GAMBARAN PENGETAHUAN TUGAS PENGAWAS MINUM OBAT

PENDERITA TB PARU DI UPTD KESEHATAN SE KOTA BLITAR

KARYA TULIS ILMIAH

DIMAS SURYA BAGASKORO

NIM 0901300052

PROGRAM STUDI DIPLOMA III KEPERAWATAN BLITAR

POLITEKNIK KESEHATAN KEMENTERIAN KESEHATAN MALANG
2012
PERNYATAAN KEASLIAN TULISAN

Saya yang bertanda tangan dibawah ini:

Nama

: Dimas Surya Bagaskoro

NIM

: 0901300052

Program Studi

: Keperawatan Blitar Jurusan Keperawatan Politeknik Kesehatan

Kemenkes Malang

Menyatakan dengan sebenarnya bahwa Karya Tulis Ilmiah yang saya tulis ini
benar-benar merupakan hasil karya saya sendiri, bukan merupakan pengambilan
tulisan atau pikiran orang lain yang saya akui sebagai tulisan hasil tulisan atau
pikiran saya sendiri.
Apabila dikemudian hari terbukti atau dapat dibuktikan karya tulis ilmiah ini
hasil jiplakan, maka saya bersedia menerima sangsi atas perbuatan tersebut.

Blitar, 4 Agustus 2012

Yang membuat pernyataan,

Dimas Surya Bagaskoro

NIM. 0901300052

Mengetahui,
Pembimbing Utama

Pembimbing Pendamping

Sri Winarni, S.Pd, M.Kes

NIP. 19641016 198603 2 002

M. Jaelani, S.Kep. Ns
NIP. 19690112 199003 1 005

LEMBAR PERSETUJUAN

Karya Tulis Ilmiah ini telah disetujui oleh pembimbing penyusunan Karya
Tulis Ilmiah Prodi DIII Keperawatan Blitar Politeknik Kesehatan Kementerian
Kesehatan Malang pada 4 Agustus 2012.

Mengetahui,

Pembimbing Utama

Pembimbing Pendamping

Sri Winarni, S.Pd, M.Kes

NIP. 19641016 198603 2 002

M. Jaelani, S.Kep. Ns
NIP. 19690112 199003 1 005

LEMBAR PENGESAHAN

Karya Tulis Ilmiah yang berjudul Gambaran Pengetahuan Tugas Pengawas

Minum Obat Penderita TB Paru di UPTD Kesehatan se Kota Blitar
Oleh Dimas Surya Bagaskoro NIM. 0901300052
Telah dipertahankan di depan dewan penguji pada 4 Agustus 2012.

