BSE Practice and BSE Self-Efficacy Among Nursing Students in Aceh, Indonesia

Purpose: To survey the level of BSE practice among female nursing students in Aceh, and the degree of self-efficacy in those who did practice it.Method: Seventy-six nursing students from the Public Nursing College, Syiah Kuala University in Aceh who met the inclusion criteria were recruited. Stratified proportionate random sampling was used to determine the required number of first, second, and third year students. BSE self-efficacy of the students was measured by the BSE Self-Efficacy Questionnaire which was modified from an existing tool developed by Khatun (2010). In addition, the students' doing BSE or not was measured by BSE Practice Questionnaire which was developed by the researcher. The data were analyzed by using descriptive statistics.Result: Only 39.5% of the students practiced BSE with more than half of the students saying they did not practice BSE (60.5%). The main factors that influenced the students' performing BSE were not having a family history of breast cancer, single, and no history of breast illness. Among the thirty students who practiced BSE, most of them did not practice it routinely (70%), nor at the correct time (86.7%), and their confidence in performing BSE was at a moderate level overall, with a high level for BSE procedural efficacy and moderate level for barrier management efficacy.Conclusion: A majority of the Acehnese nursing students did not practice BSE, and those who did had only a moderate level of BSE self-efficacy. Therefore, the results of this study suggest emphasizing the need to teach nursing students about BSE in their undergraduate courses, with future follow-up research regarding the success of the educational program

The Development of a Cultural-Based Educational Program to Enhance Breast Self-Examination (BSE) Self-Efficacy

Purpose: To develop the educational program which is appropriate with Islamic culture in order to enhance BSE self-efficacy of nursing students and thus promote BSE practice. Method: This study is a development research study which is consisting of three phases including: 1) reviewing several existing BSE educational programs; 2) program design based on SCT and Islamic culture; and 3) program validation by three experts. Result: Based on previous studies, the most appropriate theory to enhance self-efficacy was Social Cognitive Theory (SCT) because this theory provides several strategies to increase the self-efficacy. Further, the program that used Islamic culture was more appropriate to increase BSE practice among Muslim women. As a result, the newly developed program was developed used SCT and Islamic culture. This program was comprised of four sessions including: 1) exploring Islamic mandate on prevention and individual responsibility in health promotion, and culture-related beliefs toward BSE, 2) health education by conducting lecturing session and watching a video about BSE procedures, 3) BSE training activities including BSE demonstration and return demonstration, 4) follow-up by conducting a meeting. Conclusion: The cultural-based educational program for enhancing BSE self-efficacy and promoting BSE is a program using multifaceted methods. It designed based on a review of the literature from previous studies and were supported by research findings on experimental studies in other population

An Analysis Of Students\u27 Ability And Difficulties In Writing Descriptive Texts

This paper repotrs on an investigation towardsthe tenth graders\u27 ability and difficulties in writing descriptive text in one class of one senior high school in Bandung. The research used a qualitative case study as the method and texts analysis as the data collection techniques. Nine texts written by Low, Mid, and High achievers were analyzed in terms of schematic structure and linguistic features using Systemic Functional Linguistics. The findings revealed that the students representing the middle and high achievers had a good control about the schematic structure of descriptive text. They also were able to use appropriate linguistic features. On the other hand, it was also revealed that the low achievers were still confused in identifying the schematic structure of descriptive text. Moreover, the low achievers still needed a lot of improvement as they still made a lot of mistakes in the text they wrote

Factors Associated with Work Performance of Midwives at Langsa Hospital, Aceh

Background: Recently, in some countries a framework for quality maternal and newborn care was developed, which encourages a system-level shift to provide skilled care for all. This care includes preventive and supportive care that works to strengthen women’s capabilities and focuses on promotion of normal reproductive processes while ensuring access to emergency treatment when needed. Midwives with high work performance have an important role in this new system. This study aimed to determine factors associated with work performance among midwives at Langsa Hospital, Aceh, with special attention to the effect of motivation. Subjects and Method: This was a cross sectional study conducted at General Hospital in Langsa, Aceh. A sample of 47 midwives was selected for this study. The dependent variable was work performance. The independent variables were employment status, skill, motivation, supervision, and training. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: High motivation improved work performance of midwives (OR= 2.35; p= 0.037), after controlling for the effects of employment status, skill, training, and supervision. Conclusion: High motivation improves work performance of midwives. Keywords: work performance, motivation, employment status, supervision, training, skill, midwife

