The Background. Treatment of Tuberculosis (TB) in the longer term often problematic behavior
of treatment as the patient was not obedient and negligent in treatment. Disobedience
Medication Anti TB is a serious problem because it can cause germs become resistant,
relapse, and also increase the morbidity and mortality. One of the important aspects in the
management of TB is the improvement of the behavior of treatment TB respectively. behavior
of Youngs analytical concordance TB treatment is a form of a harmonious cooperation between
doctors, officers and patients with TB in action treatment. The agreement between patients
and doctors and officers can be achieved after no communication with a sense of respect (trust)
and wisdom between patients to doctors and officers and done with the principles of
the partnership.
The purpose of. This research aims to analyze the behavior of TB treatment based on the
concept of Youngs analytical concordance officers to patients with TB in the City of Medan.
The method. Types of research are analytically with cross sectional design. The population is
all patients TB, 18-60 years, TB Category I with the result of the BTA (+), and the days of
treatment in the Clinic the City of Medan. The sample numbered 100 patients. Interview done
on patients with using the instrument of communication officer with patients who are based on
the principle of Youngs analytical concordance, knowledge, attitudes and actions of treatment
that has been validated. statistical analysis with chi square and logistic regression.
The results. The results of the study showed 54% officers TB do communication principles
Youngs analytical concordance, 59% knowledge patients is good, 53% good attitude and 55%
good action. There is a relationship between the behavior of Youngs analytical concordance TB
officers with the attitude and actions of patient (p< 0.05). But there is no relationship between
Youngs analytical concordance with the knowledge (p > 0.05).
The conclusion. The model of the behavior of treatment based on Youngs analytical
concordance is expected to enhance the current TB program which refers to the DOTS program
(Directly Observed Treatment Shortcourse chemotherapy induced).
Key Word: Youngs analytical concordance, treatment, patients TB, the City of Medan
Introduction researchers examine is the role of the
(Global Reports, 2014), stated that in 2013 maximum. Many patients with TB in the
insidensi TB disease around the world as clinic does not get maximum explanation of
much as 9 million and 1.5 million died officials from TB about diseases and
number of patients with TB are located in addition to the officers of the TB not
Asia and Africa, and around 75 percent with TB, especially in patients who have
patients TB is the most productive age entered the next phase of treatment.
groups namely 15-50 years. Indonesia is Patients tend to take only drugs without
currently located in the sequence of the reminded to obey in the continuation phase
four most patients with TB, after India, of treatment. This impact on the possibility
Handling of TB at the clinic has been medicines are not consumed regularly.
government some time lately. This time in (appropriate treatment) that is according to
each Clinic in Indonesia especially in the their cures and right (adequate treatment)
clinic in the City of Medan, have had a which is exactly the dose and the duration
patients with TB (North Sumatra Provincial the behavior of managements that done by
Health Office, 2013). Yet another fact that TB patients as well as the doctor or the
officers who took care of him. The behavior So far the study about how the
patients with doctors and officers TB implementation in the field especially in the
respectively. Youngs analytical concordance Clinic in Indonesia, also still limited. Another
agreement between the patient and doctor maximum, doctors tend to rush deal with
with a sense of respect (trust) and wisdom is inadequate, and the role of the doctor or
between the patient to a doctor. Youngs the officers more dominant compared to
consultation where the doctor or staff and not understand the problems patients
patients agree to make decisions against (Patriani, 2013). This research aims to
the process of treatment and combine each analyze the behavior of Youngs analytical
research with research survey explanatory for a population croseksional design with an
type using the cross sectional design that is alpha value of 5 percent and betha 20
variables with the variables bound. This 2010). The number of sample is 100 people.
research done in some clinic in the City of This research on the number of samples
Medan. The research is run has approval acquired is 104 patients. The number of
from the Commission of ethics of Health analyzed is 100 people because 4 of the
Research FK USU/RSUP H Adam Malik data is not complete died and did not
that the patients TB lungs category I (new) undergone intensive phase of treatment.
patients age > 18 years. The sample is the On the respondents conducted an interview
population that meet the criteria of with structured questionnaire that has been
the informed concern, while the criteria of communication officers based on the
onset chronic diseases such as cancer, This research Data analyzed using
HIV, Diabetes Mellitus (DM), or being the computer program. Analysis of the
The results
The results of the study showed
Research was done starting
the majority of respondents are male (69%),
March sd August 2016 in 7 Health Clinic the
and old age < 40 years (45%). Based on the
City of Medan: Puskesmas Belawan,
background of education, known that 53%
Abrasives, example, Helvetia, Johor, the
of respondents had high category
moon, and prosperity.
