaccine becomes available, healthcare providers should screen for dyspepsia and peptic ulcer disease and offer H pyloritesting to affected patients. Healthcare providers should administer drug therapy for eradication of H pylori in those who are symptomatic and H pylori-positive.

Human Herpesvirus 8: Kaposi's Sarcoma

Human herpesvirus 8 (HHV-8) is the causative agent of Kaposi's sarcoma, a once-rare sarcoma of blood vessels. Before the AIDS epidemic, Kaposi's sarcoma was primarily known to affect Mediterranean or eastern European men or immunosuppressed patients, such as organ transplant recipients. With the increasing worldwide prevalence of HIV infection, most cases of Kaposi's sarcoma are now associated with HIV or AIDS. In 2002, it was estimated that more than 60,000 cases of Kaposi's sarcoma occur yearly, and it is the most common type of cancer reported in some African countries highly affected by HIV, such as Zimbabwe. The best treatment for Kaposi's sarcoma in HIV-infected patients is initiation of antiretroviral agents to reduce HIV viral load and allow restoration of immune system function. Sometimes this is sufficient to cause regression of the cancer. In other cases, the cancer continues to spread and combination chemotherapy is required.

Role of Vaccines for Cancer Prevention in the United States

HBV vaccine. In 1991, the Centers for Disease Control and Prevention (CDC) recommended adoption of a comprehensive strategy for prevention of HBV infection, which included:

Routine maternal prenatal testing for HBV;

Immediate postpartum intervention to prevent maternal to child transmission;

§ Universal vaccination of children for HBV;

§ Vaccination of all adolescents who had not received HBV vaccine previously; and

§ Vaccination of adults at risk for becoming infected with HBV.

The childhood immunization schedule, a 3-vaccine series administered in the first year of life, confers long-term immunity to HBV. Infants born to HBV-positive mothers must receive both vaccination and hepatitis B immune globulin within the first 12 hours of life. This regimen is 85-95% effective in preventing transmission of HBV. Because children are at increased risk for becoming chronic carriers when infected with HBV, starting the vaccine at birth and completing the series during routine well-child visits during the first year of life decreases the risk for infection from HBV-positive household contacts. Analysis of immunization rates in newborns in the United States from 2003-2005 showed only a 50% vaccination rate, leaving many infants unprotected from HBV infection. Clearly, the United States needs to increase newborn vaccination rates for HBV.

HPV vaccine. Two HPV vaccines are approved for use in the United States: Gardasil® (Merck & Co., Inc., Whitehouse Station, New Jersey) and Cervarix® (GlaxoSmithKline, Philadelphia, Pennsylvania). Gardasil® targets the serotypes of the virus most associated with cervical cancer (16, 18) and genital warts (8, 11). Cervarix® also targets serotypes 16 and 18 and uses a different adjuvant than Gardasil® to boost immune response. Both vaccines are equally effective at preventing HPV infection caused by the serotypes contained in the vaccines, and both will prevent development of high-grade cervical lesions caused by the corresponding serotypes. These vaccines are most effective when given to women and girls who have not been exposed to HPV. However, in a mixed population of HPV-exposed and HPV-unexposed young women, compared with placebo, vaccination with Gardasil® led to a 60% reduction in genital warts and a nearly 20% reduction in the incidence of precancerous cervical lesions. A corresponding reduction in the number of women who required invasive surgical resection of their precancerous lesions suggests that even in older, HPV-exposed women, vaccination may be helpful in reducing cervical cancer rates. The follow-up timeframe for these vaccines is still short, so it is not clear how long the protective effect will last. Additional postapproval studies are ongoing to determine the duration of protection and to determine whether post exposure vaccination is warranted.

The availability of HPV vaccines against serotypes 16 and 18 gives healthcare providers the tools to prevent HPV infection and subsequent cervical cancer. The US Food and Drug Administration (FDA) approved Gardasil® for girls and young women from age 9 to 26 years and for boys and men in that same age group, on the basis of trials showing efficacy preventing cervical neoplasia and cancer in women and anogenital warts in both women and men. The FDA approved Cervarix® for girls and women ages 10 to 25 years for prevention of cervical neoplasia and cancer. These vaccines may also be effective in preventing cancer of the oropharynx and anus caused by HPV 16 and 18 in both men and women.

