ihwanu sholeh 22010111130087 BAB VIII

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52 LAMPIRAN

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Lampiran 2. Informed consent

PERSETUJUAN SETELAH PENJELASAN (INFORMED CONSENT)

Selamat pagi/siang/sore, Ibu/Bapak. Kami adalah mahasiswa Fakultas Kedokteran Universitas Diponegoro yang sedang mengadakan penelitian tentang gangguan metabolik. Penelitian ini bertujuan untuk mengetahui hubungan lingkar pinggang dengan arus puncak pengeluaran napas pada masyarakat dengan gangguan metabolik. Kami membutuhkan ketersediaan Ibu/Bapak untuk melakukan beberapa tes: Harvard step test (tes naik turun bangku), tes kekuatan genggaman tangan, arus puncak pengeluaran napas, dan laboratorium darah sebagai sampel penelitian yang akan kami periksa serta menjawab beberapa pertanyaan yang berhubungan dengan penelitian kami. Manfaat dari penelitian ini adalah Ibu/Bapak akan mendapatkan pemeriksaan laboratorium darah yang meliputi asam urat, gula darah puasa dan kolesterol tanpa dipungut biaya apapun. Selain itu, Bapak/Ibu juga akan mendapatkan penyuluhan tentang pencegahan faktor-faktor yang dapat menyebabkan gangguan metabolik.

Kami menjamin bahwa penelitian ini tidak akan menimbulkan efek yang merugikan pada Bapak/Ibu. Penelitian yang kami lakukan ini bersifat sukarela dan tidak ada unsur paksaan. Dalam penelitian ini, kami menjamin kerahasiaan segala data yang kami peroleh, data hanya akan kami gunakan untuk kepentingan penelitian. Penanggung jawab penelitian ini adalah dr. Bahrudin, M.Si.Med, Ph.D, dosen Bagian Anatomi FK Undip. Alamat kantor: Jl. Prof. Dr. Soedarto, Tembalang, Semarang, nomor HP 081228000876.

Demikian penjelasan dari kami. Terima kasih atas kerja sama Bapak/Ibu dalam penelitian ini.

Setelah mendengar dan memahami penjelasan penelitian, dengan ini saya menyatakan

SETUJU / TIDAK SETUJU untuk menjadi subjek penelitian.

Semarang, ………. 2015

Saksi

Nama Terang Nama Terang

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Lampiran 3. Identitas Subjek Penelitian

IDENTITAS SUBJEK PENELITIAN

“FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP SINDROM METABOLIK”

( ) Tamat perguruan tinggi/sederajat

7. Pekerjaan :

II. Riwayat Penyakit

1. Riwayat DM : Ya Tidak Tidak tahu

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2. Riwayat Hipertensi : Ya Tidak Tidak tahu

Jika Ya: . . . . tahun, terkontrol/tidak terkontrol

3. Riwayat Kolestrol tinggi (Dislipidemia)

6. Riwayat Keluarga : - Siapa dari keluarga Bapak/Ibu yang menurunkan penyakit tersebut?

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Lampiran 4. Pemeriksaan fisik subjek penelitian

PEMERIKSAAN FISIK SUBJEK PENELITIAN

“FAKTOR-FAKTOR YANG BERPENGARUH TERHADAP SINDROM METABOLIK”

 Kepala : Konjungtiva anemis ( )

Sklera ikterik ( )

Lain-lain...

 Leher : JVP...

 Dada : Jantung (Bunyi jantung): ... ...

Paru: ...

 Abdomen : ...

 Ekstremitas : ...

Rekomendasi : Ya Tidak

1. Peak flow meter ( ) ( )

2. Hand Grip Dynamometer ( ) ( ) 3. Harvard Step Test ( ) ( )

Semarang, 18 Januari 2015

(………)

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Lampiran 5. Hasil analisis statistik

*. This Is A Lower Bound Of The True Significance.