education (High School and University). In
The characteristics of respondents
general the respondents have revenues
consists of: gender, age, education, income,
between < 2 million, namely as much as
the work of the tribe and the status of
83%. Respondents have the status of the
marriage.
work of the work of 64%. Most of the tribes
Table 1 The Distribution of the characteristics of
patients with TB of the lung in the City of is the Bataks (57%) and the status of the
Medan
The The marriage is housekeeping 68%.
Karakteritik number percentage of
of
Gender Research Results Youngs analytical
The Male 69 69
Women 31 31
Age
concordance and officers of patients based
Young (< 40 years) 45 45
Medium (40-59) 42 42 on the knowledge, attitudes and actions of
Elders (> 60 years) 13 13
Education
Low (SD, SMP) 47 47 treatment seen in the following table:
High (SMA, D-III, S1) 53 53
The income
Less ( < 2 million) 83 83
Enough ( 2 million)) 17 17
The Work
Table 2 Youngs analytical concordance Konkordansi-Tindakan -1.997 1,220 0.004 3.386 Bands of
analysis and officers based on patients .41 1.484-7
treatment behavior
Logistic regression
Youngs analytical
concordance P- Logistic regression analysis results show
Good Less Good value*
N % N %
Knowledge
Youngs analytical concordance related 2.4
Good 32 59.3 19 41.3
0.954
Less 22 40.7 27 58.7 times with the attitude of patient and 3.4
The Total 54 100 46 100
The Attitude
Good 34 63 19 41.3 times with the actions of patient
0.031
Less 20 37 27 58.7
The Total 54 46 100
The actions
Good 37 68.5 18 39.1 The discussion
0.003
Less 17 31.5 28 60.9
The Total 54 100 46 100 The results of the study showed 54%
Chi Square
The results of the study showed most good has been there is a good Youngs analytical
the attitude (63%) and the actions of a good clinic the City of Medan. Different with the
treatment (68.5%) is good in patients with research Patriani (2013) who get 35.1 percent
Table 3. Keeratan analysis results the relationship and support between the officers to patients
between Youngs analytical
concordance with the attitude and Actions with TB respectively. It can lead to a sense of
Consta 95%
Variable B P-value PR trust so that patients will say honest about
nsta CI PR
Konkordansi-Sikap -1.413 0.882 0.032 2.416 1.078-5.408 what he feels and willing to cooperate with
the officers of the TB in tackling the disease. that there is a relationship between Youngs
The conditions that must be met in a Youngs analytical concordance with the attitudes and
sharing consulting), open discussion at every behavior of the officers and PMO (Officers Eat
fair and balanced and adequate time patients in the Clinic the City of Medan (P <
health problems health officials, officers maintained good will improve the behavior of
raised Youngs analytical concordance with treatment 3.4 times toward the good. This will
patients to participate with clear objectives is higher than in the behavior of Youngs
concordance is good related to the attitudes sense of responsibility toward the disease and
and actions of patients with TB in undergoing treatment of the disease. This is actually
treatment, but not related to the knowledge needed in tackling the treatment of chronic
of the patient. Most (51%) knowledge level of diseases such as TB respectively. They must be
the patient is good, it because the patients aware and responsible for the disease. A
have to get information from various sources sense of responsibility and a high level of
and not only from the officers only. This is in commitment as well as this will prevent the
line with the research Patriani (2013) stating surrounding environment from contracting TB
disease and at the same time prevented from There is a need to increase the skills
the disease that MDR treatment difficult and of the officers TB in better communication
requires a very long time (2 years). based on Youngs analytical concordance with
basis for the government to improve the open, positive, support and empathy.
because the officer TB as a leading line that The Ministry of Health of the Republic of Indonesia,
2007. National guidelines Tackling
Tuberculosis. Mold 8 Jakarta: Ministry of Health OF
has an important influence in managing the THE REPUBLIC OF INDONESIA.
The conclusion and Suggestions The Ministry of Health Of The Republic Of Indonesia,
2011. The Directorate General of Disease Control
Most of the behavior of Youngs and Environmental. The National Strategy for TB
control in Indonesia 2010-2014. Jakarta