Pengaruh Patient Decision Aid terhadap Knowledge, Attitude, Practice, dan Tekanan Darah Pasien Hipertensi di UPTD Puskesmas Tabanan III

Abstract

Prevalensi pasien hipertensi semakin meningkat dan salah satu penyebab utamanya adalah faktor perilaku. Perubahan perilaku dan outcome terapi hipertensi dapat dilakukan oleh apoteker melalui edukasi dengan metode knowledge, attitude, practice (KAP). Teori perilaku yang sesuai untuk mengukur perubahan perilaku dalam diri pasien adalah health belief model (HBM). Sarana edukasi yaitu patient decision aid (PDA) berupa booklet digunakan untuk mengedukasi pasien hipertensi. Tujuan penelitian ini adalah mengetahui perbedaan KAP dan tekanan darah pasien hipertensi sebelum dan sesudah mendapatkan intervensi PDA. Metode penelitian pre-experimental one group pretest-posttest melibatkan 55 pasien hipertensi berusia 18–65 tahun peserta Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan yang berobat di UPTD Puskesmas Tabanan III, Bali, Indonesia, pada bulan Agustus–Oktober 2017. Setiap pasien memperoleh satu kali edukasi melalui PDA berupa booklet disertai komunikasi interaktif kemudian KAP diukur melalui kuesioner KAP yang tervalidasi dan diukur tekanan darah pre-post. Kuesioner KAP dibuat berdasarkan konstruk HBM. Diperoleh hasil yaitu perbedaan practice pasien hipertensi (p<0,05) pada perceived susceptibility, perceived severity, perceived barrier, cues to action; terdapat perbedaan attitude dan practice (p<0,05) pada self-efficacy; terdapat perbedaan KAP (p<0,05) dari segi perceived benefit serta terdapat perbedaan tekanan darah sistolik dan diastolik pasien (p<0,05). Disimpulkan bahwa terdapat perbedaan knowledge, attitude, practice dan tekanan darah pasien hipertensi di Puskesmas pre-post studi.

Kata kunci: Booklet, HBM, hipertensi, KAP, PDA, tekanan darah

Influence of Patient Decision Aid to Knowledge, Attitude, Practice and Blood Pressure of Hypertensive Patient in a Primary Health Care Tabanan III

Abstract
The prevalence of hypertensive patients is increasing and one of the main causes is behavior factor. Appropriate method of behavioral theory for measuring behavioral changes in patients is health belief model (HBM). Patient decision aid (PDA) in a form of booklet was used to educate hypertensive patient. The aim of this research was to know the difference of knowledge, attitude, practice (KAP) and blood pressure of hypertensive patient before and after getting PDA intervention. The method used was pre-experimental one group pretest-posttest study involving 55 hypertensive patients aged 18–65 years which were participants of The Indonesian National Health Insurance in primary health care Tabanan III, Bali, Indonesia, in the period of August–October 2017. Each subject received PDA education from booklet with interactive communication, then their KAP was measured through validated KAP questionnaire as well as pre-post blood pressure. KAP questionaire was made based on HBM’s construct. There were differences in practice of hypertensive patients (p<0.05) on HBM domain in perceived susceptibility, perceived severity, perceived barrier, and cues to action; there was a difference of attitude and practice (p<0.05) in self-efficacy; difference of KAP (p<0.05) in perceived benefit; and difference of systolic and diastolic blood pressure. It was concluded that there were differences of KAP and blood pressure of hypertensive patients in primary health care pre-post study.

Keywords: Booklet, blood pressure, HBM, hypertension, KAP, PDA