Whereas HPV vaccines have been approved and are being administered in the United States, the uptake of the vaccines has been uneven. A backlash against HPV vaccination has occurred in some communities. Further interventions are required to improve vaccination among those most at risk for invasive cervical neoplasia. Clinicians should offer HPV vaccination to all adolescent girls and young women who have not yet had their sexual debut, and they should consider giving the vaccine to young women after sexual debut, on the basis of the findings described above. These vaccines do not cover all of the subtypes of HPV that cause cervical cancer, and widespread vaccination does not replace the need for intermittent cervical cancer screening, although it is projected to reduce the number of invasive procedures.

Cancer Prevention Outside of the United States

Role of vaccines. The use of vaccines and eradication treatments to prevent infection-caused cancer in the United States and other developed countries will continue to reduce mortality and morbidity from these diseases. However, the major burden of disease and corresponding mortality lie in the developing world. Taken together, the number of infection-related cancers is estimated at nearly 2 million cases per year, accounting for almost 20% of all cancer cases. Widespread application of vaccines for HBV and HPV could decrease the global burden of cancer by 900,000 cases per year, on the basis of 2002 estimates.

The HPV vaccine is approved for use in more than 60 countries. Widespread vaccination for HPV coupled with limited cervical cancer screening can be considered cost-effective in developing countries if a vaccine can be delivered for approximately $1 per dose (in a 3-dose regimen). The current course in the United States costs more than $300 USD. Improvements in HPV vaccines to make them more thermostable and efficacious, and less costly, will increase the feasibility of vaccinating adolescents in developing countries.

Drug treatment of HCV and H pylori infections to prevent cancer. Development of new vaccines or widespread identification and eradication efforts could further reduce the global cancer burden by reducing the carriage rate of H pylori, leading to fewer cases of gastric cancer (now estimated to be more than 500,000 cases per year). Eradication of HCV by use of ribavirin plus pegylated interferon, although expensive, could eliminate the nearly 200,000 cases per year of HCC that are attributed to HCV. To eliminate HCV in less developed countries successfully and cost-effectively, either a vaccine against HCV or a less burdensome eradication regimen is needed.

Burden of HIV as a cancer predisposition syndrome. The growing HIV epidemic is adding to the already substantial burden of cancer in lower-income countries (and in affected populations in the United States). Chronic HIV infection should be considered a cancer predisposition syndrome. Loss of immune surveillance as a result of HIV infection can lead, in HPV infection, to a rapid progression of precancerous lesions to cancer, and to increases in de novo cancer, particularly in HHV-8 and EBV-infected individuals. Restoration of immune function as evidenced by normalizing CD4 helper T-cell numbers after initiation of highly active antiretroviral therapy (HAART) can lead to stabilization or regression of cancer. However, in lower-income countries, initiation of HAART continues to encounter multiple barriers (lack of healthcare providers, lack of drug distribution infrastructure, and cultural barriers to testing and starting treatment). Although initial trials of an HIV-prevention vaccine have not succeeded, additional trials of new strategies for an HIV vaccine are ongoing and under development.

Role of vaccines in immunocompromised hosts. For patients who are already HIV-infected, the ability to respond to an antiviral vaccine, such as the HBV vaccine, may be severely attenuated, depending on their CD4 count. Vaccination before HIV infection (such as in an HIV-negative child) may prevent subsequent infection with the target of the vaccine, even if the patient has become HIV-positive. Much depends on the degree of destruction of the immune system and the extent to which the immune system is reconstituted after starting antiretroviral therapy.

Pengaruh Pendidikan Kesehatan Terhadap Ansietas pada Klien Preoperasi di Rs Dr. Mohammad Hoesin Palembang Tahun 2010: Quasi Eksprimen

Ns. Lukman*, S.Kep.,MM, Ns. Sumitro Adi Putra*, S.Kep,  dan Nurna Ningsih**, S.Kp.,M.Kes

*   Politeknik Kesehatan Palembang

** Program Studi Ilmu Keperawatan Fakultas Kedokteran Universitas Sriwijaya

 