Dewan Penguji
Ketua

Sri Winarni, SPd, M.Kes

NIP. 19641016 198603 2 002
Anggota I

Anggota II

Wahyu Tri Lukiono, SKM, M. Kes

NIP. 19610222 198410 1 002

M. Jaelani, S.Kep. Ns
NIP. 19690112 199003 1 005

Mengesahkan,
Ketua Jurusan Keperawatan
Politeknik Kesehatan Kemenkes Malang

Tri Anjaswarni, S.Kp, M.Kep

NIP. 19670519 199103 2 001

ABSTRAK
Bagaskoro, Dimas Surya. 2012. Gambaran pengetahuan tugas pengawas minum
obat penderita TB Paru di UPTD Kesehatan Kota Blitar. Karya Tulis Ilmiah,
Program Studi DIII Keperawatan Blitar, Jurusan Keperawatan, politeknik
Kesehatan Kemenkes Malang. Pembimbing utama Sri Winarni, S.Pd, M.Kes,
pembimbing pendamping M. Jaelani, S.Kep. Ns
Tuberculosis (TB) paru adalah penyakit infeksi yang disebabkan oleh
Microbakterium Tuberculosis dengan gejala yang sangat bervariasi. Program
penanggulangan secara terpadu baru dilakukan pada tahun 1995 melalui strategi
DOTS, adapun tujuan dari DOTS adalah Menurunkan angka kesakitan dan angka
kematian TB, memutuskan rantai penularan, serta mencegah terjadinya MDR TB.
Tujuan dari penelitian ini adalah untuk mengidentifikasi gambaran pengetahuan
tugas pengawas minum obat penderita TB Paru di UPTD Kesehatan se Kota
Blitar. Metode penelitian diskriptif dengan instrumen penelitian berupa kuisioner.
Populasi pengawas minum obat di wilayah UPTD Kesehatan se Kota Blitar
sejumlah 54 responden dengan menggunakan total sampling. Waktu pengumpulan
data dilaksanakan selama 2 minggu. Hasil penelitian, diperoleh data Tingkat
pengetahuan pengawas minum obat penderita TB Paru di wilayah UPTD
Kesehatan Kecamatan se-Kota Blitar sebesar 62,96% (34 responden) memiliki
pengetahuan baik dan 27,77% (15 responden) memiliki pengetahuan cukup baik.
Adanya variasi pengetahuan responden diduga dapat dipengaruhi oleh beberapa
hal yaitu umur, pendidikan, dan pekerjaan responden. Rekomendasi dari
penelitian ini adalah kepada petugas di Poli Paru UPTD Kesehatan se Kota Blitar,
bagi pengawas minum obat penderita TB Paru diharapkan mendapatkan pelatihan
khusus tentang tugas pengawas minum obat penderita TB paru guna
meningkatkan kesembuhan penderita TB Paru di Kota Blitar.
Kata Kunci

: Pengetahuan, TB Paru, Pengawas minum obat.

ABSTRACT
Bagaskoro, Dimas Surya. 2012. Preview knowledge watchdog task medication in
patients with pulmonary Tubercoluse in Public Health Facility Blitar. Scientific
Writing, Program DIII Blitar Nursing, Department of Nursing, Health polytechnic
of Malang Health Ministry. Primary preceptor Sri Winarni, S.Pd, Kes, supervising
companion M. Jaelani, S. Kep. Ns
Tuberculosis (TB) is a lung disease caused by infection with Tuberculosis
Microbacterium symptoms vary greatly. New integrated control programs
conducted in 1995 through the DOTS strategy, as for the purpose of DOTS is
Reduce morbidity and mortality of Tubercoluse, break the chain of transmission
and prevent the occurrence of MDR Tubercoluse. The purpose of this study was to
identify the picture of knowledge watchdog task medication in patients with
pulmonary Tubercoluse Public Health Facility in Blitar. Descriptive research
methods to the research instruments such as questionnaires. Population
supervisors take medication in the Public Health Facility Blitar a number of 54
respondents using total sampling. When data collection conducted for 2 weeks.
The results of the study, the data obtained knowledge level supervisors Pulmonary
Tubercoluse medication in the Health District as Public Health Facility Blitar of
62.96% (34 respondents) have a good knowledge and 27.77% (15 respondents)
had a pretty good knowledge. Knowledge of the respondents believed the
variation can be influenced by several things: age, education, and occupation of
respondents. Recommendations from this study was the clerk at the Poly Lung
Public Health Facility in Blitar, the superintendent of pulmonary Tubercoluse
patients taking medicine is expected to get special training on supervisory duties
pulmonary Tubercoluse patients taking medicine to enhance recovery of
pulmonary Tubercoluse patients in the city of Blitar.
Keywords: Knowledge, Pulmonary Tubercoluse, Supervisory medication.

