PENGETAHUAN DAN KETERAMPILAN BIDAN UNTUK SKRINING KANKER SERVIKS DENGAN METODE INSPEKSI VISUAL ASAM ASETAT (IVA) DI KALIMANTAN BARAT

Mardiana 1 , Djaswadi Dasuki 2 , Heru Pradjatmo 2 ABSTRACT Background: Globally it is estimated that every two minutes a woman dies of cervical cancer and 500,000 women are diagnosed to have cervical cancer each year. In Indonesia, the incidence of cervical cancer is by 12.6 per 100,000 women with a mortality rate of 7 per 100,000. Screening method can reduce the incidence of cervical cancer if done cumulatively in 2012, the coverage of screening with a VIA method in Indonesia was 1.57%, whereas screening coverage with IVA in West Kalimantan Province was 1.06 % Objective: To assess midwives’ knowledge and skills of screening practices with a VIA method in health centers Method: This was an observational study with a cross-sectional study, using quantitative and qualitative approaches. The study was conducted in health centers in the province of West Kalimantan. This study was conducted in September to October 2014. The subjects of research were midwives who served in health centers doing a VIA examination in West Kalimantan who met inclusion and exclusion criteria. The total sample of this study was 42 taken with purposive sampling. The variables of this study were the dependent variable, ie, the practice of screening skills with a VIA method, the independent variable, ie, knowledge, and the extraneous variables, ie, age, education, and years of service. Analysis of the data included univariable, bivariable, multivariable, and qualitative. The quantitative data analysis used the chi-square and logistic regression with a significance level of p <0.05 and an OR value with confidence interval (CI) of 95%. Result & Discussion: The mean value of midwives’ knowledge was 26.0 from assessment scores of 0-30. A mean score of screening practice skills was 94.4 from 38-114. Of clinical assessment scores skill practice of competent midwives with good knowledge was higher than bad knowledge (OR= 6,98 CI 95% 1,21-40,33). After controlling education and years of service variables, good knowledge influenced screening clinical practice by 33%. Conclusion: Most of the midwives in West Kalimantan had good knowledge and skills to perform cervical cancer screening with a VIA method. Keywords: Knowledge, screening practice skills, VIA methods ABSTRAK Latar Belakang: Di seluruh dunia diperkirakan setiap dua menit seorang wanita meninggal karena kanker servik dan sekitar 500.000 wanita di diagnosis kanker seviks setiap tahun. Di Indonesia insiden kanker serviks sebesar 12,6 per 100.000 perempuan dengan angka kematian sebesar 7 per 100.000. Metode skrining dapat menurunkan kejadian kanker serviks jika dilakukan secara kumulatif. Pada tahun 2012 cakupan skrining dengan metode IVA di Indonesia sebesar 1,57%, sedangkan cakupan skrining dengan metode IVA Propinsi Kalimantan Barat sebesar 1,06%. Tujuan: Menilai pengetahuan dan keterampilan praktek skrining bidan dengan metode IVA di puskesmas Metode: Jenis penelitian observasional dengan rancangan cross-sectional study , menggunakan pendekatan kuantitatif dan kualitatif. Penelitian dilakukan di puskesmas di Provinsi Kalimantan Barat. Penelitian ini dilaksanakan bulan September sampai dengan Oktober 2014. Subjek penelitian bidan yang melayani pemeriksaan IVA di puskesmas di Provinsi Kalimantan Barat yang memenuhi kriteria inklusi dan eksklusi. Total sampel penelitian ini 42 sampel dengan pengambilan sampel purposive sampling. Variabel penelitian ini yaitu: variabel terikat adalah keterampilan praktek skrining metode IVA, variabel bebas: pengetahuan, dan variabel luar: usia, pendidikan, dan lama bekerja. Analisis data meliputi: univariabel, bivariabel, multivariabel, dan kualitatif. Untuk analisis data kuantitatif meng-gunakan metode chi square dan logistic regresi dengan tingkat kemaknaan p < 0,05 dan nilai OR dengan Confidence Interval (CI) 95%. Hasil & Pembahasan: Nilai mean pengetahuan bidan sebesar 26,0 dari skor penilaian 0-30. Keterampilan praktik dengan nilai mean 94,4 dari skor 38-114. Keterampilan praktik klinik yang kompeten lebih tinggi pada bidan berpengetahuan baik daripada bidan berpengetahuan kurang (OR= 6,98 CI 95% 1,21-40,33). Pengetahuan baik setelah dikontrol variabel pendidikan dan lama bekerja berpengaruh terhadap keterampilan praktik skrining sebesar 33%. Kesimpulan: Sebagian besar bidan di Kalimantan Barat memiliki pengetahuan baik dan keterampilan yang kompeten untuk skrining kanker serviks dengan metode IVA. Kata Kunci: Pengetahuan, keterampilan praktek skrining, metode IVA 1 Dinas Kesehatan Provinsi Kalimantan Barat 2 Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta