Improving village health post (Ponkesdes) nurses' performance, which model should be used?

Background: Village Health Post (Ponkesdes) has become a part of Public Health Nursing (PHN) program since year 2009 which criticized has a poor performance. From 2910 Ponkesdes that spread all over East Java region, only 10% of nurses implemented PHN. This situation will hamper the regional health development particularly and the nation commonly. Objective: The purpose of this study was to develop a new model to improve the performance of Ponkesdes nurses' especially in implementing PHN. Method: The method was an observational analytic with cross sectional approach. Multi stage random sampling was employed to decide the district and simple random sampling was assigned to choose the participants, a total of 117 Ponkesdes nurses involved in this study. The study conducted in four districts in East Java Province (Blitar, Jember, Lamongan, and Bangkalan). Data were collected by questionnaire on variables namely reinforcing, personal, cognitive, affective, commitment, interaction, and nurses' performance factors. The Partial Least Squares (PLS)-method is used for constructing predictive model. Results: This study found a new model which was developed based on combination of Health Promotion Model (HPM) and Health Interaction Model (HIM) with additional of reinforcing factor. Statistical result confirmed that personal, affection and interaction factors considered as important factors in improving Ponkesdes nurses' performance. Conclusion: Ponkesdes nurses' performance will improve by considering three main factors, personal, affection and interaction. This model can be adapted by Provincial District Health Office East Java Province as the main actor in regional health development. In addition, this model may become a reference for other province in improving their nurses' performance in community setting and other country that have similar program in PHN

Safe Concentration of Benzene Exposure as Ref ere nee for Determining Threshold Limited Value in Enviromental Working

Background: The aim was to measure the limits of the safe concentration of benzene in the shoe home industry in Romokalisari Surabaya. Method: The study was pre-experimental study with single group design. Samples taken were 25 workers at shoe home industry in Romokalisari, Surabaya. To determine the safe concentration of benzene for workers obtained data on weight of experimental animal (W animal), body surface of experimental animals (BSA animal), weight of workers (W), height of workers (h), body surface area of workers (BSA), breathing rate of workers (BR), working time (t), concentration benzene, Animal Km, Human Km, NOAEL, and safe human dose (SHD). Results: The average measurement of benzene concentration was 1.98 ppm (6.34 mg I m which means it was above the threshold value (TLV) at Indonesia. The safe limit value of benzene concentration of 0.0275 ppm also exceeds the stipulated level of 0.009 ppm daily for acute effects and 0.003 ppm daily for chronic effects. 3), Conclusion: Control efforts are needed so that workers are protected so they are not adversely affected by benzene exposure. The recommendation such as use appropriate personal protective equipment and plant a number of ornamental plants that can absorb and reduce the concentration of benzene

Effect of Food Consumption Contain Glutahione Anti-oxidant towards LDL Cholesterol Concentrations on Benzene-exposed-workers at the Romokalisari Shoe Industry, Surabaya

Background: Benzene is a chemical that is often used in the shoe making industry. Recent studies have shown that benzene can cause a risk of cardiovascular disease by increasing LDL levels in blooda. One efficient intervention is consumption antioxidant-rich foods regularly to reduce blood LDL levels. Research on the effect of LDL cholesterol levels before and after treatment of consumption in benzene-exposed workers is still limited in Indonesia. Methods and Material: A sample of 25 workers with the pre-post test design method. Benzene measurement using the method ofNIOSH 1501 with an activated carbon ( charcoal) pipe which uses a gaschromatography­ flame ionization detector (GC-FID) technique using standard NIOSH 1501. An LDL cholesterol sample is taken by taking blood from a vein in the elbow fold (fossa cubiti). The statistical analysis used was Pearson and Spearman test and Paired t-test. Result: The majority of respondents have male sex, aged over 50 years. having a high school education background, never wearing a mask while working and having a smoking habit. There is no a difference between the levels of LDL cholesterol in blood before and after consumption food rich in glutathione antioxidants (p = 0107) and there is no correlation between the levels of benzene before and after treatment (p = 0.425; p = 0597). Conclusion: There are patterns that vary between LDL cholesterol-rich antioxidants before and after treatment. This can be due to lack time of monitoring in the study, the majority of respondents who still have normal concentration standards and the presence of demographic factors that can influence, for example smoking habit so there is no difference between LDL cholesterol levels before and after treatment. However, workers are recommended to always use PPE, do routine health checks while do physical activity and consume antioxidant-rich foods especially glutahione to prevent cardiovascular risk due to exposure to long­ term benzene (more than 10 years)

Determination of Highest Dose of Ammonia without Effect at Work Environment through the Expression of Interleukin-2 Cell in Rattus Novergicus

BACKGROUND: For determining the threshold limit value firstly determined the highest dose of ammonia without effect (NOAEL). However, research on the determination of NOAEL ammonia didn't conduct in Indonesia. AIM: The aim of this study to determine the value of the highest dose of ammonia without effect (No Observed Adverse Effect Level/NOAEL) through interleukin-2 (IL-2) expression on white mice. METHODS: This study used experimental laboratory research with post-test only control group design using white mice as experimental subjects. The treatment group divided into 6 groups (a group of controls and five groups with different ammonia exposure through inhalation). The trend curve of Remmele Scale Index (IRS) and histopathologic analysis could be used for determining NOAEL. RESULT: The location of the highest dose of ammonia without any effect (NOAEL) of white mice was in the second group, with 0.0103 mg/kg body weight dose. Analysis of statistical tests Kruskal Wallis stated there was no significant difference in interleukin-2 expression between the control with ammonia exposed group with a significance of p (0.747) > α (0.05). CONCLUSION: There is no difference between some interleukin-2 expression in the lymphocyte cell lung white mice group exposed to ammonia and control group. The highest dose of ammonia without any effect (NOAEL) on white mice was 0.0103 mg/kg body weight

Risk analysis characterization of benzene and demographic factors toward immunoglobulin A

Background: Research on risk assessment at industrial sites has experienced growth during the end of this year. But in Indonesia, there is still limited research on risk assessment, especially regarding the importance of measuring non-carcinogenic risk assessment in the workplace. Benzene exposure is believed to reduce levels of immunoglobulin A (IgA) in workers. AIM: The purpose of this study was to analyse the relationship between risk quotient (RQ) of non-carcinogenic risk assessment of benzene and demographic factors on IgA levels. Material and methods: The subjects of the study were shoe craftsmen who were at risk of benzene exposure. The study design was cross-sectional with a total population of 20 workers. Measurement of IgA levels by Immunoturbidimetric Assay with a normal standard of 2-3 mg/ml. Calculation of non-carcinogenic (RQ) risk characteristics with a comparison between risk agent non-carcinogenic intake with RfD or RfC benzene. Resuts: The majority of the study subjects aged over 45 years and had a working period of ≥ 25 years. There were 2 location points that had a threshold value exceeding the benzene standard (> 0.05 ppm), and 40% of the subjects had decreased IgA levels. Age and working periods had a significant relationship to IgA levels (p = 0.027; p = 0.047), while benzene and RQ levels did not have a significant relationship with IgA levels (p = 0.179; p = 0.436). Conclusion: Increasing age and working period can reduce IgA levels in the body. Further research is needed on risk assessment, especially on the safe limits of benzene concentration in the workplace to find out how long benzene exposure forms a non-carcinogenic or carcinogenic risk in workers’ bodies exposed to benzene

Model of Nursing Group Intervention based on Interpersonal Human Caring (IHC) Toward Psychological Needs of the Adolescent in the Orphanage

Introduction. Live at the Orphanage with various facility limitations requires teenagers to develop according to the situation. The facts that exist in the Orphanage, orientation of meeting the youth group’s needs are physical needs. Purpose. The study aimed to develop an interpersonal human caring (IHC) -based group nursing intervention model on adolescents’ psychological needs in the Orphanage. The contribution of this research is to increase the psychological needs of adolescents so that adolescents are confident in carrying out activities even at the orphanage. Method. The method used is observational analytic. The sample is some teenagers who live in orphanages in Surabaya City and Sidoarjo Regency, taken by random cluster sampling, totaling 260 people. Research variables include predisposing factors and values of care, supporting aspects and environmental caring, driving factors, interpersonal behavior of adolescents’ human caring, and psychological needs. Phase 2 research with the quasi-experimental method for model testing. The samples were some of the teenagers who lived in one of the orphanages in Surabaya and Sidoarjo, amounting to 32 people taken by simple random sampling. The instrument uses a questionnaire. Data analysis used descriptive analysis and model testing with Partial Least Square (PLS) software. Results and Discuss. The first stage of the study found that all indicators of the variables can explain the construct variables (T>1,96). Path diagram analysis of all exogenous variables influences psychological needs. The second phase of paired t-test testing found differences in psychological needs before and after the trial model. Model of Nursing Group Intervention based on interpersonal human caring (IHC) can be usedto support physical needs for teenagers in the Orphanage (p<0,05). Every In the Orphanage needs added a Psychology as a consultant.Conclusion. The new scientific findings from this study were the formation of IHC-based group intervention models. This model can fulfill psychological needs in adolescents at the Orphanage. The conclusion that predisposing factors and values of care, supporting elements and caring environment, and driving factors are essential factors that can influence human affectionate interpersonal behavior. Implication.This behavior can improve the fulfillment of the psychological needs of adolescents in the Orphanage

Peningkatan Kesejahteraan Spiritual pada Klien Penyakit Ginjal Kronis Melalui Pemberdayaan Keluarga: Improving Spiritual Well-being in Chronic Kidney Disease Clients Through Family Empowerment

