ISRUNCH
2. Material and Methodes
This study uses the method of one group pretest-posttest design. Samples were collected by accidental sampling with a sample size of 40 respondents using booklet media and questionnaires. Data retrieval is done by guided free interview method based on a valid and reliable questionnaire (Notoatmodjo, 2010). Sampling is done by accidental sampling method. The sample in this study was all Tuberculosis patients who met the inclusion requirements. Primary data obtained through interviews with respondents based on questionnaires that have been tested for validity and rebility. Data collection was done twice from the same respondents, namely before (pre-test) and after (post-test) education was provided in the form of booklets containing material on tuberculosis treatment, side effects and incomplete treatment effects. Post tests were carried out after a period of 14 days after giving the booklet with an estimate that the respondents had used the anti- tuberculous drug.
The research instruments used included questionnaires and pocketbooks. The compliance questionnaire is a standard questionnaire Morisky Medication Adherence Scale (MMAS) consisting of 8 questions translated into Indonesian. The results of filling out questionnaires in the form of patient identity and questionnaire values were recapitulated using Microsoft Exel to then process data with SPSS. Determining the answer to the questionnaire using the Guttman scale, namely the respondent's answer is only limited to two answers, yes or no. The compliance variable adopted Morisky's interpretation of the original questionnaire, where the assessment category was divided into 3 cut of points, namely low, medium, and high.
2.1.Questionnaire Scoring Method
The Morisky Medication Adherence Scale (MMAS-8) questionnaire consisted of 8 questions and level of compliance are measured from a range of 0 to 8. The response category consists of yes or no for question items 1 to 7. In item questions 1 to 4 and 6 to 7 values 1 if the answer is no and 0 if the answer is yes, while the item Question 5 is rated 1 if with a 5 likert scale with a value of 1 = never, 0.75 = occasionally, 0.5 = sometimes, 0.25 = usually, and 0 = always. The level of adherence to therapy was categorized into three levels, namely high adherence (MMAS value equal to 8), moderate compliance (MMAS 6 to less than 8), and low compliance (MMAS value was less than 6). Both pre and post compliance questionnaires of all research subjects were recorded, then were revised using Microsoft exel 2007 and analyzed for normality with Kolmogorov- Smirnov. Statistical testing is carried out according to the results of the normality test.
34 3. Result and Discussion
Table.1. Frequency distribution by gender
Gender Quantity Percentage
Male 16 40 %
Female 24 60 %
Total 40 100 %
In the table above (Table – 1), the highest number of respondents is female patients 24 people (60%) and the number of male patients is 16 (40%). According to Budiarto &
Anggraeni (2002) in Kurniasih (2014), there are differences in several diseasesfrequency between men and women that can be caused by work differences, life habits, genetics, or physiological conditions. So the possibility of the influence of these things affects the number of female patients more than male patients, another possibility is that the percentage of female patients more than men can occur because of the condition of men who prefer to work rather than check conditions his health.
Table 2. Frequency distribution by age
Age (year) Number Precentage
18 - 30 4 10,0%
31 - 45 15 37,5%
46 - 56 20 50%
>57 1 2,5%
Total 40 100%
tuberculosis is often found in 18-50 years of young age or productive age, this can be because at productive age more interaction with the social world occurs both at work, at school or in other public places. In accordance with the research of Heryanto and friends (2004).
Assessment of the level of adherence to taking medication for tuberculosis patients Tabel 3. The results of the validity of the MMAS questionnaire in 20 patients
No Item Question r-count r- table validity
35
1. Question 1 0,908 0,444 Valid
2. Question 2 0702 0,444 Valid
3. Question 3 0,470 0,444 Valid
4. Question 4 0,564 0,444 Valid
5. Question 5 0,784 0,444 Valid
6. Question 6 0,855 0,444 Valid
7. Question 7 0,687 0,444 Valid
8. Question 8 0,607 0,444 valid
The r-table value for 20 patients with a 95% confidence rate is 0.444.
Based on the validity test in table 1, the results obtained that the value of r-count> r- table (0.444), it can be concluded that all questions on the MMAS questionnaire are valid. The reliability test results with Chronbach's alpha produce a value of 0.841. The questionnaire is said to be reliable if the value obtained is> 0.60. Chronbach's alpha value is 0.841> 0.060, so MMAS questionnaire is reliable.
Table 4.Kolmogorov-Smirnov normality test table One-Sample Kolmogorov-Smirnov Test
pretest postest
N 40 40
Normal Parametersa,b Mean 6,5700 7,6813
Std. Deviation 1,08065 0,50949
Most Extreme
Differences
Absolute 0,184 0,384
Positive 0,170 0,266
Negative -,184 -,384
Test Statistic ,184 ,384
Asymp. Sig. (2-tailed) ,002 ,000
If sig> 0.05 then the data is normal If sig <0.05, the data is not normal
Significancy data for pretest is 0.002 <0.005, the pre-test research data is abnormally distributed. Significancy data for posttest is 0,000 <0,005, so the posttest research data is abnormally distributed.
Table 5. The level of adherence to taking medication for tuberculosis patients Level
of adherence
Pre Post p
∑ % ∑ %
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High 7 17,5 26 65 0,000
Middle 24 60 14 35
Low 9 22,5 - -
From the results of the Wilcoxon test in table 4.5, get p value of 0,000 (p <0,005). It was concluded that there was a significant change in the level of compliance of tuberculosis patients in Ciamis Hospital before and after providing education through booklets. This shows that the information contained in the booklet is beneficial to adherence behavior to taking medication for tuberculosis patients. This is in line with the Panjaitan study (2014) that there was a significant increase in the actions of patients before and after being given health education about pulmonary TB. Data collection through questionnaires is very dependent on the honesty of the research subjects (respondents) so that the data obtained does not necessarily describe the real reality.