Studi Kasus Ketidakpatuhan Orang Kontak Serumah terhadap Anjuran Pemeriksaan Tuberkulosis

Abstract

Ketidakpatuhan orang kontak serumah terhadap anjuran pemeriksaan Tuberkulosis (TB) merupakan fenomena
kompleks, dinamis dari faktor yang berkaitan dengan perilaku. Penelitian ini bertujuan untuk menggali perilaku
ketidakpatuhan orang kontak serumah terhadap anjuran pemeriksaan TB dengan menggunakan Health Belief
Model(HBM). Penelitian ini adalah studi kasus yang dilakukan di Kelurahan Pajajaran Kota Bandung. Subjek
penelitian adalah sembilan orang kontak serumah dan enam orang perawat Puskesmas Pasirkaliki. Pengumpulan
data dilakukan dengan studi dokumentasi, observasi pasif tidak berstruktur, wawancara mendalam, dan diskusi
kelompok terarah. Data dianalisis dengan menggunakan model Miles dan Huberman, yaitu reduksi data, penyajian
data, dan penarikan kesimpulan. Hasil penelitian meliputi persepsi kerentanan, persepsi keseriusan, persepsi
manfaat pemeriksaan orang kontak serumah, dan isyarat untuk melakukan tindakan berdasarkan HBM. Persepsi
orang kontak serumah tentang kerentanan TB meliputi adanya perasaan takut tertular, melakukan pemisahan, dan
menerima takdir. Persepsi orang kontak serumah mengenai keseriusan penyakit TB yaitu kematian, perasaan
malu atau minder. Persepsi orang kontak serumah tentang manfaat skrining yaitu akan diketahui apakah orang
kontak serumah terkena TB atau tidak. Isyarat untuk melakukan tindakan pemeriksaan TB menurut orang
kontak serumah yaitu apabila mereka sudah sakit atau muncul gejala-gejala TB. Hasil penelitian dari perawat
menunjukkan bahwa perawat mengetahui bahwa salah satu standar program penanggulangan TB (P2TB) adalah
pemeriksaan TB pada orang kontak serumah penderita TB paru terutama yang basil tahan asam (BTA) positif
dan anak dengan TB. Pemeriksaan TB tersebut dilakukan dengan pemeriksaan dahak sewaktu-pagi-sewaktu
(SPS). Persepsi perawat mengenai hambatan dalam menjalankan peran dan fungsinya yaitu adanya keterbatasan
jumlah tenaga di puskesmas, pendidikan perawat masih rendah, dan perawat mendapat tugas limpahan di klinik.

Kata kunci:Ketidakpatuhan, kontak serumah, pemeriksaan TB, studi kualitatif.

 

Abstract
Non-adherence of household contacts to undergo screening for Tuberculosis (TB) is a dynamic and complex
phenomenon of the various factors related to behaviour. The objective of this study was to explore the behaviours
related to non-adherence of household contacts to undergo screening for TB. This study is a descriptive case
study that was conducted at the Pajajaran village, Bandung city. Participant were 9 household contacts of smear
positive TB patients and 6 nurses who is working in the Pasirkaliki Community Health Center (CHC). Data
collection was performed with the study documentation, non-structured passive observation, in-depth interview,
and focus group discussion (FGD). Data analysis was according to Miles and Huberman model, which consist
of data reduction, data display and drawing conclusions. The result includes perception of vulnerability of TB,
perceptions of seriousness of TB, perceptions of benefits of TB screening, and cues to action for the TB patients
household contact. The result showed that perceptions of the household contact of TB vulnerability were: fear
of infection, make the separation and accept fate. Perceptions of the seriousness of TB were that TB could cause
death and feelings of shame or inferiority. As for the perception of benefits was by doing screening,it will be known
whether household contacts are exposed to TB or not. While the cues to action for household contact to perform
screening for TB was if they are sick or have emerging symptoms of TB. The nurses knew that according to P2TB
(TB management program) standards, the household contacts of TB patients should undergo screening for TB,
especially for smear-positive pulmonary TB patients and paediatric TB. They knew that TB screening was done
through sputum smear microscopy. Nurses’ perceptions about the barriers in carrying out their role and function were
limited number of human resources in CHC, lack of education, and the presence of abundance tasks at the clinic.
.
Key words:Household contact, non-adherence, qualitative study, TB screening.