KATA PENGANTAR

Puji syukur Alhamdulillah penulis panjatkan kehadirat Allah SWT karena atas
berkah rahmat-Nya, penulis dapat menyelesaikan Karya Tulis Ilmiah dengan judul
Gambaran Pengetahuan Tugas Pengawas Minum Obat Penderita TB Paru di
UPTD Kesehatan se Kota Blitar ini dengan baik.
Dalam menyelesaikan Karya Tulis Ilmiah ini, penulis banyak mendapatkan
bantuan dari berbagai pihak. Oleh karena itu penulis mengucapkan banyak terima
kasih kepada :
1. B. Doddy Riyadi, SKM., MM., selaku Direktur Politeknik Kesehatan
Kementerian Kesehatan Malang.
2. Tri Anjaswarni, S.Kp., M.Kep selaku Ketua Jurusan Keperawatan Politeknik
Kesehatan Kementerian Kesehatan Malang.
3. Sri Winarni, S.Pd., M.Kes selaku Ketua Program Studi Diploma III
Keperawatan Blitar Politeknik Kesehatan Kementerian Kesehatan Malang
serta pembimbing utama yang telah banyak memberi bimbingan dan arahan
dalam penyusunan Proposal Karya Tulis Ilmiah ini.
4. Wahyu Tri Lukiono, SKM, M. Kes selaku ketua penguji Karya Tulis Ilmiah
ini yang telah memberikan bimbingan dan sarannya untuk kesempurnaan
Karya Tulis Ilmiah ini.
5. M. Jaelani, S.Kep. Ns selaku pembimbing pendamping yang telah memberi
bimbingan dan sarannya untuk kesempurnaan penyusunan Karya Tulis
Ilmiah.
6. Bapak dan ibu yang telah memberikan dukungan baik materiil maupun
spiritual.
7. Semua pihak yang telah memberikan bantuan dan dukungan dalam
menyelesaikan penelitian
Penulis menyadari bahwa Karya Tulis Ilmiah ini masih jauh dari sempurna.
Oleh karena itu kritik dan saran sangat penlis harapkan demi kesempurnaan
Proposal Karya Tulis Ilmiah ini. Semoga Proposal Karya Tulis Ilmiah ini akan
bermanfaat bagi semua pihak.
Blitar, Agustus 2012
Penulis

DAFTAR ISI
Halaman
LEMBAR HALAMAN JUDUL ......................................................................
PERNYATAAN KEASLIAN TULISAN.........................................................
LEMBAR PERSETUJUAN ............................................................................
LEMBAR PENGESAHAN .............................................................................
ABSTRAK .......................................................................................................
ABSTRACT.....................................................................................................
KATA PENGANTAR ......................................................................................
DAFTAR ISI ....................................................................................................
DAFTAR TABEL ............................................................................................
DAFTAR GAMBAR .......................................................................................
DAFTAR LAMPIRAN ....................................................................................
BAB 1

BAB 2

2.2

2.3

PENDAHULUAN
1.1 Latar Belakang............................................................................
1.2 Rumusan Masalah.......................................................................
1.3 Tujuan Penelitian ........................................................................
1.4 Manfaat Penelitian ......................................................................
1.4.1 Bagi peneliti....................................................................
1.4.2 Bagi Institusi Pendidikan keperawatan...........................
1.4.3 Bagi Institusi Pelayanan kesehatan.................................
1.4.4 Bagi Peneliti lain.............................................................
1.4.5 Bagi Masyarakat..............................................................

i
ii
iii
iv
v
vi
vii
viii
ix
x
xi
1
3
3
3
3
3
3
3
4

TINJAUAN PUSTAKA
2.1 Konsep Pengetahuan....................................................................
5
2.1.1.......................................................................................Peng
ertian pengetahuan...........................................................
5
2.1.2.......................................................................................Tingk
at Pengetahuan.................................................................
5
2.1.3.......................................................................................Fakto
r-faktor yang mempengaruhi pengetahuan......................
6
2.1.4.......................................................................................Prose
s penerimaan pengetahuan...............................................
8
2.1.5.......................................................................................Penil
aian Pengetahuan.............................................................
8
TB Paru.......................................................................................
9
2.2.1 Pengertian TB Paru..........................................................
9
2.2.2 Proses Penularan..............................................................
9
2.2.3 Patofisiologi TB paru....................................................... 10
2.2.4 Gambaran Klinik............................................................. 11
2.2.5 Klasifikasi secara umum.................................................. 12
2.2.6 Terapi............................................................................... 13
2.2.7 Efek Samping OAT.......................................................... 14
Konsep DOTS............................................................................. 16

