HUBUNGAN KUALITAS PELAYANAN ADMINISTRASI TERHADAP KEPUASAN MASYARAKAT DI PUSKESMAS WIYUNG KOTA SURABAYA

ABSTRAKSI HUBUNGAN KUALITAS PELAYANAN TERHADAP KEPUASAN MASYARAKAT DI PUSKESMAS WIYUNG KOTA SURABAYA. Penelitian ini dilatar belakangi adanya fenomena jam operasional uskesmas tidak sesuai dengan aturan yang ada dan juga fasilitas mobil ambulans ang digunakan tidak semestinya sehingga masyarakat merasa kurang puas erhadap pelayanan yang diberikan. Tujuan penelitian adalah untuk mengetahui Hubungan Kualitas Pelayanan Terhadap Kepuasan Masyarakat di Puskesmas Wiyung Kota Surabaya. Metode ang digunakan dalam penelitian ini adalah Deskriptif kuantitatif yang memiliki ua variabel yaitu Kualitas pelayanan dan Kepuasan masyarakat. Untuk mencapai kepuasan masyarakat dibutuhkan tolok ukur kualitas elayanan menggunakan 5 dimensi menurut zeithml dkk(1990) yaitu dimensi angibel,reliability,reponsiviness,assurance,empathy. Dalam penelitian ini yang menjadi responden adalah para pasien di Puskesmas Wiyung Kota Surabaya ebanyak 99 responden, pengumpulan data menggunakan kuisioner. Teknik engambilan sampel dalam penelitian ini menggunakan teknik Simple Random ampling. teknik analisi yang digunakan dalam penelitian ini menggunakan teknik Analisis Korelasi Spearman. Hasil dari penelitian ini menunjukan bahwa adanya Hubungan Kualitas elayanan terhadap Kepuasan Masyarakat di Puskesmas Wiyung Kota Surabaya dalah sebesar 4,849 % yang berarti variabel Kualitas Pelayanan mempunyai ubungan terhadap variabel Kepuasan Masyarakat di Puskesmas Wiyung Kota urabaya adalah sebesar 4,849 % sedangkan sisanya sebesar 95,151 % ipengaruhi oleh variabel lain diluar model penelitian ini Berdasarkan Uji ipotesis statistik yang menyatakan nilai thitung (2,22) > ttabel (1,6605) berarti danya hubungan yang signifikan atau nyata antara Kualitas Pelayanan dengan Kepuasan Masyarakat Dengan kesimpulan Indikator dengan skor tertinggi variabel Kualitas elayanan yaitu wujud fisik (tangible) jawaban C (baik) , skor 3 dengan 72 esponden, tentang respon petugas kepada pasien rawat jalan di Puskesmas Wiyung Kota Surabaya. Indikator dengan skor terendah variabel Kualitas elayanan yaitu wujud fisik (tangible) jawaban B (cukup baik) skor 2 dengan 53 rang responden. Pada kenyamanan ruang di Puskesmas Wiyung Kota Surabaya. ndikator dengan skor tertinggi variable Kepuasan Masyarakat yaitu respon / anggapan (responsiviness) jawaban C (puas), skor 3 dengan 56 orang responden, ada kepuasan terhadap kecepatan petugas dalam menangani pasien rawat jalan. ndikator dengan skor terendah variabel Kepuasan Masyarakat yaitu pada epuasan terhadap ketanggapan (responsiviness) jawaban B (cukup puas) skor 2 engan 54 responden yaitu pada kepuasan terhadap ketetapan petugas dalam menangani pasien rawat jalan. Kata Kunci : Kualitas Pelayanan, Kepuasan Masyaraka

MONITORING OF ANTITHROMBOTICS’ADVERSE EFFECT ON UNSTABLE ANGINA PECTORIS PATIENTS IN A PUBLIC HOSPITAL OF YOGYAKARTA, INDONESIA

Patients with unstable angina pectoris are at risk of death or recurrent ischemic events, despite receiving aspirin and heparin. The benefit from using aspirin in high‐risk vascular disease patients comes at the cost of increased gastrointestinal complications. The complications include gastroduodenum ulcerations, dyspepsia, esophagitis and ulcerations in the stomach and duodenum. This research investigated the monitoring of antithrombotics adverse effect in a public hospital of Yogyakarta during January 2006‐December 2007. This research used patients’medical records as patients’database in adverse drug effect monitoring. The populations were all unstable angina inpatients in a public hospital of Yogyakarta January 2006 to December 2007. We identified that the adverse effects’ monitoring has been done well. The monitoring has been done to the gastrointestinal distrubance (100%), bleeding risk (30%), thrombocytopenia (35%) and renal dysfunction (20%). There were 35% patients experienced antithrombotics’adverse effects, such as bleeding, thrombocytopenia and renal dysfunction. Clinical manifestation of dual antithrombotic therapy was experienced by 10% patients

Polymorphisms of organic cation transporter 1 and the drugs response

Polymorphisms of proteins which have an important role in drug transport, metabolism, and disposition in the bodycould affect the drugs efficacy and toxicity. The organic cation transporter 1 (OCT1), encoded by SLC22A1 gene,has been known as one of the polyspecific protein transporters which could affect some of the cationic drugresponse such as metformin, levodopa and imatinib. However, the findings of many studies an association of OCT1polymorphisms and drug response both in Caucasian and Asian were still inconsistent. Moreover, this study’s topicin Asians was still uncommon. This review was aimed to explore the polymorphisms of OCT 1 in Asians and Caucasiansand to find the challenges of the next studies in Asians. The articles about OCT1 polymorphisms were searched inthe PubMed with the keywords; OCT1 or SLC22A1, polymorphisms. There were ten articles of OCT1 polymorphismswhich are related to the drug response and most of the studies were performed in Caucasian subjects. In Caucasians,the rs622342 variant might associated with the response of metformin and levodopa. Moreover, the R61C and420del variants still showed the inconsistent findings associated with metformin response. The non-synonymousvariants which were found in Caucasians were not found in Asian. However, the new non-synonymous variantswere found in Japanese, Chinese, Indian and Korean population and some of them were associated with the metforminresponse. The recent findings found in Caucasians cancer patients, were related to the association of non-synonymousvariants haplotype and the 5-Hydroxytriptamine Receptor Antagonists drug response. The inconsistent results ofOCT1 polymorphisms studies could be related to the study’s sample size and design of the studies. Further studieswhich exploring the association of OCT1 polymorphisms and drug pharmacokinetic profiles and/or drug response,which were adjusted by genetic variants of proteins involved in drug tansport, metabolism and disposition are stillneeded in both Caucasians and Asians. Additional large studies also considering non-genetic risk factors are warranted,to implement the results of the various studies into clinical practice.Key words: OCT1- polymorphisms – Asians – Caucasians - drug respons

Assesment of Antibiotic Utilization on Pediatric Patients with Upper Respiratory Tract Infection at Public Health Centers, Gunung Kidul Period of January-June 2000

Abstract The study about the use of antibiotics on paediatric patients with upper respiratory tract infections (URTI) has been carried out at Public Health Centres (PHC), Gunung Kidul during January - June 2007. This research was aimed to know the use of antibiotics on paediatric patients and the antibiotics rationality, which held in Public Health Centres Gunung Kidul Yogyakarta. The study was a descriptive study with retrospective data collecting. We used all outpatient prescriptions of paediatric (2-12 years old) patients who diagnosed as URTI. The antibitotics rationality was analyzed based on the analysis of right indication, type of drug, patient, and dosage. We found 1008 persicription in paediatrics with URTI at four Public Health Centres at the rural area of Gunung Kidul. Amoxycillin was the most prescribed antibiotic in the URTI (mean = 41.8%). Common cold was the most URTI experienced by paediatric patients. The average of rationality among four PHC was 30.3%. The. used of antibiotics in children with URTI in Gunung Kidul was high, but the rationality of the antibiotics used is still need to be evaluated, principally with the right indication of antibiotic Key word : Antibiotic, Paediatric, Upper Respiratory Tract Infection, Public Health Centre

SAFETY EVALUATION OF STATIN IN YOGYAKARTA, INDONESIA

Background : The 3-hydroxy-3-methylglutaryl-coenzyme (HMG-Co-A) reductase inhibitors, also known as statins, are the most effective class of drugs for lowering serum Low-Density Lipoprotein cholesterol (LDL-c)concentrations. They are first-line agents for patients who require drug therapy to reduce serum LDL-c concentrations. Although these drugs have been very successful in managing the cardiovascular health of many patients, there are also potential adverse effects that have been identified. The most common adverse effects reported include muscle pain or weakness that can progress to rhabdomyolysis and mortality. If detected early, statin-related symptoms are reversible after withdrawal of the statin. Objective : This research was aimed to know the safety of statin used at Public Hospitals in Yogyakarta. Method : This research was observational study with retrospective data collected. The target population are all of diabetes mellitus, cardiovascular and stroke patients that recorded on the medical record of Public Hospitals in Yogyakarta during 2 months. Results : There were 28 patients who used simvastatin and 8 patients who used atorvastatin, experienced adverse effects of statins (n=157). Headache was the most adverse effect which was experienced by the patients. However rhabdomyolysis was not found in this reasearh. Interaction between simvastatin and nifedipine resulted more adverse effects such as headache, insomnia and abdominal pain than with other drugs. Conclusions : Simvastatin, rosuvastatin and atorvastatin were well tolerated use in Yogyakarta, Indonesia. Only 22.9% from 157 patients experienced the adverse effects of statin. Adverse effects because of the interaction between simvastatin and other drugs were experienced by 8.92% patients. The result of this study need to be confirmed with additional study with larger sample sizes and vigilant surveillance to abolish the toxicity of the statin

IDENTIFIKASI RESIDU PESTISIDA ORGANOFOSFAT PADA BAWANG MERAH DI KABUPATEN KULON PROGO

Di Indonesia pestisida organofosfat banyak digunakan pada tanaman buah dan sayuran seperti bawang merah. Pestisida organofosfat mengalami translokasi ke seluruh bagian tanaman sehingga residu pestisida organofosfat dapat tertinggal di umbi bawang merah yang dikonsumsi oleh masyarakat. Di Kabupaten Kulon Progo Provinsi DIY, pestisida organofosfat banyak digunakan terutama oleh petani bawang merah. Metode penelitian menggunakan rancangan observasional dan experimental. Sampel bawang merah diambil dari 10 petani yang tersebar di Kabupaten Kulonprogo. Kuisioner dibagikan kepada petani mengenai jenis pestisida yang digunakan dan waktu diaplikasikan oleh petani serta frekuensi penggunaan pestisida. Penentuan kadar organofosfat dilakukan dengan melakukan proses ekstraksi bawang merah dengan aseton, diklorometan, dan petroleum benzena kemudian dianalisis menggunakan kromatografi gas. Pestisida organofosfat yang diuji residunya adalah diazinon, parathion, ethion, profenofos, malation, dan klorpirifos. Hasil dari kuisioner kepada petani bawang merah, pestisida organofosfat yang digunakan adalah pestisida dengan bahan aktif profenofos dan klorpirifos dengan rata-rata penggunaan 0,5% (v/v) sekali penyemprotan. Hasil analisis residu pestisida organofosfat menunjukkan bahwa sampel bawang merah dari 1 petani mengandung diazinon dengan kadar rata-rata 1,97 ppb. Residu pestisida pada bawang merah dari 9 petani menunjukkan hasil tidak terdeteksi untuk pestisida diazinon, parathion, ethion, profenofos, malation dan klorpirifos. Batas deteksi  (LOD) untuk metode analisis pestisida organofosfat yang digunakan adalah diazinon 3,7 ppb, parathion 6,4 ppb, ethion 4,3 ppb, profenofos 4,8 ppb, malathion 1,24 ppb, dan klorpirifos 0,83 ppb

POTENSI PERAN FARMASIS DALAM MENINGKATKAN KUALITAS HIDUP PASIEN LANJUT USIA: PERSPEKTIF RAWAT RUMAH

The Home Health Care program is getting popular as well. One of the outcomemeasured in this program is patient’s quality of life. Home Health Care program is amultidisciplin program, which need the pharmacist role. The aim of this study was tofind out the potencial pharmacist role in increasing elderly patients’quality of lifeparticipated in Home Health Care program. This study used descriptive design withprospective data sampling. (World Health Organization Quality of Life) We usedWHOQoL as the instrument. The study period was conducted for 13 week in 2009 byvisiting the patients at their homes. The patients were participated in Home HealthCare program of Dr Sardjito hospital, Yogyakarta. Data was descriptively analized.We're recruited seven subjects in this study. In average, their quality of life was low(46,1±4,4). All of the patients received polypharmacy and were found the patientsincompliance in taking the medicines. The role of pharmacist were important in HomeHealth Care program for elderly patients to increase their quality of life. Thepharmacists are supposed to do the drug used monitoring, especially to the elderlypatients with polypharmacy. The advance technique for communication, information,and education is suggested to the pharmacist in this program

