Sikap Mengenai Keselamatan pada Residen dan Perawat di Rumah Sakit Pendidikan

Background: Provider attitudes about issues pertinent topatient safety may be related to errors and adverse events.Residents as the main health provider in teaching hospitalsplay an important factors for assuring patient safety.Objective: To assess the attitudes of residents towards patientsafety and compare the attituted to other health providersnurse/midwive) in the Obstetrics Gynaecology Outpatient Clinic.Methods: This was a survey conducted in a teaching hospitalat Yogyakarta. Safety Attitude Questionnare (SAQ)-A questionnairewas adapted into Indonesian setting to assess attitudesamong residents and nurses at Obstetrics Gynaecologyoutpatient clinic. All residents and health providers were invitedto participate in this survey.Results: Total of 71 respondents involved in this survey (consistedof 79% of total residents and 82% of total nurses). TheSAQ-A questionnaire which was used here had comparableinternal consistency with the previous study. In general attitudestowards patient safety were higher among nurses/midwive than residents. Significant differences revealed relatedto perception to management and stress recognition.Perception to management score was the lowest compared toother scales (19,6% residents versus 33,3% nurses withpositive attitudes). There was no differences for other scalesbut still with low attitude scores. Aspects related to informationtransfer between residents and consultant, clinic referralsystem and care in test results management were perceivedas poor by residents and nurses.Conclusion: Residents have lower attitudes towards patientsafety compare to nurses/midwive. This study shows theimportance of providing orientation among residens beforetheir training program to improve patient safety attitude.Key Words: attitude towards patient safety, safety attitudesquestionnaire, teaching hospita

Spatial Patterns Associating Low Birth Weight with Environmental and Behavioral Factors

Low birth weight (LBW) is a significant public health problem in the world. It was estimated globally by the World Health Organization (WHO) that prevalence of LBW was 15% of all births. In Murung Raya district LBW cases remain high. This paper aimed to identify and discuss the relationship between environmental risk factors with LBW in Murung Raya.A spatial analysis was conducted with 150 women as the total participantswho were recruited through the incidence data in 2013-2014. The questionnaires, medical records, and geographic data were measured by Stata software, ArcGis, SatScan, and Geoda. The study results indicated there was significant correlation between health behavior and environmental variables with the strength of external neighborhood effect across LBW risk factors. More intense clustering of high values (hot spots) was found through the spatial analysis showing that most of the cases were located near the defined buffer zone. This research demonstrates that the spatial pattern analysis provided greater statistical power to detect an effect that was not apparent in the previous epidemiology studies

Determinan Abortus di Indonesia

Abortion has become a main problem in public health because of its impact on maternal morbidity and mortality. There is no comprehensive data on abortion in Indonesia. So far, data were based on survey with limited coverage. Unsafe abortion is responsible to 11 percent of maternal mortality in Indonesia. This research objective is to determine factors related to abortion in Indonesia. The study was an observational method with cross sectional design. Thesedata are gathered from Indonesian Demography and Health Survey 2002–2003. Data analysis used univariate, bivariate and multivariate analysis with logistic regression. The risk of an abortion increased in line with the increasing of maternal age. Women with 0-2 parity have higher risk than multiparity (OR=5.2, IK95%=3.49-7.89). Employed women have higher risk than unemployed (OR=2.7, IK95%=2.10-3.58). The risk of abortion increased among women married at 30 years old or over (OR=1.8, IK95%=1.30-2.48). There is no significant association between history of abortion, education, socioeconomic and risk of abortion

Penggunaan Intra Uterin Device (IUD) dan Pola Aktivitas Seksual pada Perempuan di Kupang

The use of intra uterine device (IUD) and sexual activity patterns in women in KupangPurposeThe purpose of this study was to know the influence of intra uterine device type contraceptive use to the pattern of sexual activity.MethodsThis research was an observational study with a cross-sectional design using questionnaires to collect data. The samples were 190 women of fertile age in the city of Kupang. The correlation of intra uterine device USAge and sexual activities pattern was analyzed by using chi square tests, and continued with multivariate analysis using logistic regression tests, using confidence interval (CI) of 95% and a level of significance of p<0.05.ResultsThere was no significant difference in patterns of sexual activities of women using intra uterine device with those who were not using contraception. The variables that were statistically significant were age, parity, duration of marriage and effects of intra uterine device use. Meanwhile variables that were not statistically significant were working status and duration of intra uterine device use.ConclusionThe USAge of intra uterine device contraception did not affect patterns of sexual activities of women in Kupang. However, the effect of intra uterine device USAge did have influence toward sexual activity, but such effect would be reduced over time up to 1 year of using. The recommendations given in this research is that it is necessary to further analyze intra uterine device USAge effects toward sexual activities patterns

Measuring students’ approaches to learning in different clinical rotations

BACKGROUND: Many studies have explored approaches to learning in medical school, mostly in the classroom setting. In the clinical setting, students face different conditions that may affect their learning. Understanding students’ approaches to learning is important to improve learning in the clinical setting. The aim of this study was to evaluate the Study Process Questionnaire (SPQ) as an instrument for measuring clinical learning in medical education and also to show whether learning approaches vary between rotations. METHODS: All students involved in this survey were undergraduates in their clinical phase. The SPQ was adapted to the clinical setting and was distributed in the last week of the clerkship rotation. A longitudinal study was also conducted to explore changes in learning approaches. RESULTS: Two hundred and nine students participated in this study (response rate 82.0%). The SPQ findings supported a two-factor solution involving deep and surface approaches. These two factors accounted for 45.1% and 22.5%, respectively, of the variance. The relationships between the two scales and their subscales showed the internal consistency and factorial validity of the SPQ to be comparable with previous studies. The clinical students in this study had higher scores for deep learning. The small longitudinal study showed small changes of approaches to learning with different rotation placement but not statistically significant. CONCLUSIONS: The SPQ was found to be a valid instrument for measuring approaches to learning among clinical students. More students used a deep approach than a surface approach. Changes of approach not clearly occurred with different clinical rotations

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Exploring Clinical Rotation Competence Improvements After Interpersonal Skills Development in At-Risk Medical Students

Pada mahasiswa kedokteran yang baru masuk dilakukan pemeriksaan psikologis untuk memperoleh gambaran penalaran dan kepribadian untuk memprediksi kemampuan mahasiswa dalam menyelesaikan pendidikan. Berdasarkan pemeriksaan tersebut diperoleh 56,45% mahasiswa dengan hasil uji psikometrik kategori rekomendasi 4 (diragukan) dan 5 (tidak disarankan) yang disebut sebagai kelompok at-risk. Kelompok at risk memiliki peluang keberhasilan rendah untuk menyelesaikan pendidikan dan akan mengalami kesulitan mencapai kompetensi klinik sesuai Standar Kompetensi Dokter Indonesia. Tujuan penelitian ini adalah menggali pengalaman pencapaian kompetensi klinik mahasiswa kelompok at-risk &nbsp;pada tahun ketiga, setelah mengikuti pelatihan pengembangan keterampilan interpersonal yang dilaksanakan pada bulan Juli 2011. Penelitian ini menggunakan rancangan studi kualitatif dengan wawancara mendalam setelah dilakukan pelatihan. Pengembangan keterampilan interpersonal pada mahasiswa kedokteran kelompok at-risk memberikan dampak positif terhadap pembentukan kepribadian sebagai helping profession. Disimpulkan bahwa pengembangan keterampilan interpersonal yang diberikan dalam bentuk pelatihan dapat digunakan untuk membantu meningkatkan pencapaian kompetensi mahasiswa khususnya kelompok at-risk di tahap klinik