Initiation of Increasing Tuberculosis Medication Supervisors Roles: An Action Research Approach
https://doi.org/10.33860/jik.v18i2.2200
Keywords:
action research, health promotion, medication supervisor, tuberculosisAbstract
Indonesia is ranked second in the number of Tuberculosis (TB) cases worldwide. TB patients and their families experience a complex burden. Hence, support and strengthening TB medication supervisors (Pengawas Minum Obat/ PMO) role is needed. The aim of this study was to enhance the Community Health Center (CHC)-based PMOs’ role by improving their knowledge and strengthening peer group support. The method used was an action research cycle with four stages. The diagnosis stage was carried out by consensus decision making group with CHC to determine priority problems, namely the need to increase basic knowledge of TB and its treatment. Optimizing peer group was also necessary, as the Self Reporting Questionnaire-20 showed that more PMOs from patient families have psychological problems than cadres. The planning stage was conducted by preparing educational sessions and creating educational media. The action stage was a quasi-experimental (without control, non-randomization)—an educational talk show provided by the TB program manager, pulmonologist, and psychiatrist. Peer groups are also activated by triggering shared media education and discussion. At the evaluation stage, knowledge was measured by giving pre and post-tests (n= 21, total sampling). The results of the analysis using the Wilcoxon's Signed Ranks Test showed that participants' knowledge had increased significantly (p=0.000; r=0.59). In conclusion, education can increase PMO knowledge as an initial step to strengthen their role in supporting the success of TB treatment. Innovation, cross-sector assistance, and support are needed to enable the PMO to succeed in the TB program.
References
WHO. WHO: operational handbook on tuberculosis [Internet]. Module 5: Management of tuberculosis in children and adolescents. 2020. 264 p. Available from: https://apps.who.int/iris/bitstream/handle/10665/331525/9789240002906-eng.pdf
WHO. Global Tuberculosis Report [Internet]. WHO. 2022. Available from: https://www.who.int/publications/i/item/9789240061729
Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, et al. Global Tuberculosis Report 2020 – Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis [Internet]. 2021 Dec;113:S7–12. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1201971221001934
WHO. Global Tuberculosis Report 2020 [Internet]. WHO. Geneva; 2020. Available from: https://www.who.int/publications/i/item/9789240013131
Republic Indonesia Ministry of Health. The Republic of Indonesia Joint External Monitoring Mission for Tuberculosis [Internet]. Republic Indonesia Ministry of Health. 2020. p. 1–105. Available from: https://tbindonesia.or.id/wp-content/uploads/2021/06/INDONESIA-JEMM-2020-Eng-1.pdf
Oladimeji O, Othman Y, Oladimeji KE, Atiba BP, Adepoju VA, Odugbemi BA. Patterns of Presentation of Drug-Resistant Tuberculosis in Nigeria: A Retrospective File Review. Microbiol Res (Pavia) [Internet]. 2022 Aug 21;13(3):609–19. Available from: https://www.mdpi.com/2036-7481/13/3/43
Bykov I, Dyachenko O, Ratmanov P, Liu H, Liang L, Wu Q. Factors contributing to the high prevalence of multidrug-resistance/Rifampicin-resistance in patients with tuberculosis: an epidemiological cross sectional and qualitative study from Khabarovsk krai region of Russia. BMC Infect Dis [Internet]. 2022;22(1):1–13. Available from: https://doi.org/10.1186/s12879-022-07598-7
Seung KJ, Keshavjee S, Rich ML. Multidrug-Resistant Tuberculosis and Extensively Drug-Resistant Tuberculosis. Cold Spring Harb Perspect Med [Internet]. 2015 Sep;5(9):1–20. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561400/pdf/cshperspectmed-TUB-a017863.pdf
