Made Delta Dwihartami, Ni Made Ari Suryathi, I Gede Raka Widiana, Wayan Gede Jayanegara, Cokorda Istri Dewiyani Pemayun, Made Agus Kusmadjaja, Anak Agung Ayu Sukartini Djelantik

Perbedaan pengetahuan, sikap, perilaku, dan implementasi kader kesehatan sebelum dan setelah penyuluhan pelatihan katarak

Introduction

Perbedaan pengetahuan, sikap, perilaku, dan implementasi kader kesehatan sebelum dan setelah penyuluhan pelatihan katarak. Penelitian ini menguji perbedaan pengetahuan, sikap, perilaku, dan implementasi kader kesehatan tentang katarak di Bali setelah pelatihan. Ditemukan peningkatan pengetahuan dan implementasi.

Abstract

Introduction: Cataracts are still the leading cause of blindness in the world, especially in developing countries until now. Bali is one of the islands in Indonesia with a number of workers and health facilities that have not been fully distributed. Cadre training program is one of the strategies in improving the primary health care system as early detection, recording and improvement of the referral system through provisioning of cadre training. This study aims to determine the differences in knowledge, attitudes, behavior of health cadres regarding cataract problems through questionnaires before and after debriefing training and cataract training for cadres and their implementation. Method: This research was carried out in the Busungbiu Village and the Busungbiu I Health Center; Tejakula Village and Tejakula I Health Center; and Gerokgak Village and Gerokgak I Health Center and 62 samples were obtained by using the Proportional Random Sampling technique. A preliminary study was conducted to assess the validation and reliability of the questionnaire used. The research data sought the relationship between before and after the cataract counseling-training activities in the two groups on knowledge, attitudes and behavior and its implementation and analyzed bivariately with age, sex, and cadre work. Results: The study sample was dominated by 58.1% women, with the largest age range being the age group 24-29 years (42.4%), and Nurses constituted the most cadre work by 58.1%. This study found differences in knowledge between before and after counseling-training of cadres in the two groups, differences in attitudes in the group of village cadres, and improvement in the implementation of the two groups. However, there was no reduction in attitudes in the health cadre group and behavior in both groups. Conclusion: The research questionnaire is valid and reliable for use, with significant improvements in health cadres' knowledge after cataract training, although no changes were observed in their attitudes or behaviors. Furthermore, the implementation scores were higher for health cadres at health centers compared to village cadres, and the program has a positive impact, serving as an effective educational model for village cadres. Pendahuluan: Katarak masih menjadi penyebab utama kebutaan di dunia, terutama di negara berkembang hingga saat ini. Bali adalah salah satu pulau di Indonesia dengan jumlah tenaga kerja dan fasilitas kesehatan yang belum merata. Program pelatihan kader merupakan salah satu strategi dalam meningkatkan sistem pelayanan kesehatan primer sebagai deteksi dini, pencatatan, dan perbaikan sistem rujukan melalui penyediaan pelatihan kader. Penelitian ini bertujuan untuk mengetahui perbedaan pengetahuan, sikap, dan perilaku kader kesehatan mengenai masalah katarak melalui kuesioner sebelum dan setelah pelatihan penyuluhan dan pelatihan katarak bagi kader serta implementasinya. Metode: Penelitian ini dilakukan di Desa Busungbiu dan Puskesmas Busungbiu I; Desa Tejakula dan Puskesmas Tejakula I; serta Desa Gerokgak dan Puskesmas Gerokgak I dengan jumlah sampel 62 yang diperoleh menggunakan teknik Proportional Random Sampling. Studi pendahuluan dilakukan untuk menilai validitas dan reliabilitas kuesioner yang digunakan. Data penelitian mencari hubungan antara sebelum dan setelah kegiatan penyuluhan-pelatihan katarak pada kedua kelompok mengenai pengetahuan, sikap, perilaku dan implementasinya serta dianalisis secara bivariat dengan usia, jenis kelamin, dan pekerjaan kader. Hasil: Sampel penelitian didominasi oleh perempuan sebanyak 58,1%, dengan rentang usia terbesar pada kelompok usia 24-29 tahun (42,4%), dan profesi perawat merupakan pekerjaan kader terbanyak sebanyak 58,1%. Penelitian ini menemukan perbedaan pengetahuan antara sebelum dan setelah penyuluhan-pelatihan kader pada kedua kelompok, perbedaan sikap pada kelompok kader desa, dan peningkatan implementasi pada kedua kelompok. Namun, tidak ditemukan penurunan sikap pada kelompok kader kesehatan dan perilaku pada kedua kelompok. Kesimpulan: Kuesioner penelitian ini valid dan reliabel untuk digunakan, dengan peningkatan pengetahuan yang signifikan pada kader kesehatan setelah pelatihan katarak, meskipun tidak ada perubahan yang diamati pada sikap atau perilaku mereka. Selain itu, skor implementasi lebih tinggi pada kader kesehatan di puskesmas dibandingkan dengan kader desa, dan program ini memberikan dampak positif, menjadi model pendidikan yang efektif untuk kader desa.

Review

This study addresses a critical public health issue by evaluating a training program aimed at improving cataract prevention and early detection through health cadres in Bali, Indonesia. The research sought to determine the impact of a counseling and training intervention on the knowledge, attitudes, behavior, and implementation practices of cadres. Utilizing a pre-post design with a sample of 62 individuals across three villages and health centers, the methodology incorporated proportional random sampling and validated questionnaires. While the approach of leveraging community health workers for early detection is commendable, the abstract introduces some ambiguity regarding the composition of "cadres," specifically noting that nurses constituted a significant proportion (58.1%), which is an unusual characteristic for a community health cadre. Clarification on the distinct roles and training levels of "village cadres" versus "health cadres at health centers" would further strengthen the methodological description. The findings reveal a nuanced impact of the intervention. A significant and positive difference in knowledge was observed among cadres in both groups after the training, indicating the effectiveness of the educational component. Encouragingly, there was also an improvement in the implementation of related tasks across both cadre groups, with health center cadres demonstrating higher implementation scores than village cadres. However, the study noted a less consistent effect on attitudes, with improvements only seen in village cadres and no change among health center cadres. More critically, no significant improvement was found in the behavior of either group. This disconnect between improved knowledge, partial attitudinal shift, and unchanged behavior presents a key finding that warrants deeper exploration, as it suggests potential barriers to translating learned information into practical actions. Overall, the research demonstrates the program's utility as an effective educational model, particularly for enhancing the knowledge base of village cadres and improving implementation scores across the board. The use of valid and reliable questionnaires adds to the study's credibility. While the program shows promise in strengthening primary healthcare, the lack of substantial behavioral change highlights an important area for future investigation. Subsequent studies could explore the underlying factors hindering the translation of knowledge into action and attitudes into sustained behavior, perhaps through qualitative methods or longer-term follow-up, to ensure the full realization of such interventions in reducing the burden of cataract-related blindness.

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