Factors Associated with Adherence to Implementation of Early Breastfeeding Initiation among Midwives at Aceh Tamiang General Hospital, North Sumatera

Background: Breastfeeding has many health benefits for both the mother and infant. World Health Organization recommends the provision of mother’s breast milk to infants within one hour of birth referred to as “early initiation of breastfeeding”. It ensures that the infant receives the colostrum or “first milk” rich in protective factors. Midwives have an important role to help lactating mothers to implement early initiation of breastfeeding. This study aimed to examine factors associated with adherence to implementation of early breastfeeding initiation among midwives at Aceh Tamiang general hospital, North Sumatera. Subjects and Method: This was a cross-sectional study conducted at Tamiang General Hospital, North Sumatera. A total of 46 midwives were selected for this study. The dependent variable was adherence to implementation early initiation of breastfeeding. The independent variable was competence. The confounding factors included among others availability of standard operating procedure. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Midwives with higher competence were more likely to adhere to the implementation early initiation of breastfeeding, after adjusting for confounding factors (OR= 6.49; p= 0.002). Conclusion: Competence is associated with adherence to the implementation early initiation of breastfeeding among midwives. Keywords: early initiation of breastfeeding, competence, adherence, implementation, midwives

Bpjs Barrier to Strategic Purchasing of Primary Care Service at Public and Private Health Facilities in Subulussalam, Aceh

Background: Strategic purchasing plays an important role in the cost structure and competitiveness of small and large businesses. Managing Board of Social Insurance (BPJS) has implemented strategic purchasing of health services in the National Health Insurance (JKN) scheme. Strategic purchasing is important to provide quality products and services at low costs. Strategic purchasing of health service has five critical criteria: (1) what is to purchase; (2) to whom it is for; (3) whom it is from; (4) what is the price; (5) how to purchase it. This study aimed to assess BPJS barrier to strategic purchasing of primary care service at public and private health facilities in Subulussalam, Aceh. Subjects and Method: This was a qualitative study conducted in Subulussalam, Aceh, from February to July 2015. A total of 12 key informants for this study, including BPJS administrators, hospital managers. The theme was strategic purchasing of health service. The data were collected by in-depth interview, direct observation, and document review. The data was analyzed by thematic analysis. Results: BPJS administered the same standards of strategic purchasing health service from the public and private health providers. However, there were some unresolved problems: (1) BPJS faced difficulty to select primary care providers independently; (2) Illegal use of other member’s JKN card to get health service; (3) Redundant claims from the primary care providers; (4) Claim of inpatient days exceeding the maximum allowable limit; (5) Delay in non-capitations reimbursement payment to primary care provider; (6) Inequitable distribution of health manpower across health facilities. Conclusion: BPJS has implemented strategic purchasing of primary care services with the same standards applied to public and private primary care providers. However, there remain some problems of purchasing health services that call for immediate corrective actions, including routine monitoring, explanation of delay, advocacy, equitable distribution of health manpower. Keywords: strategic purchasing, primary care service, health facility, BPJS

A Qualitative Study on The Work Performance of Nutrition Technicians in Nutrition Control in Medan, North Sumatera

Background: Malnutrition continues to be a major public health problem throughout the developing world, particularly in southern Asia and sub-Saharan Africa. Malnutrition is the most important risk factor for the burden of disease in developing countries. It is the direct cause of about 300,000 deaths per year and is indirectly responsible for about half of all deaths in young children. Nutrition technicians play a key role in providing quality, cost-effective client care, and food service management. Nutrition technicians work to plan menus and prepare food for people with special nutritional needs. This study aimed to assess the work performance of nutrition technicians in nutrition control in Medan, North Sumatera. Subjects and Method: This was a qualitative study conducted in Medan, North Sumatera. A sample of nutrition technicians, health center doctors, municipality health office administrators, and mothers who had malnourished children, was selected for this study. The theme of study was work performance in nutritional control. The data were collected by in-depth interview, direct observation, and document review. Results: Work performance of nutrition technicians was still sub-optimal so that some of the nutrition recovery program target were not achieved. This problem arose due to various causes, including (1) limited number, low skill, low discipline, and low motivation of the nutrition technicians; (2) lack of monitoring and supervision by health center doctor and municipality health office administrator; (3) limited infrastructure and facilities. Conclusion: Work performance of nutrition technicians is still sub-optimal due to limited number and low motivation, lack of monitoring and supervision by health center doctor and municipality health office. Keywords: performance, nutrition technicians, nutrition contro

Factors Associated with Utilization of Hiv Counseling Service at Budi Kemuliaan Hospital, Batam, Riau