2.4

2.5
2.6

2.7

2.8

2.9

2.10
BAB 3

2.3.1 Pengertian DOTS............................................................. 16

2.3.2 Komponen DOTS............................................................ 16
2.3.3 Pengembangan DOTS..................................................... 17
Penanggulangan TB di Indonesia................................................ 17
2.4.1 Pendahuluan..................................................................... 17
2.4.2 Visi dan Misi.................................................................... 18
2.4.3 Tujuan Dan Target............................................................ 19
2.4.4 Kebijakan ........................................................................ 19
Kerangka kerja strategi penanggulanagn TB.............................. 20
2.5.1 Pendahuluan..................................................................... 20
2.5.2 Kegiatan .......................................................................... 22
Organisasi pelaksanaan............................................................... 22
2.6.1 Tingkat pusat.................................................................... 22
2.6.2 Tingkat Provinsi............................................................... 22
2.6.3 Tingkat Kabupaten........................................................... 22
2.6.4 Tingkat Unit pelayanan Kesehatan.................................. 22
Tata laksana Pasien Tuberkolusis................................................ 23
2.7.1 Pendahuluan..................................................................... 23
2.7.2 Penemuan Pasien TB....................................................... 23
2.7.3 Gejala Klinis Pasien TB................................................... 24
2.7.4 Pemeriksaan Dahak Mikroskopis.................................... 24
2.7.5 Diagnosis TB................................................................... 25
2.7.6 Klasifikasi Penyakit dan Tipe Pasien............................... 26
Pengobatan TB............................................................................ 29
2.8.1 Tujuan Pengobatan........................................................... 29
2.8.2 Prinsip Pengobatan.......................................................... 29
2.8.3 Paduan OAT yang digunakan Di Indonesia..................... 30
2.8.4 Tata Laksana TB pada Anak............................................ 34
Konsep PMO............................................................................... 36
2.9.1 Pengertian........................................................................ 36
2.9.2 Persyaratan PMO............................................................. 36
2.9.3 Siapa yang bias menjadi PMO......................................... 36
2.9.4 Tugas PMO...................................................................... 37
2.9.5 Informasi penting yang perlu diketahui PMO................. 38
Kerangka Konsep........................................................................ 39
METODE PENELITIAN
3.1 Desain Penelitian.........................................................................
3.2 Kerangka Kerja ..........................................................................
3.3 Populasi, Sampel dan Sampling..................................................
3.3.1 Populasi...........................................................................
3.3.2 Sampel.............................................................................
3.3.3 Sampling..........................................................................
3.4 Tempat dan Waktu pengumpulan data.........................................
3.4.1 Tempat.............................................................................
3.4.2 Waktu...............................................................................
3.5 Definisi Operasinal dan Variabel Penelitian................................

40
40
41
41
41
41
42
42
42
42

BAB 4

3.5.1 Definisi Operasional........................................................

3.5.2 Variabel Penelitian...........................................................
3.6 Pengumpulan Data danAnalisa Data...........................................
3.6.1 Instrumen Pengumpulan Data.........................................
3.6.2 Teknik Pengumpulan Data..............................................
3.7 Teknik Pengolahan Data dan Analisa Data.................................
3.7.1 Teknik Pengolahan Data..................................................
3.7.2 Analisa Data....................................................................
3.8 Etika Penelitian...........................................................................
3.8.1 Informed Consent ..............................................................
3.8.2 Anonimity...........................................................................
3.8.3 Confidentiality ...................................................................
3.9 Keterbatasan...............................................................................

42
42
44
44
44
45
45
45
46
46
46
46
47

HASIL PENELITIAN DAN PEMBAHASAN

4.1 Hasil penelitian............................................................................
4.1.1 Gambaran tempat Peneltian ............................................
4.2 Hasil Penelitian ...........................................................................
4.2.1 Data Umum ........................................................................
4.2.2 Data Khusus........................................................................
4.3 Pembahasan .................................................................................
4.4 Keterbatasan.................................................................................

