Analisa Faktor Yang Berpengaruh Terhadap Konversi Pasien Tb Mdr Di Provinsi Sumatera Utara Tahun 2013 - 2014
ABSTRAK
Konversi TB MDR merupakan indikator pemantauan pengobatan dimana
keadaan Mycobacterium tuberculosis secara bersamaan menunjukkan hasil negatif
pada pemeriksaan biakan dan BTA. Secara nasional, angka konversi TB MDR
40,68%. Di Provinsi Sumatera Utara angka konversi sebesar 40,32%. Penelitian ini
bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap konversi pasien
TB MDR di Provinsi Sumatera Utara Tahun 2013 - 2014.
Jenis penelitian ini adalah kajian analitis dengan rancangan studi kasus
kontrol. Populasi adalah seluruh pasien TB MDR di RSUP H.Adam Malik yang
memulai pengobatan mulai tahun 2013 – 2014 sebanyak 187 orang. Jumlah sampel
sebanyak 41 kasus dan 41 kontrol. Analisis data secara univariat, bivariat dan
multivariat menggunakan uji regresi logistik berganda.
Hasil analisis multivariat menunjukkan variabel efek samping obat (p = 0,002,
OR = 11,60, 95% CI: 2,41 – 55,82), kepuasan pasien (p = 0,002, OR = 11,90, 95%
CI: 2,44 – 57,99), pendapatan keluarga (p = 0,007), OR = 11,18, 95% CI: 1,92 –
64,98), Peran aktif PMO (p = 0,013, OR = 5,92, 95% CI: 1,46 – 24,04), dan jarak ke
fasyankes (p = 0,007, OR = 10,71 (95% CI: 1,92 – 59,84) memiliki pengaruh yang
signifikan terhadap konversi pasien TB MDR dan variabel yang tidak berpengaruh
secara signifikan terhadap konversi pasien TB MDR adalah pekerjaan, tipe pasien,
pendidikan, pengetahuan, keteraturan berobat dan perilaku petugas kesehatan.
Diharapkan kepada Fasyankes agar menyediakan waktu ekstra untuk pasien
TB MDR dalam rangka konseling dan penanganan efek samping obat,
meningkatkan pelayanan di fasyankes dan pelatihan program TB Resisten Obat
kepada petugas kesehatan serta peningkatan akses pengobatan TB MDR melalui
Poskesdes. Kepada masyarakat diharapkan tetap melanjutkan pengobatan dan pergi
ke fasyankes jika terdapat efek samping selama dalam masa pengobatan serta kepada
PMO agar memberikan motivasi kepada pasien untuk teratur berobat dan kontrol
secara teratur sampai pengobatan selesai.
Kata Kunci : Konversi Pasien TB MDR, Faktor Instrinsik, Faktor Ekstrinsik
i
ABSTRACT
TB MDR conversion is an indicator for monitoring medication in which
Microbacterium tuberculosis at the same rime indicates negative result in the
examination of breeding and BTA. Nationally, TB MDR conversion rate was 40.68%.
In North Sumatera, TB MDR conversion rate was 40.32%. The objective of the
research was to find out some factors which influencer TB MDR patient conversion in
North Sumatera in the period of 2013 - 2014.
The research was analytical with case control study. The population was 187
TB MDR patients at RSUP H. Adam Malik who began their medication in the period
of 2013 - 2014, and 41 respondents were in case group, while the other 41
respondents were in control group. The data were analyzed by using univatriate
analysis, bivatriate analysis, and multivatriate analysis with multiple logistic
analysis.
The result of the multivatriate analysis showed that the variables of medicine
side effect (p = 0.002, OR = 11.60, 95% CI: 2.41-55.82), patient satisfaction (p =
0.002, OR = 11.90, 95% CI: 2.44-57.99), family income (p = 0.007, OR = 11.18,
95% CI: 1.92-64.98), Active Role of PMO (p = 0.013, OR = 5.92, 95% CI: 1.4624.04), and distance from health facility (p = 0.007, OR = 10.71, 95% CI: 1.9259.84) had significant influence on TB MD patient conversion, and the variables
which had insignificant influence on TB MDR patient conversion were occupation
patient type, education, knowledge, medication rule, and the behavior of health care
providers.
It is recommended that the health facility Service provide extra time for TB
MDR patients in counseling and handling side effect of medicine increase health
service facility training program of medicine resistance TB for health care providers,
increase the access to TB MDR medication through Poskesdes so that patients will be
easy to do medication. People should carry on medication to the Health facility
service if there is side effect during medication and PMO give motivation for TB
MDR patients do the medication and control regularly until medication is done.
