Pengetahuan Kader Kesehatan tentang Terapi Pencegahan Tuberkulosis Berdasarkan Model Rasch

Abstract

The implementation of tuberculosis preventive therapy began in 2016 by the Ministry of Health of the Republic of Indonesia. However, until now, research related to health cadres' knowledge of tuberculosis preventive therapy is still limited. The purpose of this study was to describe the level of knowledge of health cadres regarding the implementation of tuberculosis preventive therapy and analyze each item using the Rasch model. This study is a descriptive quantitative study and was conducted in April 2023. The subjects of the study were 74 community health workers at the Binong Health Center, Tangerang Regency, who were selected using a purposive sampling technique. Knowledge was measured by filling out a questionnaire from WHO and the Indonesian Ministry of Health. Data were analyzed using descriptive research based on Rasch with Winstep. The Rasch model was used to analyze validity and reliability (items and respondents) and to evaluate the level of difficulty of the questions. The results showed that the knowledge of health cadres regarding the implementation of tuberculosis preventive therapy was in the high category (98.6%). Health cadres still havd a high level of response errors regarding the implementation of tuberculosis preventive therapy in children (85.1%), tuberculosis transmission media (20.3%), and side effects of Rifampicin (13.5%). The Rasch model showed that the person reliability was 0.00 (very poor), the item reliability was 0.93 (very good), and there were 2 items that meet the three criteria (Outfit mean square, outfit Z-standard, and Point measure correlation). This study concluded that although the correct response description mostly gives good results, when the Rasch modeling analysis is applied, the person's reliability results are poor. This study has the lowest person reliability and person separation indicating that there are not enough cadres to distinguish between those with higher and lower abilities.

Keywords: Rasch analysis; health cadres; knowledge, tuberculosis prevention therapy

ABSTRAK

Implementasi terapi pencegahan tuberkulosis dimulai pada tahun 2016 oleh Kementerian Kesehatan Republik Indonesia. Namun hingga kini penelitian terkait pengetahuan kader kesehatan tentang terapi pencegahan tuberkulosis masih terbatas. Tujuan penelitian ini adalah mendeskripsikan tingkat pengetahuan kader kesehatan mengenai pelaksanaan terapi pencegahan tuberkulosis dan menganalisis setiap item dengan model Rasch. Penelitian ini merupakan studi kuantitatif deskriptif dan dilakukan pada bulan April 2023. Subyek penelitian adalah 74 petugas kesehatan masyarakat di Puskesmas Binong, Kabupaten Tangerang, yang dipilih dengan teknik purposive sampling. Pengetahuan diukur melalui pengisian kuesioner dari WHO dan Kemenkes RI. Data dianalisis Penelitian secara deskriptif berbasis Rasch dengan Winstep. Model Rasch digunakan untuk menganalisis validitas dan reliabilitas (item dan responden) serta mengevaluasi tingkat kesulitan soal. Hasil penelitian menunjukkan bahwa pengetahuan kader tentang pelaksanaan terapi pencegahan tuberkulosis berada pada kategori tinggi (98,6%). Kader kesehatan masih mempunyai tingkat kesalahan respon yang tinggi mengenai penerapan terapi pencegahan tuberkulosis pada anak (85,1%), media penularan tuberkulosis (20,3%), dan efek samping Rifampisin (13,5%). Model Rasch menunjukkan bahwa reliabilitas orang adalah 0,00 (sangat buruk), reliabilitas item adalah 0,93 (sangat baik), dan terdapat 2 item yang memenuhi tiga kriteria (Outfit mean square, outfit Z-standard, dan Point measure correlation). Penelitian ini menyimpulkan bahwa meskipun deskripsi respon yang benar sebagian besar memberikan hasil yang baik tetapi ketika analisis pemodelan Rasch diterapkan maka hasil reliabilitas orang tersebut buruk. Penelitian ini memiliki keandalan orang dan pemisahan orang yang paling rendah yang menunjukkan tidak cukup kader untuk membedakan antara mereka yang berkemampuan lebih tinggi dan lebih rendah.

Kata kunci: analisis Rasch; kader kesehatan; pengetahuan, terapi pencegahan tuberkulosis