Abstrak

Penelitian ini bertujuan untuk mengetahui pengaruh pendidikan kesehatan (penkes) terhadap ansietas pada Klien pre operasi di RS dr. Mohammad Hoesin Palembang Tahun 2009. Disain penelitian adalah quasi eksperimen, dengan besar sampel 32 orang diambil dengan cara consecutive sampling. Uji statistik yang digunakan adalah uji t, dengan tingkat kepercayaan 95% (a= 0,05). Rata usia responden adalah 44,59 tahun (SD 10,156), dengan usia terbanyak 45 tahun 4 orang. Jenis kelamin terbanyak adalah laki-laki, 18 orang (56,3%), dengan responden bekerja sebanyak 22 orang (68,8%)dan  pendidikan tinggi sebanyak 23 orang (71,9%) Sebanyak 28 orang (87,5%). Tingkat kecemasan pasien preoperasi cemas ringan, sedang, berat, dan panik berturut-turut adalah 8 orang (25,0%), 19 orang (59,4%), 4 orang (12,5%) dan 1 orang (3,1%). Sementara setelah dilakukan penkes terjadi penurunan kecemasan menjadi tidak cemas 3 orang (9,38%), cemas ringan 16 orang (50%), cemas sedang 12 orang (37,5%), dan cemas berat 1 orang (3,1%). diperoleh rata-rata delta kecemasan adalah 2,94 (SD 3,121) dengan nilai p= 0,000, artinya hipotesis Ho gagal diterima. Sehingga terdapat pengaruh yang signifikan tindakan pendidikan kesehatan terhadap penurunan kecemasan pada pasien preoperasi. Bagi perawat, sebaiknya tindakan pendidikan kesehatan (penkes) tentang preoperasi terus ditingkatkan, melalui pelatihan dan seminar. Perlu penelitian lanjutan untuk mengidentifikasi faktor-faktor yang mempengaruhi 

Kata Kunci: Kecemasan, preoperasi, penyuluhan kesehatan

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Pengaruh Lingkungan Sosial dan Kepribadian terhadap Penyalahgunaan Napza pada Anak Remaja Kasus Narkoba di LP Kelas II A Palembang Tahun 2008.

Oleh: Lukman, Lisdarwati (Alm), dan Azwaldi*

* Politeknik Kesehatan Palembang

Abstrak

Penelitian bertujuan untuk mengetahui pengaruh lingkungan sosial dan kepribadian terhadap penyalahgunaan NAPZA pada anak remaja kasus narkoba di LP Kelas II A Palembang tahun 2010. Jenis penelitian ini adalah penelitian kuantitatif dengan desain deskriptif dan  kausal-komparatif (ex-post facto). Jumlah sampel penelitian 51 orang remaja (14 – 24 tahun. Uji statistik yang digunakan adalah uji regresi berganda, uji F dan uji T dengan bantuan  program  komputerisasi. Hasil penelitian diperoleh, usia responden (remaja laki-laki) paling banyak adalah 20 tahun 45,1%, 28 orang (54,9%) responden tidak bekerja, pendidikan responden terbanyak SD dan SMP sebesar 41,2% dan 31,4%, serta beragama islam 96,1%. Penyalahgunaan narkoba dilakukan oleh 23 orang (45,1%) sedangkan ketergantungan terhadap narkoba terjadi pada 28 remaja laki-laki (54,9%). Lingkungan yang mendukung terjadinya penggunaan narkoba oleh remaja sebesar 27 (52,9%), dan keperibadian remaja yang kurang baik sebanyak 28 remaja (54,9%). Hubungan antara lingkungan sosial dan keperibadian terhadap penggunaan narkoba secara bersama-sama positif, sedang dan memiliki hubungan searah (R²=0,499). Terdapat pengaruh kepribadian terhadap penyalahgunaan NAPZA pada anak remaja kasus narkoba (p= 0,001), dan terdapat pengaruh lingkungan sosial dan kepribadian secara simultan (p=0,001) terhadap penyalahgunaan NAPZA di LP Kelas II A Palembang tahun 2010. Namun tidak terdapat pengaruh lingkungan sosial terhadap penyalahgunaan NAPZA (p= 0,0674) pada anak remaja kasus narkoba di LP Kelas II A Palembang tahun 2010.

Usia remaja harus menjadi perhatian bagi semua warga, karena remaja banyak memyimpan potensi baik untuk kebaikan bahkan hal-hal yang tidak diharapkan. Perlu penelitian lanjutan untuk mengidentifikasi faktor-faktor lain yang mempengaruhi  penggunaan narkoba pada remaja.Download PDF [Full text]

Kata Kunci: Anak-anak, Sosialisasi, Narkoba, karakter

KEPATUHAN PERAWAT DALAM MENERAPKAN ASUHAN KEPERAWATAN DI RUANG RAWAT INAP RS DR. SOBIRIN KABUPATEN MUSI RAWAS SUMATERA SELATAN TAHUN 2007

Jhon Feri, Lukman

Dimuat pada: Jurnal Kedoteran dan Kesehatan Fakultas Kedokteran Universitas Sriwijaya, Tahun 40 No.3  Juli 2008