Kemenkes RI. Laporan Nasional Riset Kesehatan Dasar (RISKESDAS). Kementrian Kesehat RI [Internet]. 2018;1–582. Available from: https://repository.badankebijakan.kemkes.go.id/id/eprint/3514/1/Laporan Riskesdas 2018 Nasional.pdf
Kementerian Kesehatan RI. Data dan Informasi - Profil Kesehatan Indonesia (Data and Information - Indonesia Health Profil) [Internet]. 2018. Available from: http://www.pusdatin.kemkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/Data-dan-Informasi_Profil-Kesehatan-Indonesia-2017.pdf
Fandinata SS, Darmawan R. Hubungan Antara Peran Pengawas Menelan Obat (PMO) dengan Keberhasilan Pengobatan Tuberkulosis Paru Kategori I. J Syifa Sci Clin Res [Internet]. 2019 Sep 12;1(2):70–9. Available from: http://ejurnal.ung.ac.id/index.php/jsscr/article/view/2664
Arini M, Ahmad RA, Utarini A. Tuberculosis and type 2 Diabetes Mellitus (TB-DM) comorbidity care: Barriers from the patients’ perspective. Enferm Clin [Internet]. 2020;30(S6):174–8. Available from: https://doi.org/10.1016/j.enfcli.2020.06.040
Selasa P, Teli M, Merlin NM, Wawomeo A, Acob JRU. Tuberculosis Drugs Supervisor Roles Improved The Tb Recovery At The Community Health Center In Kupang City. Wind Heal J Kesehat [Internet]. 2022;5(3):697–704. Available from: http://jurnal.fkmumi.ac.id/index.php/woh/article/view/woh5310%0ATuberculosis
Richard O, Abiodun H, Queen O, Seyi O, Lucia O, Oluremilekun K, et al. Role of treatment supporters beyond monitoring daily drug intake for TB-patients: Findings from a qualitative study in Nigeria. J Public Heal Epidemiol [Internet]. 2017 Apr 30;9(4):65–73. Available from: http://academicjournals.org/journal/JPHE/article-abstract/FC73EBE63328
Pratama ANW, Aliong APR, Sufianti N, Rachmawati E. Hubungan antara Tingkat Pengetahuan Pasien dan Pengawas Menelan Obat (PMO) dengan Kepatuhan Pasien Tuberkulosis di Puskesmas Kabupaten Jember. e-Jurnal Pustaka Kesehat [Internet]. 2018 May 4;6(2):218–24. Available from: https://jurnal.unej.ac.id/index.php/JPK/article/view/7570
Montgomery A, Doulougeri K, Panagopoulou E. Implementing action research in hospital settings: a systematic review. J Heal Organ Manag. 2015;29(6):729–49.
Coghlan D, Brannick T. Doing Action in Your Own Organization. 2nd ed. London: SAGE Publications; 2005. 1–61 p.
Febriyanti F. Tingkat Pengetahuan Pasien Tuberkulosis Tentang Penyakit dan Pengobatan (Studi Kasus Pasien TB Di Puskesmas Pujon Tahun 2020). Universitas Islam Negeri Maulana Malik Ibrahim; 2020.
Prasetio CE, Triwahyuni A, Prathama AG. Psychometric Properties of Self-Report Questionnaire-20 (SRQ-20) Indonesian Version. J Psikol [Internet]. 2022 Apr 25;49(1):69–86. Available from: https://jurnal.ugm.ac.id/jpsi/article/view/69782
Republic Indonesia Ministry of Health. Strategi Nasional Penanggulangan Tuberkulosis di Indonesia 2020-2024 [Internet]. 2020. 1–219 p. Available from: https://tbindonesia.or.id/wp-content/uploads/2021/06/NSP-TB-2020-2024-Ind_Final_-BAHASA.pdf
Bennett M. A Review of the Literature on the Benefits and Drawbacks of Participatory Action Research. First Peoples Child Fam Rev [Internet]. 2019;14(1):109–22. Available from: https://fpcfr.com/index.php/FPCFR/article/view/375/307
Arini M, Hidayah FN, Prakoso DA. Pemberdayaan Pasien Kelompok Prolanis DM Melalui Edukasi Pencegahan Dan Deteksi Dini Komorbiditas Tuberculosis-Diabetes Melitus (TB-DM). J Pengabdi Kpd Masy [Internet]. 2021;27(4):339–45. Available from: https://jurnal.unimed.ac.id/2012/index.php/jpkm/article/view/23377
Arini M, Primastuti HI, Triatmaja R, Trisna EY. Pendampingan Promosi Media Sosial dan Kesehatan Kerja pada UMKM Kerajinan Rotan. Caradde J Pengabdi Kpd Masy. 2022;4(3):413–21.
