You are on page 1of 9

Youngs analytical concordance analysis Treatment Behavior

Patients with TB of the lung in the City of Medan

Arlinda Sari Wahyuni1, Noni Novisari Soeroso2, Dian Dwi Wahyuni3


1Department of Community Health Science/Prevention/Community FK USU,
2Department of pulmonary disease and the respiration FK USU,
3Department of Microbiology FK USU

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

The World Health Organization officer TB at the clinic is still less a

(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

because TB respectively. Most (85%) the treatments in some Health Clinic. In

number of patients with TB are located in addition to the officers of the TB not

developing countries such as countries in continuous provide explanation on patients

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

China and South Africa. of Multy Drug Resistence (MDR) when

Handling of TB at the clinic has been medicines are not consumed regularly.

getting more attention from the The appropriate operative TB

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

special officer in providing services on and how treatment, is very dependent on

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

of the best treatment is the establishment concept of Youngs analytical concordance

of Youngs analytical concordance between TB treatment is still limited. Its

patients with doctors and officers TB implementation in the field especially in the

respectively. Youngs analytical concordance Clinic in Indonesia, also still limited. Another

is a form of a harmonious cooperation fact is that the quality of the interaction

between doctors and medical personnel between the doctor/officers patients

and patients in action treatment. The Youngs analytical concordance is not

agreement between the patient and doctor maximum, doctors tend to rush deal with

can be achieved after no communication chronic disease, especially TB, consultation

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

analytical concordance focused on the patients, doctors less cooperate and do

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

views with based on the principle concordance officers with characteristic,

of partnership (Cushing, and Metcalf, 2007, knowledge, attitudes and actions TB

NCCSDO, 2005, Benson, 2005). This patients to treatment.

condition will cause the behavior of

patients who are faster our commitment to

patients undergoing high treatment. The Method


The type of this study were Great sampel minimum is calculated

quantitative. Quantitative based on the formula of the hypothesis test

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

intended to explain the relationship of free percent for stage I (Sastoasmoro,

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

Medan. return the control treatment. Research

The population in this research is respondents this is TB patients who have

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

inclusion: patients TB lungs category I with validated namely questionnaire knowledge,

positive BTA, age18-60 years, willing to sign attitudes, action, interpersonal

the informed concern, while the criteria of communication officers based on the

exclusion include TB patients with early principle of Youngs analytical concordance.

onset chronic diseases such as cancer, This research Data analyzed using

HIV, Diabetes Mellitus (DM), or being the computer program. Analysis of the

treated with steroids. frequency distribution is used for


descriptive analysis, chi square test for Does not work 36 36
a. Work 64 64
The tribe of
bivariat analysis and logistic regression to A. Bataks 57 57
B. Central Java 29 29
C. Etc. 14 14
determine the relationship keeratan. The status of marriage
A. Marry 68 68
B. Not in marriage 32 32

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

konkordasi behavior by the officer TB shows concordance to service patients TB at the

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

TB respectively. There is of Youngs analytical concordance patients

a relationship between Youngs analytical RSUD Mataram. This research on Youngs

concordance of treatment with the attitude analytical concordance includes also

and actions of patients (p< 0.05), and there intersectoral

is no relationship with the knowledge of Effective communication and based on the

patients with TB (p>0.05). principles of partnership, openness, empathy

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

analytical concordance is consultations to behavior of patient. Besides Rugun dkk (2014)

share in a fair (a power- stated that there is a relationship between the

sharing consulting), open discussion at every behavior of the officers and PMO (Officers Eat

opportunity, information intake, discussion a Drugs) with compliance medication TB

fair and balanced and adequate time patients in the Clinic the City of Medan (P <

(Benson, 2005). Patients give confidence to 0.05). Youngs analytical concordance is

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

communication partnership, facilitating the cause adherensi or the compliance of patients

patients to participate with clear objectives is higher than in the behavior of Youngs

(Wahl, 2004). analytical concordance is less good. So the

This research on Youngs analytical patient has commitment, motivation and a

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

The results of research can be as the develop communication behavior partnership,

basis for the government to improve the open, positive, support and empathy.

quality of the service on the TB patients with A list of the Library

Benson, J. 2005. His Concordance an alternative term


developing the behavior of Youngs analytical to 'compliance' in the Australian Aborigines
Population. Australian Family Physician Vol. 34, No.
concordance of officials from TB at the clinic, 10.

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.

behavior of patient TB (Ministry of Health, The North Sumatra Provincial Health


Office. 2013 Health Profile of North Sumatra
Province 2012. Medan. The Health Service Provsu.
2011). 2013

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

analytical concordance, knowledge, attitudes The Ministry of Health Directorate General of


Disease Control and Environmental 2011b. The
and actions in good groups. There is a National Action Plan: Communication Advocacy and
Social Mobilization Tuberculosis Control Indonesia
2011-2014, Jakarta
relationship between Youngs analytical
The National Co-ordinating Center for NHS Service
concordance with the attitude and actions of Delivery and organization R & D NCCSDO. 2005. His
Concordance adherence and compliance in medicine-
patient TB respectively. But there is no taking.

Patriani, I., Ayuningtyas, D. 2013. Physician


relationship between Youngs analytical communication with the attitude of Youngs
analytical concordance in patients with lung
concordance with knowledge paisen TB tuberculosis, hypertension, asthma. National Public
Health Journal (8), 2:forever conscious.
against disease and treatment.
Perhimpunan Lungs Indonesia, 2011. Tuberculosis Development, Media Health R&D XVI, No.4 Year
Guidelines diagnosis and managements in 2006, Hlm. 15-21
Indonesia. Jakarta: Beautiful Offset Grafika Image .
Wahl.C, Gregoire.J.P, Teo.K,Beaulieu.M, Lebelle.S,
Basic Health Research (Riskesdas), 2013. The
Leduc.B et al, 2004. His concordance compliance and
research and development of the health of the
adherence in health care. Canada: closing gaps and
Ministry of Health OF THE REPUBLIC OF INDONESIA
improving outcomes.
2013
The World Health Organization (WHO), 2014. Global
Rugun, H.N.N., Amir, Z.A., Abidin, A. Secure, T. N,
Tuberculosis Control Report 2014. Geneva,
Wahyuni, U.S., 2014, factors related to the
Switzerland: World Health Organization (WHO).
conversion failure patients TB Lungs Category I at
the end of the intensive phase of treatment in the
City of Medan, Medical magazine of the Archipelago.

Sastroasmoro, S. & Ishmael, S., 2012. The


basics of clinical research method. Jakarta.
Sagung Seto.

Umar, F. 2005, Infuenced for tuberculosis lungs are


compromised, Media Health Research and