Background: Testing for Human Immunodeficiency Virus (HIV) is the gateway to treatment, care, and prevention. To scale up treatment and prevention, rapid increases in both the volume of testing and the ability to counsel those who are tested are needed. The use of testing globally, however, is very low. Most people living with HIV get testing and counseling only when they already have advanced clinical disease. This study aimed to examine the association between perceived risk of illness and the utilization of HIV counseling service at Budi Kemuliaan Hospital, Batam, Riau. Subjects and Method: This was a cross-sectional study conducted at Budi Kemuliaan Hospital, Batam, Riau. A sample of 76 patients with HIV was selected for this study. The dependent variable was utilization of HIV counseling service. The independent variables were perceived risk of illness and environment. Data on the use of HIV counseling service were taken from the medical record. The data were collected by questionnaire and analyzed by a multiple logistic regression. Results: Utilization of HIV counseling was associated with high perceived risk of illness (OR= 6.63; p= 0.001), after adjusting for the effect of environmental factor. Conclusion: Utilization of HIV counseling is associated with high perceived risk of illness, after adjusting for the effect of environmental factor. Keywords: human immunodeficiency virus, counseling, utilization, perceived risk, illness, environment

Inkulturasi Musik Gereja Di Batak Toba Dan Simalungun (Inculturation of Church Music in Batak Toba and Batak Simalungun)

Musik ibadat Gereja sangat besar peranannya untuk mendukung terciptanya suasanaperibadatan. Nyanyian musik ibadat Gereja menjadi bersuasana lebih khidmat, terutamamembantu umat dalam berdoa, karena dengan nyanyian, doa dapat diungkapkan secara lebihmendalam. Penelitian ini mengetengahkan analisis hasil Lokakarya Musik Liturgi sebagaiproses Inkulturasi Musik Gereja di Batak Toba dan Simalungun dalam suatu kajian pustakapada tahun 1986 sampai tahun 1995, dengan tujuan realisasi dinamis dari kepentingan musikLiturgi dan suatu perembesan hidup Katolik ke dalam unsur-unsur budaya musik Batak Tobadan Simalungun pada khususnya serta untuk memperkaya musik Gereja Katolik. Penyesuaianmusik Gereja terhadap unsur musik daerah Batak Toba dan Simalungun terlihat jelas padahasil Lokakarya Musik Liturgi tersebut. Musik Batak Toba pada umumnya bersifat kuat danmegah. Musik Batak Simalungun bersifat tenang, mengalir. Maka dua corak musik Batak inidapat memperkaya khasanah musik Gereja

Evaluasi Kebijakan Berobat Gratis di Kabupaten Tanjung Jabung Timur Propinsi Jambi

Background: In the decentralized era, local government haswider authority to decide policies relevant with local needs.For this reason the Regent of Tanjung Jabung Timur District in2005 issued a decree on free medication at the health centerand secondary health center. However there are problemswith the sources and allocation of budget to support the decree.Besides, there is also a problem with target of the programfunded by the government. Therefore there should be anevaluation to find out facts for future improvement.Objective: The study aimed to identify mechanisms of funding,relevance of target and efficiency of the policy.Method: This was an explanatory case study which usedquantitative and qualitative approaches. Analysis units of thestudy were local government, health center and secondaryhealth center; and the subject were members of localparliament, head of health office, head of local planning council,head of health centers, staff of health centers/secondary healthcenters and the community. The size of samples to measuretarget relevance was determined using stratified sampling;qualitative method was determined using purposive sampling.Data were obtained through questionnaire, in-depth interviewand document checklist. Data were analyzed qualitatively andquantitatively in proportion.Result: Local government of Tanjung Jabung Timur allocatedbudget in the form of operational fund of health centers, drugallocation and incentives. The realization of budget was delayedso that health centers used alternative financial resources,i.e. budget of health insurance for poor community. Operationalfund did not give much support for free medication when therewas no clear cut distinction between users of health insurancefor poor communities and free medication. This caused overlapin budgeting which might end in inefficiency. The authority didnot do monitoring and supervision appropriately. Users of freemedication were mostly non poor communities. Poorcommunities utilized free medication at secondary healthcenters more frequently than at health centers.Conclusion: The local government of Tanjung Jabung TimurDistrict had not implemented good health insurance principlesin health financing to support free medication policies. Therewas misallocation of funding because more non poorcommunities used the service. This increased the potential ofinefficiency in government budget utilization.Keywords: free medication policy, health financing, budgetefficienc