48
48
49
49
52
54
57

KESIMPULAN DAN SARAN

5.1 Kesimpulan .................................................................................
5.2 Saran ...........................................................................................
5.2.1 Kepada Peneliti Lain .........................................................
5.1.2 Bagi Institusi Pnedidikan Keperawatan ............................
5.2.3 Bagi Institusi Pelayanan Kesehatan ..................................
5.2.4 Bagi Masyarakat ................................................................

58
58
58
58
58
59

BAB 5

DAFTAR PUSTAKA

............................................60
DAFTAR TABEL
Halaman

Tabel 2.1

Obat TB Paru
..........................................................................................................
..........................................................................................................
13

Tabel 2.2

Efek Samping Berat dari OAT

..........................................................................................................
..........................................................................................................
15

Tabel 2.3

Efek Samping Ringan dari OAT

10

..........................................................................................................
..........................................................................................................
15
Tabel 2.4

Jenis OAT
..........................................................................................................
..........................................................................................................
29

Tabel 2.5

Dosis untuk panduan OAT KDT untuk kategori 1

..........................................................................................................
..........................................................................................................
31

Tabel 2.6

Dosis paduan OAT-Kombipak untuk Kategori 1

..........................................................................................................
..........................................................................................................
32

Table 2.7

Dosis untuk paduan OAT KDT Kategori 2

..........................................................................................................
..........................................................................................................
32

Tabel 2.8

Dosis paduan OAT Kombipak untuk Kategori 2

..........................................................................................................
..........................................................................................................
32

Tabel 2.9

Dosis KDT untuk Sisipan Berat Badan Tahap Intensif tiap hari
selama 28 hari
..........................................................................................................
..........................................................................................................
33

Tabel 2.10 Dosis OAT Kombipak untuk Sisipan

..........................................................................................................
..........................................................................................................
33
Tabel 2.11 Sistem skoring (scoring system) gejala dan pemeriksaan
penunjang TB
..........................................................................................................
..........................................................................................................
34
Tabel 3.1 Definisi operasional
..........................................................................................................
..........................................................................................................
43
Tabel 4.1

Frekuensi Tingkat Pengetahuan

11

..........................................................................................................
..........................................................................................................
53
Tabel 4.2

Frekuensi tingkat pengetahuan masing masing UPTD

..........................................................................................................
..........................................................................................................
53

12

DAFTAR GAMBAR
Halaman
Gambar 2.1 Kerangka
Konseptual
.....................................................................................................
.....................................................................................................
39
Gambar 3.1 Kerangka
Kerja
.....................................................................................................
.....................................................................................................
40
Gambar 4.1 Diagram
Pendidikan
.....................................................................................................
.....................................................................................................
49
Gambar 4.2 Diagram
umur
.....................................................................................................
.....................................................................................................
50
Gambar 4.3 Diagram
pekerjaan
.....................................................................................................
.....................................................................................................
50
Gambar 4.4 Diagram ada tidaknya anggota keluarga yang menderita TB
Paru
.....................................................................................................
.....................................................................................................
51
Gambar 4.5 Diagram
Anggota
keluarga
.....................................................................................................
.....................................................................................................
51
Gambar 4.6 Diagram pernah atau tidaknya mendapat pelatihan atau
penyuluhan singkat tentang tugas PMO TB Paru
.....................................................................................................
.....................................................................................................
52

13

14

DAFTAR LAMPIRAN

Halaman
Lampiran 1 Lembar
persetujuan
responden
.....................................................................................................
.....................................................................................................
61
Lampiran 2 Kisikisi
kuesioner
.....................................................................................................
.....................................................................................................
62
Lampiran 3 Lembar
kuesioner
.....................................................................................................
.....................................................................................................
63
Lampiran 4 Tabulasi
Data
Umum
.....................................................................................................
.....................................................................................................
67
Lampiran 5 Tabulasi
Data
Khusus
.....................................................................................................
.....................................................................................................
69
Lampiran 6 Crosstab
and
frequency
.....................................................................................................
.....................................................................................................
72
Lampiran 7 Surat
ijin
penelitian
.....................................................................................................
.....................................................................................................
75
Lampiran 8 Jadwal
kegiatan
penelitian
.....................................................................................................
.....................................................................................................
79

15

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