ABSTRACT

Compliance is an obedient human being to order, comand, discipline and procedure. Compliance can influence by internal factor and eksternal, like age, education, knowledge, year of service, and motivation. Less obedient of nurse in applying treatment upbringing will cause the lowering of itself upbringing quality. This study done in RS dr. Sobirin Sub-Province of Musi Rawas in the year 2007, entangling 44 people nurse of room take care of lodged. The purpose study is to identify relation between nurse, responsibility, and facility work with compliance of nurse in treatment upbringing documentation. Desain Research the used is quantitative with approach of way and crosssectional intake of sampel with sampling random simple. Bivariate analysis use nonparametrik test, Chi Square. The result of the study showed that there are relation between nurse with compliance of nurse in applying documentation of nursing care (p= 0.011), there are relation between nurse responsibility with compliance of nurse in applying documentation of nursing care (p= 0.032), and there are relation between facility work with compliance of nurse in applying documentation of nursing care (p= 0.014) in RS dr. Sobirin Sub-Province of Musi Rawas year 2007. The study concluded that, there are relation between nurse responsibility, relation between nurse, and facility work with compliance of nurse in treatment upbringing documentation. Compliance of nurse in applying treatment upbringing require to be improved, for example with formulation of special policy (like standard operating procedure) concerning documentation of nursing care, including sanction and appreciation for nurse which not yet treatment upbringing. Require to be strived by the make-up of ability (skill and knowledge) treatment upbringing application better and correctness, passing workshop applying of nursing care entangling entire/all nurse. Expected, management can guarantee the executing of good treatment upbringing documentation, passing ready/enough facility and according to requirement.

 

Keyword : nurse performance, nursing documentation, nursing methodelogy.

 

 

ABSTRAK

Kepatuhan adalah suatu prilaku manusia yang taat terhadap aturan, perintah, prosedur dan disiplin. Kepatuhan dapat dipengaruhi oleh faktor internal dan eksternal, seperti usia, pendidikan, pengetahuan, masa kerja, dan motivasi. Kurang patuhnya perawat dalam menerapkan asuhan keperawatan akan berakibat rendahnya mutu asuhan itu sendiri. Penelitian ini dilakukan di RS dr. Sobirin Kabupaten Musi Rawas pada tahun 2007, yang melibatkan 44 orang perawat ruang rawat inap. Tujuan penelitian adalah mengidentifikasi hubungan antar perawat, tanggung jawab, dan fasilitas kerja dengan kepatuhan perawat  dalam pendokumentasian asuhan keperawatan. Desain Penelitian yang digunakan adalah kuantitatif dengan pendekatan crosssectional dan cara pengambilan sampel dengan simple random sampling. Analisis bivariat menggunakan uji nonparametrik Chi Square. Hasil penelitian membuktikan terdapat hubungan yang signifikan antara hubungan antar perawat dengan kepatuhan perawat dalam menerapkan pendokumentasian askep (p= 0.011), terdapat hubungan yang signifikan antara tanggung jawab perawat dengan kepatuhan perawat dalam menerapkan pendokumentasian askep (p= 0.032), dan terdapat hubungan yang signifikan antara fasilitas kerja dengan kepatuhan perawat dalam menerapkan pendokumentasian askep (p= 0.014) di RS dr. Sobirin Kabupaten Musi Rawas tahun 2007. Hasil di atas menyimpulkan bahwa terdapat hubungan antara tanggung jawab perawat, hubungan antar perawat, dan fasilitas kerja dengan kepatuhan perawat dalam pendokumentasian asuhan keperawatan. Kepatuhan perawat dalam menerapkan asuhan keperawatan perlu ditingkatkan, misalnya dengan perumusan kebijakan khusus (seperti protap) tentang pendokumentasian askep, termasuk penghargaan dan sanksi bagi perawat yang belum mengaplikasikan asuhan keperawatan. Perlu diupayakan peningkatan kemampuan (pengetahuan dan keterampilan) mengaplikasikan asuhan keperawatan dengan baik dan benar, melalui workshop penerapan askep yang melibatkan seluruh perawat. Diharapkan manajemen dapat menjamin terlaksananya pendokumentasian asuhan keperawatan yang baik, melalui penyediaan fasilitas yang cukup dan sesuai kebutuhan.

 

Kata Kunci    :  Kinerja perawat, dokumentasi keperawatan, metodelogi keperawatan.