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Frequency Percent Valid Percent Cumulative Percent

Valid

Perempuan 22 73.3 73.3 73.3

Laki-Laki 8 26.7 26.7 100.0

Total 30 100.0 100.0

Status Gizi

Valid

Tidak 28 93,3 93,3 93,3

Ya 2 6,7 6,7 100,0

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Kategori Tekanan Darah Sistolik

Kategori Tekanan Darah Diastolik

Kategori Gula Darah Puasa

Valid

Normal 19 63,3 63,3 63,3

Meningkat 11 36,7 36,7 100,0

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Kategori HDL

*. This is a lower bound of the true significance. A. Lilliefors significance correction

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Kategori APE

Valid

Normal 13 43.3 43.3 43.3

Tidak Normal 17 56.7 56.7 100.0

Total 30 100.0 100.0

6,66% 2

46,67% 14 46,67%

14

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43,3% 13 56,7%

17 Normal

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Correlations

Pearson Correlation 1 -.420*

Sig. (2-tailed) .021

N 30 30

Lingkar Pinggang (cm)

Pearson Correlation -.420* ₁

N 30 30

*. Correlation is significant at the 0.05 level (2-tailed).

Kategori Lingkar Pinggang * KAT_APE Crosstabulation

Kategori APE Total

Normal Tidak Normal

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Chi-Square Tests

Value df Asymp. Sig.

(2-sided)

Monte Carlo Sig. (2-sided)

Sig. 95% Confidence Interval

Lower Bound Upper Bound

Pearson Chi-Square 6,438a ₂ _{,040 ,027}b _,024 _,030 Likelihood Ratio 7,384 2 ,025 ,027b _,024 _,030 Fisher's Exact Test 5,956 ,027b _,024 _,030 Linear-by-Linear

Association

6,200c ₁ _{,013 ,014}b _,011 _,016

N of Valid Cases 30

a. 2 cells (33,3%) have expected count less than 5. The minimum expected count is ,87. b. Based on 10000 sampled tables with starting seed 2000000.

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Correlations

*. Correlation is significant at the 0.05 level (2-tailed).

Correlations

Chi-Square Tests Kat APE dengan Status Gizi

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Chi-Square Tests Kat APE dengan JK

a. 2 cells (50,0%) have expected count less than 5. The minimum expected count is 3,47. b. Computed only for a 2x2 table

Correlations

Pearson Correlation 1 .052

N 30 30

Berat Badan (kg)

Pearson Correlation .052 1

N 30 30

Chi-Square Tests Kat APE dengan Riwayat Merokok

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Correlations

Arus Puncak Ekspirasi (L/menit)

Berat Badan (kg)

Arus Puncak Ekspirasi (L/menit)

Pearson Correlation 1 .052

N 30 30

Berat Badan (kg)

Pearson Correlation .052 1

N 30 30

Variables in the Equation

B S.E. Wald df Sig. Exp( B)

95% C.I.for EXP(B)

Lower Upper

Step 1a

Umur .118 .083 2.018 1 .155 1.126 .956 1.325

Kat LP .419 .179 5.474 1 .019 1.521 1.070 2.160

Constant -44.164 17.192 6.599 1 .010 .000

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Lampiran 6. Dokumentasi penelitian

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Gambar 12. Pengambilan data berat badan, tinggi badan dan lingkar pinggang

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Lampiran 7. Biodata mahasiswa

Identitas

Nama : Ihwanu Sholeh NIM : 22010111130087

Tempat Lahir : Cirebon Tanggal Lahir : 2 Juli 1991

Jenis Kelamin : Laki-laki

Alamat : Jl. Yudhistira No. 43 Desa Karangasem, Plumbon, Cirebon Nomor HP : 08977261640

Email : [email protected]

Riwayat Pendidikan Formal

1. SD : SD Negeri 1 Karangasem Lulus tahun : 2003

2. SMP : SMP Negeri 1 Plumbon Lulus tahun : 2006

3. SMA : SMA Negeri 1 Cirebon Lulus tahun : 2009

4. S1 : Pendidikan Dokter Fakultas Kedokteran

Universitas Diponegoro Masuk tahun : 2011

Keanggotaan Organisasi

1. HIMA KU Universitas Diponegoro Tahun 2011-2013