Arini M, Primastuti HI. Inisiasi Pendirian Posyandu Lansia Jomboran, Sleman Melalui Pelatihan dan Pendampingan Kader Kesehatan. Poltekita J Pengabdi Masy [Internet]. 2023;4(1):140–51. Available from: https://jurnal.poltekkespalu.ac.id/index.php/PJPM/article/view/1461
CDC. Self-Study Modules on Tuberculosis : Managing Tuberculosis Patients and Improving Adherence. Centers Dis Control Prev [Internet]. 2014;6–9. Available from: https://www.cdc.gov/tb/education/ssmodules/pdfs/modules6-508.pdf
Gyimah FT, Dako-Gyeke P. Perspectives on TB patients’ care and support: a qualitative study conducted in Accra Metropolis, Ghana. Global Health [Internet]. 2019 Dec 5;15(1):19. Available from: https://globalizationandhealth.biomedcentral.com/articles/10.1186/s12992-019-0459-9
Kusheno FT, Nguse TM, Gebretekle GB. Assessment of Knowledge and Attitude of Tuberculosis Patients in Direct Observation Therapy Program towards Multidrug-Resistant Tuberculosis in Addis Ababa, Ethiopia: A Cross-Sectional Study. Tuberc Res Treat [Internet]. 2020 Jun 8;1–10. Available from: https://www.hindawi.com/journals/trt/2020/6475286/
Suprajitno S, Sunarno I, Ardiansah OA. Perception of Supervisor Taking Medicine about the Side Effect of Tuberculosis Medication for Patients. J Ners dan Kebidanan (Journal Ners Midwifery) [Internet]. 2018 Apr 1;5(1):58–61. Available from: http://jnk.phb.ac.id/index.php/jnk/article/view/258
De Fretes F, Mangma YE, Dese DC. Analisa Peran Pengawas Minum Obat (PMO) Dalam Mendampingi Pasien Tuberkulosis di Kota Kupang. J Keperawatan Muhammadiyah [Internet]. 2021 Sep 1;6(3). Available from: http://journal.um-surabaya.ac.id/index.php/JKM/article/view/9058
Barik AL, Purwaningtyas RA, Astuti D. The Effectiveness of Traditional Media (Leaflet and Poster) to Promote Health in a Community Setting in the Digital Era: A Systematic Review. J Ners. 2019;14(3):76.
Hou SI. Health Education: Theoretical Concepts, Effective Strategies and Core Competencies. Health Promot Pract. 2014;15(5):619–21.
Pueyo-Garrigues M, Pardavila-Belio MI, Canga-Armayor A, Esandi N, Alfaro-Díaz C, Canga-Armayor N. nurses’ knowledge, skills and personal attributes for providing competent health education practice, and its influencing factors: A cross-sectional study. Nurse Educ Pract [Internet]. 2022;58:103277. Available from: https://doi.org/10.1016/j.nepr.2021.103277
Mainga T, Gondwe M, Stewart RC, Mactaggart I, Shanaube K, Ayles H, et al. Conceptualization, detection, and management of psychological distress and mental health conditions among people with tuberculosis in Zambia: a qualitative study with stakeholders’ and TB health workers. Int J Ment Health Syst [Internet]. 2022;16(34):1–12. Available from: https://doi.org/10.1186/s13033-022-00542-x
Agbeko CK, Mallah MA, He B, Liu Q, Song H, Wang J. Mental Health Status and Its Impact on TB Treatment and Its Outcomes: A Scoping Literature Review. Front Public Heal [Internet]. 2022 May 31;10(May). Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2022.855515/full
Rachmawati DS, Priyantini D, Aini Q. Family Factors and Their Relation to the Treatment Adherence of Pulmonary TB Patients in Surabaya. J Ners [Internet]. 2020 Jul 7;15(2):45–9. Available from: http://localhost/demo3309/index.php/JNERS/article/view/18909
Agarwal N, Sarthi P. The necessity of psychological interventions to improve compliance with Tuberculosis treatment and reduce psychological distress. J Fam Med Prim Care [Internet]. 2017;6(2):169–70. Available from: http://www.jfmpc.com/article.asp?issn=2249-4863;year=2017;volume=6;issue=1;spage=169;epage=170;aulast=Faizi
Arfan I, Rizky A, Alkadri SR. Optimalisasi Kemampuan Kader TB dalam Pengendalian Tuberkulosis. Dharma Raflesia J Ilm Pengemb dan Penerapan IPTEKS [Internet]. 2020 Dec 27;18(2):209–17. Available from: https://ejournal.unib.ac.id/index.php/dharmaraflesia/article/view/13927
Bio RB, Akweongo P, Adomah-afari A. Economic Burden and Coping Mechanisms by Tuberculosis Treatment Supporters : A Mixed Method Approach from Bono Region , Ghana. Res Sq. 2023;1–24.
World Health Organization. Implementing the Stop Tb Strategy [Internet]. World Health Organization. 2008. 2008 p. Available from: http://www.who.int/tb/publications/2008/who_htm_tb_2008_401_eng.pdf
Davies PDO. The Role of DOTS in Tuberculosis Treatment and Control. Am J Respir Med [Internet]. 2003 Jun 20;2(3):203–9. Available from: http://link.springer.com/10.1007/BF03256649
Kelly MP, Barker M. Europe PMC Funders Group Why is changing health-related behaviour so difficult ? Public Health. 2016;136:109–16.
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with Poltekita : Jurnal Ilmu Kesehatan agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License (CC BY-SA 4.0) that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
This work is licensed under a Creative Commons Attribution-ShareAlike 2.0 Generic License.
Poltekita : Jurnal Ilmu Kesehatan is licensed under a Creative Commons Attribution-Share Alike 4.0 International License
You are free to:
- Share, copy and redistribute the material in any medium or format
- Adapt, remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