Keywords: TB MDR Patient Conversion, Intrinsic Factor, Extrinsic Factor
ii
Konversi TB MDR merupakan indikator pemantauan pengobatan dimana
keadaan Mycobacterium tuberculosis secara bersamaan menunjukkan hasil negatif
pada pemeriksaan biakan dan BTA. Secara nasional, angka konversi TB MDR
40,68%. Di Provinsi Sumatera Utara angka konversi sebesar 40,32%. Penelitian ini
bertujuan untuk mengetahui faktor-faktor yang berpengaruh terhadap konversi pasien
TB MDR di Provinsi Sumatera Utara Tahun 2013 - 2014.
Jenis penelitian ini adalah kajian analitis dengan rancangan studi kasus
kontrol. Populasi adalah seluruh pasien TB MDR di RSUP H.Adam Malik yang
memulai pengobatan mulai tahun 2013 – 2014 sebanyak 187 orang. Jumlah sampel
sebanyak 41 kasus dan 41 kontrol. Analisis data secara univariat, bivariat dan
multivariat menggunakan uji regresi logistik berganda.
Hasil analisis multivariat menunjukkan variabel efek samping obat (p = 0,002,
OR = 11,60, 95% CI: 2,41 – 55,82), kepuasan pasien (p = 0,002, OR = 11,90, 95%
CI: 2,44 – 57,99), pendapatan keluarga (p = 0,007), OR = 11,18, 95% CI: 1,92 –
64,98), Peran aktif PMO (p = 0,013, OR = 5,92, 95% CI: 1,46 – 24,04), dan jarak ke
fasyankes (p = 0,007, OR = 10,71 (95% CI: 1,92 – 59,84) memiliki pengaruh yang
signifikan terhadap konversi pasien TB MDR dan variabel yang tidak berpengaruh
secara signifikan terhadap konversi pasien TB MDR adalah pekerjaan, tipe pasien,
pendidikan, pengetahuan, keteraturan berobat dan perilaku petugas kesehatan.
Diharapkan kepada Fasyankes agar menyediakan waktu ekstra untuk pasien
TB MDR dalam rangka konseling dan penanganan efek samping obat,
meningkatkan pelayanan di fasyankes dan pelatihan program TB Resisten Obat
kepada petugas kesehatan serta peningkatan akses pengobatan TB MDR melalui
Poskesdes. Kepada masyarakat diharapkan tetap melanjutkan pengobatan dan pergi
ke fasyankes jika terdapat efek samping selama dalam masa pengobatan serta kepada
PMO agar memberikan motivasi kepada pasien untuk teratur berobat dan kontrol
secara teratur sampai pengobatan selesai.
Kata Kunci : Konversi Pasien TB MDR, Faktor Instrinsik, Faktor Ekstrinsik
i
ABSTRACT
TB MDR conversion is an indicator for monitoring medication in which
Microbacterium tuberculosis at the same rime indicates negative result in the
examination of breeding and BTA. Nationally, TB MDR conversion rate was 40.68%.
In North Sumatera, TB MDR conversion rate was 40.32%. The objective of the
research was to find out some factors which influencer TB MDR patient conversion in
North Sumatera in the period of 2013 - 2014.
The research was analytical with case control study. The population was 187
TB MDR patients at RSUP H. Adam Malik who began their medication in the period
of 2013 - 2014, and 41 respondents were in case group, while the other 41
respondents were in control group. The data were analyzed by using univatriate
analysis, bivatriate analysis, and multivatriate analysis with multiple logistic
analysis.
The result of the multivatriate analysis showed that the variables of medicine
side effect (p = 0.002, OR = 11.60, 95% CI: 2.41-55.82), patient satisfaction (p =
0.002, OR = 11.90, 95% CI: 2.44-57.99), family income (p = 0.007, OR = 11.18,
95% CI: 1.92-64.98), Active Role of PMO (p = 0.013, OR = 5.92, 95% CI: 1.4624.04), and distance from health facility (p = 0.007, OR = 10.71, 95% CI: 1.9259.84) had significant influence on TB MD patient conversion, and the variables
which had insignificant influence on TB MDR patient conversion were occupation
patient type, education, knowledge, medication rule, and the behavior of health care
providers.
It is recommended that the health facility Service provide extra time for TB
MDR patients in counseling and handling side effect of medicine increase health
service facility training program of medicine resistance TB for health care providers,
increase the access to TB MDR medication through Poskesdes so that patients will be
easy to do medication. People should carry on medication to the Health facility
service if there is side effect during medication and PMO give motivation for TB
MDR patients do the medication and control regularly until medication is done.
Keywords: TB MDR Patient Conversion, Intrinsic Factor, Extrinsic Factor
ii