 

Pendahuluan

Insiden kecelakaan merupakan salah satu dari lima masalah kesehatan utama di negara-negara maju, modern dan industri. Kelima masalah kesehatan utama tersebut adalah kecelakaan, penyakit kardiovaskuler, kanker, penyakit degeneratif dan gangguan gangguan jiwa (Depkes RI, 2007).                                                                                      

Badan kesehatan dunia  (WHO) mencatat tahun 2005 terdapat lebih dari 7 juta  orang  meninggal dikarenakan insiden kecelakaan  dan sekitar 2 juta orang mengalami kecacatan fisik. Salah satu  insiden kecelakaan yang memiliki prevalensi cukup tinggi yakni insiden fraktur ekstremitas bawah yakni sekitar 46,2% dari insiden kecelekaan yang terjadi. Fraktur merupakan suatu keadaan dimana terjadi diistegritas tulang, penyebab terbanyak adalah insiden kecelakaan, tetapi faktor lain seperti proses degeneratif juga dapat berpengaruh terhadap kejadian fraktur (Depkes RI, 2007).

Berdasarkan data dari Departemen Kesehatan RI tahun 2007 didapatkan sekitar delapan juta orang mengalami kejadian fraktur dengan jenis fraktur yang berbeda dan penyebab yang berbeda, dari hasil survey tim depkes  RI didapatkan 25% penderita fraktur yang mengalami kematian, 45 mengalami cacat fisik, 15% mengalami stress psikologis karena cemas dan bahkan  depresi, dan 10% mengalami kesembuhan dengan baik. Respon cemas (ansietas) adalah reaksi normal terhadap ancaman stress dan bahaya. Ansietas merpakan reaksi emosional terhadap persepsi adanya bahaya, baik yang  nyata maupun yang dibayangkan. respon cemas merupakan reaksi umum yang terjadi  terhadap perubahan status kesehatan yang dirasakan sebagai ancaman: ancaman umum terhadap kehidupan, kesehatan dan keutuhan tubuh, pemajanan dan rasa malu, ketidaknyaman akibat nyeri dan keterbatasan gerak.

Di Sumatera Selatan berdasarkan data dinas  Kesehatan Provinsi Sumatera Selatan tahun 2007 didapatkan sekitar 2700 orang mengalami insiden fraktur, 56% penderita mengalami kecacatan fisik, 24% mengalami kematian, 15% mengalami kesembuhan dan 5% mengalami gangguan psikologis atau depresi terhadap adanya kejadian fraktur (Dinkes Pemrov Sumsel, 2008). Sementara itu pada tahun  yang sama   di Rumah Sakit Umum Kota Prabumulih tercatat terdapat 676 kasus fraktur dengan distribusi 86,2% fraktur jenis terbuka dan 13,8% fraktur jenis tertutup. Berdasarkan catatan rekam medik RSUD Kota Prabumulih diketahui 68,14% jenis fraktur yang terjadi adalah  fraktur ektremitas bawah (Medikal Record RSUD Kota Prabumulih, 2008). Selengkapnya [doc]

HUBUNGAN FUNGSI KELUARGA DENGAN KEKAMBUHAN PADA PENDERITA GANGGUAN JIWA SCHIZOFRENIA DI RUMAH SAKIT JIWA DAERAH PALEMBANG

Oleh: Lukman, Sri Tirtayanti, dan Nur Alam Fajar

 

Dimuat pada: Jurnal Kedokteran dan Kesehatan (JKK) Th. 39 No.1 Januari 2007; hal 1569-1573. 

ABSTRACT

This study conducted to know family function relation with relapsing at patient of schizofrenia. Where becoming and population of sampel is family monomaniac of taken care of schizofrenia at Mental Hospital of Palembang. Method the used is method of survey analytic with Cross sectional desain, with sampling random technic. Processing datas which weared by using software of computer and analysed by univariat and bivariate. Result of study, by using analysis of univariat can know that family giving support at patient recovering process only 25 people (29,4%) pursuant to psychological function. By using bivariate analysis at obtained by psychological function value p=0,014 ( p<0,05). While at education function (knowledge) value p=1,000 ( p>0,05) and at function of biologis obtained by value p= 0,623 ( p>0,05). So that can be concluded , there is relation between psychological function with relapsing of schizofrenia, there no relation between education function (knowledge) and  biologis function with relapsing of schizofrenia at Mental Hospital of  Palembang. Require to be strived health education and family entangling to health in compilation of planning discharge, for the agenda of optimal [of] role and also family in treatment at home and prevent relapsing.

 

Keywords : Family, prevention, recurrence, schizofrenia

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