PERAN GURU PAIBP DALAM PEMBERIAN BIMBINGAN DAN KONSELING DI SDN BABAKAN SUKAMULYA KABUPATEN BANDUNG

Guidance and counseling are very important in providing the basics of religion and character for elementary school students. The aim of the study was to determine the role of Islamic religious education and morals (IREM) teachers in providing Guidance and Counseling. This study uses a descriptive qualitative approach, and data collection through interviews, observation and document study. The results of the study show that the role of IREM teachers is in providing guidance and counseling to students through personal, social, career and learning guidance. Personal guidance through habituation in attitude and speech, advice and giving exemplary examples. Social guidance, namely providing an understanding of how to communicate and interact with the social environment and school regulations. Career guidance, namely providing stimulus and introduction to advanced levels of education. Learning guidance, namely providing motivation and special services for students who experience problems in learning.  Keywords: Role of IREM Teachers, Counseling Guidance, Elementary School

HUBUNGAN PERSEPSI TENTANG PENYAKIT DENGAN KUALITAS HIDUP PADA PASIEN DIABETES MELITUS TIPE 2 DENGAN KOMPLIKASI DI RSUD ABDUL WAHAB SJAHRANIE SAMARINDA

Diabetes mellitus tipe 2 (DMT2) terjadi karena adanya resistensi insulin dan gangguan sekresi insulin. Insidensi DMT2 mencapai 90-95% dari penyakit diabetes mellitus secara  umum. Adanya komplikasi yang menyertai DMT2 dapat membahayakan jiwa dan menurunkan kualitas hidup. Persepsi pasien tentang penyakit juga dapat berkontribusi terhadap kualitas hidup pasien. Oleh karena itu, penilaian terhadap persepsi dengan kualitas hidup pasien DMT2 dengan komplikasi sangat penting karena kualitas hidup yang menurun akibat persepsi tentang penyakit yang buruk dapat memperparah penyakit dan menyebabkan kematian. Untuk mengetahui hubungan persepsi pasien dengan kualitas hidup DMT2 dengan komplikasi yang dinilai dengan menggunakan kuesioner Short Form 36 (SF-36) dan Brief Illness Perceptions Questionnaire (B-IPQ). Penelitian ini menggunakan rancangan penelitian observasional analitik dengan pendekatan cross sectional, pengambilan data secara prospektif pada pasien DMT2 dengan komplikasi di RSUD Abdul Wahab Sjahranie Samarinda. Instrumen yang digunakan dalam penelitian adalah kuesioner SF-36 dan kuesioner persepsi B-IPQ. Pada penelitian ini dilakukan uji validasi pada kuesioner Sf-36. Analisis data  dilakukan secara deskriptif dan menggunakan uji regresi linear multivariat. Hasil penelitian menunjukkan bahwa domain konsekuensi, durasi, identitas dan respon emosi pada kuesioner persepsi B-IPQ berpengaruh terhadap kualitas hidup pasien DMT2. Hasil tersebut didasarkan pada analisis regresi linear dengan metode stepwise yang menunjukkan bahwa terdapat hubungan signifikan antara domain persepsi tentang penyakit (B-IPQ) dengan domain kualitas hidup (SF-36) yaitu domain fungsi fisik (p = 0,014), keterbatasan peranan emosi (p = 0,002), keterbatasan peranan emosi (p = 0,003),  fatigue (p = 0,000), kesehatan mental (p = 0,000), fungsi sosial (p = 0,002), nyeri (p = 0,008) dan kesehatan umum (p = 0,000). Ada hubungan bermakna antara persepsi tentang penyakit dengan kualitas hidup pada pasien DMT2 dengan komplikasi. Penelitian ini dapat menjadi dasar kepada seluruh tenaga kesehatan agar dapat meningkatkan kualitas pelayanan kesehatan, intervensi klinis serta pemahaman pasien terkait penyakit DMT2 dengan komplikasi sehingga dapat meningkatkan kualitas hidup pasien.