•  
  •  
 

Abstract

Pengobatan penyakit kronik tidak hanya membutuhkan ketersediaan obat dan petugas kesehatan yaitu dokter, tetapi juga tiga faktor yakni kepatuhan (compliance), aderensi (adherency), dan konkordansi ( concordance). Ketiga faktor tersebut sangat penting dalam upaya penanganan penyakit kro-nik, termasuk tuberkulosis (TB) paru, hipertensi, dan asma. Untuk mewujudkan sikap konkordansi, dibutuhkan komunikasi efektif antara dokter dan pasien. Komunikasi yang terjalin efektif akan meningkatkan pemahaman dan motivasi dalam diri pasien untuk mengikuti nasihat dari dokter. Adapun penelitian ini dilatarbelakangi oleh tingginya angka penderita dan angka kegagalan berobat ( drop out) pasien tuberkulosis paru, hipertensi, asma di Rumah Sakit Umum Daerah Kota Mataram. Penelitian ini bertujuan untuk melihat hubungan komunikasi dokter dan karakteristik pasien dengan sikap konkordansi pasien. Penelitian dengan desain studi potong lintang ini dilakukan terhadap 174 pasien TB paru, hipertensi, dan asma sebagai responden. Hasil penelitian ini menunjukkan bahwa pendidikan, pengeluaran, dan komunikasi merupakan variabel yang berhubungan dengan sikap konkordansi pada pasien TB paru, hipertensi, dan asma. Rekomedasi tindak lanjut dari penelitian ini adalah peningkatan fasilitas ruangan untuk meningkatkan kenyamanan komunikasi pasien dan dokter, penyelenggaraan program pengembangan kemampuan komunikasi dokter, dan survei berkala untuk menilai proses komunikasi dokter-pasien. The therapy of chronic diseases is not only needed drugs supply and health staff, that is physician, but also three factors such as compliance, adherence, and concordance. The three of factors are crucial in the handling of chronic diseases like lung tuberculosis, hypertension, and asthma. To accomplish a concordance attitude is needed an effective communication between physician and patient. The effective communication may increase the understanding and motivation of patients to comply the physician’s advice. The research is based on the high prevalence rate and drop out rate of the patients of lung tuberculosis, hypertension, and asthma at Mataram City General Hospital. This research is proposed to show the association of the effectiveness of physician communication and characteristics of patients to the concordance attitude of patients. Cross sectional design was employed in this study with 174 patients of lung tuberculosis, hypertension, and asthma as respondents. The results of this study indicate that education, expenditures, and communication are variables related to concordance in TB, hypertension and asthma patients. It is recommended to maintain room facilities so that patient and doctor feel comfortable to communicate and to conduct a doctor communication skill development program as well as a regular survey of patient-doctor communication process.

References

1. Benson J. Concordance, an alternative term to ‘compliance’ in the Aboriginal population. Australian Family Physician. 2005; 34(10): 831-4. 2. Cangara H. Pengantar ilmu komunikasi. Jakarta: Rajawali Pers; 2006. 3. Cushing A, Metcalf R. Optimizing medicines management: from compliance to concordance. International Journal of Therapeutics and Clinical Risk Management. 2007; 3(6):1047-58. 4. Tisnado DM, Adams JL, Liu HH, Damberg CL, Hu FA, Chen WP, et al. Does the concordance between medical records and patient self-report vary with patient characteristics? International Journal Health Services Outcomes Research Methodology. 2006; 6(3-4): 157-75. 5. Eng E and Blanchard L. Action-oriented community diagnosis: a health education tool. International Quarterly of Community Health Education. 2006/2007; 26(2): 141-58 6. Notoatmodjo, Soekidjo. Ilmu kesehatan masyarakat: prinsip-prinsip dasar. Jakarta: Rineka Cipta; 2009. 7. Liliweri A. Dasar-dasar komunikasi kesehatan. Cetakan ke-3 Yogyakarta: Pustaka Pelajar Offset; 2009. 8. Fieldstein. Health care economic. 7th ed. California: Delmar Publisher Inc; 2006. 9. Metcalfe R. Compliance, adherence, concordance – what’s in a name?. Practical Neurology. 2005; 5: 192–3. 10. Peterson, Andrew M. Development of a methodology to use the national ambulatory medical care survey and the medical expenditure panel survet concurrently: The Case of Initial Medication Compliance [disertasi]. Philadelphia: Partial Fulfillment of the Requirements of the Degree of Doctor of Philosophy; 2009. 11. Prayoga GLPR. Faktor-faktor yang memengaruhi pilihan pasien rawat jalan RS Risa Medica Mataram terhadap pemilihan tempat bersalin [tesis]. Depok: Fakultas Kesehatan Masyarakat Universitas Indonesia; 2012. 12. Thistlethwaite JE, Raynor DK, Knapp P. Medical students’attitudes toward concordance in medicine taking: exploring the impact of an educational intervention. Education for Health. 2003; 16 (3): 307-17.

Share

COinS