Faktor-Faktor yang Mempengaruhi Kinerja Bidan Puskesmas dalam Pengelolaan Dini Hipertensi pada Kehamilan di Kabupaten Jember Tahun 2014

Abstract

Universitas Diponegoro Fakultas Kesehatan masyarakat Program Magister Ilmu Kesehatan masyarakat Konsentrasi Kesehatan Ibu dan Anak 2015 ABSTRAK Juvinda Wahyu Puspadini Faktor-Faktor yang Mempengaruhi Kinerja Bidan Puskesmas dalam Pengelolaan Dini Hipertensi pada Kehamilan di Kabupaten Jember Tahun 2014 xii + 149 Halaman + 29 tabel + 3 Gambar + 6 Lampiran Preeklampsia adalah penyebab utama kematian ibu di Kabupaten Jember (41,9%; 58,3%; 39%) dalam tiga tahun terakhir. Preeklampsia dapat ditangani dengan segera bila bidan dapat mengenali dan menemukan secara dini hipertensi pada kehamilan. Tujuan penelitian ini adalah untuk mengalisis faktor-faktor yang mempengaruhi kinerja bidan puskesmas dalam pengelolaan dini hipertensi pada kehamilan di Kabupaten Jember. Jenis penelitian ini adalah survey analitik dengan design cross sectional. Terdiri dari Variabel bebas (pengetahuan, pengalaman, beban kerja, ketersediaan alat dan sikap bidan) dan variabel terikat (kinerja bidan puskesmas). Jumlah sampel 64 bidan puskesmas yang berada di 10 Puskesmas dengan angka Kejadiaan hipertensi/preeklampsia yang tinggi. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner terstruktur yang telah diuji validitas dan reliabilitas. Analisis bivariat dengan uji chi-square dan analisis multivariat dengan uji regresi logistik. Hasil penelitian ini menunjukkan bahwa sebagian besar responden memiliki kinerja kurang (59,4%), pengetahuan kurang (60,9%), pengalaman kerja kurang (65,6%), beban kerja berat ( 56,3%), ketersediaan alat kurang (53,1%), dan sikap bidan kurang (42,2%) dalam pengelolaan dini hipertensi pada kehamilan. Ada hubungan positif antara pengetahuan (p=0,0001), pengalaman (p=0,0001), sikap bidan (p=0,001) dan ada hubungan negatif beban kerja (p=0,0001) sedangkan ketersediaan alat tidak ada hubungan (p=0,503) dengan kinerja bidan puskesmas dalam pengelolaan dini hipertensi pada kehamilan. Ada pengaruh bersama-sama variabel pengetahuan (Exp B= 8,052; p=0,006) dan pengalaman kerja (Exp B= 7,377; p=0,010) terhadap kinerja bidan puskesmas dalam pengelolaan dini hipertensi kehamilan di Kabupaten Jember. Disarankan kepada Dinas kesehatan beserta pihak puskesmas dan IBI untuk mengadakan pelatihan dan workshop kepada bidan puskesmas mengenai penulisan diagnosa, pendokumentasian, pengkajian masalah dan pemecahan masalah, penanganan rujukan dalam pengelolaan dini hipertensi kehamilan. Kata kunci : Kinerja, Bidan Puskesmas, Pengelolaan, Hipertensi kehamilan Referensi : 48 (1982-2013) Diponegoro University Faculty of Public Health Master’s Program in Public Health Majoring in Maternal and Child Health 2015 ABSTRACT Juvinda Wahyu Puspadini Factors Influencing Work Performance of Health Centre Midwife in Conducting Early Management of Hypertension in Pregnancy in District of Jember in 2014 xii + 149 pages + 29 tables + 3 figures + 6 enclosures Preeclampsia (PE) was the main cause of maternal mortality in District of Jember in the past three years (41.9%; 58.3%; and 39% respectively). PE can be handled immediately if a midwife can recognise and diagnose hypertension in pregnancy as quick as possible. The aim of this study was to analyse factors influencing work performance of health centre midwife in conducting early management of hypertension in pregnancy in District of Jember. This was an analytical survey using cross-sectional approach. Independent variables consisted of knowledge, experience, workload, availability of equipment, and midwife’s attitude. On the other hand, work performance of health centre midwife was as a dependent variable. Number of samples were 64 midwives working at 10 health centres with high cases of hypertension/PE. Data were collected by interviewing using a structured questionnaire which had been tested for validity and reliability. Furthermore, data were analysed using bivariate analysis (chi-square test) and multivariate analysis (Logistic Regression test). The results of this study showed that most of the respondents had low work performance (59.4%), low knowledge (60.9%), lack of work experience (65.6%), heavy workload (56.3%), lack of equipment (53.1%), dan negative midwife’s attitude (42.2%) in conducting early management of hypertension in pregnancy. Variables of knowledge (p=0.0001), work experience (p=0.0001), midwife’s attitude (p=0.001) significantly positively related to the work performance. Meanwhile, the variable of workload significantly negatively related to the work performance (p=0.0001). In contrast, the variable of availability of equipment was not statistically significant (p=0.503). Variables of knowledge (Exp B= 8.052; p=0.006) and work experience (Exp B= 7.377; p=0.010) jointly influenced the work performance of health centre midwife in conducting early management of hypertension in pregnancy in District of Jember. District Health Office, Health Centres, and Indonesian Midwives Association need to conduct training and workshop to midwives working at health centres regarding writing a diagnosis, documenting, analysing and solving a problem, and handling referred patients in early management of hypertension in pregnancy. Key Words : Work Performance, Health Centre Midwife, Management, Hypertension in Pregnancy Bibliography : 48 (1982-2013)