Kesejahteraan spiritual pada klien penyakit ginjal kronis (PGK) sangat penting untuk meningkatkan produktifitas. Keteraturan perawatan dan dukungan keluarga merupakan faktor penting dalam meningkatkan kesejahteraan spiritual. Tujuan kegiatan Pengabdian kepada Masyarakat (PkM) ini adalah memandirikan keluarga dalam merawat klien PGK untuk meningkatkan kesejahteraan spiritual. Sasaran PkM adalah keluarga dengan klien PGK di wilayah kerja Puskesmas Kalijudan Surabaya sejumlah 30 orang. Metode yang digunakan adalah 5 tahap kemandirian keluarga (pre-kontemplasi, kontemplasi, persiapan, pelaksanaan tindakan, dan pemeliharaan). Hasil PkM menunjukkan sebagian keluarga mengeluhkan lamanya perawatan, namun mereka menegaskan bahwa merawat anggota keluarga yang sakit adalah tanggung jawabnya dan tetap menerima klien. Data pengetahuan keluarga tentang perawatan klien PGK sebelum dan sesudah pendidikan kesehatan meningkat. Data kemandirian yang menunjukkan peningkatan adalah mengatur konsumsi cairan, mengingatkan untuk beribadah; membaca kitab suci; berolahraga, dan memotivasi untuk bersikap ikhlas pada diri sendiri dan keluarga yag sakit. Data Kesejahteraan spiritual sebelum dan sesudah tahap pemeliharaan menunjukkan peningkatan. Keluarga dengan pasien PGK dirumah dapat mengevaluasi berbagai hal yg dialami dalam perawatan dirumah, mencapai peningkatan pengetahuan perawatan yang benar, lebih mandiri dalam perawatan sehari-hari di rumah, serta mencapai peningkatan kesejahteraan spiritual yang diharapkan. Kondisi kesejahteraan spiritual yang dapat dicapai secara optimal oleh keluarga bersama pasien akan meningkatkan kualitas hidup keduanya.Kesejahteraan spiritual pada klien penyakit ginjal kronis (PGK) sangat penting untuk meningkatkan produktifitas. Keteraturan perawatan dan dukungan keluarga merupakan faktor penting dalam meningkatkan kesejahteraan spiritual. Tujuan kegiatan Pengabdian kepada Masyarakat (PkM) ini adalah memandirikan keluarga dalam merawat klien PGK untuk meningkatkan kesejahteraan spiritual. Sasaran PkM adalah keluarga dengan klien PGK di wilayah kerja Puskesmas Kalijudan Surabaya sejumlah 30 orang. Metode yang digunakan adalah 5 tahap kemandirian keluarga (pre-kontemplasi, kontemplasi, persiapan, pelaksanaan tindakan, dan pemeliharaan).&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Hasil PkM menunjukkan sebagian keluarga mengeluhkan lamanya perawatan, namun mereka menegaskan bahwa merawat anggota keluarga yang sakit adalah tanggung jawabnya dan tetap menerima klien. Data pengetahuan keluarga tentang perawatan klien PGK sebelum dan sesudah pendidikan kesehatan meningkat. Data kemandirian yang menunjukkan peningkatan adalah mengatur konsumsi cairan, mengingatkan untuk beribadah; membaca kitab suci; berolahraga, dan memotivasi untuk bersikap ikhlas pada diri sendiri dan keluarga yag sakit. Data Kesejahteraan spiritual sebelum dan sesudah tahap pemeliharaan menunjukkan peningkatan. Keluarga dengan pasien PGK dirumah dapat mengevaluasi berbagai hal yg dialami dalam perawatan dirumah, mencapai peningkatan pengetahuan perawatan yang benar, lebih mandiri dalam perawatan sehari-hari di rumah, serta mencapai peningkatan kesejahteraan spiritual yang diharapkan. Kondisi kesejahteraan spiritual yang dapat dicapai secara optimal oleh keluarga bersama pasien akan meningkatkan kualitas hidup keduanya

Analysis of Cooperation and Motivation Nurse in Implentation Nursing of Family

Cooperation of nurses needed in helping to resolve the client's problem. Cooperation was an important element in developing quality of human resources and improving performance. The general objective of this study was to identify cooperation-relation nurse with motivation in implementing the family nursing care at Surabaya city. The research method was analytical observational with cross sectional approach. The population of this study was 175 nurses at local government clinic at Surabaya city. The sample size of this study was 122 gained by probability sampling. The research variables include the cooperation of nurses and motivation in implementing family nursing care. Instrument used questionnaire. Bivariate analysis of the data was done by Spearman correlation test. Limit the test of significance is 0.05. The test resulted that there was a relationship of cooperation with the motivation of nurses in implementing family nursing care (p = 0.03). Nurses should develop cooperative relationships in order to increase their motivation to carry out the nursing care of the family