Asupan energi dan protein pasien tidak berbeda menurut tingkat kepercayaan diri dan kinerja ahli gizi dalam menerapkan proses asuhan gizi terstandar

Merryna Nia Silvia; Martalena BR Purba; Endy Parjanto

doi:10.21927/ijnd.2016.4(1).19-28

Asupan energi dan protein pasien tidak berbeda menurut tingkat kepercayaan diri dan kinerja ahli gizi dalam menerapkan proses asuhan gizi terstandar

Merryna Nia Silvia, Martalena BR Purba, Endy Parjanto

Abstract

ABSTRACT

Background: The incidence of hospital malnutrition is still high. Prevalence of malnutrition was 56.9% at three hospital in Indonesia, such as Dr. Sardjito Hospital Yogyakarta, Jamil Hospital Padang, and Sanglah Hospital Bali. Diet therapy might improve nutritional intake. Standardized nutrition care process (SNCP) helps dietitian to make a decision with critical thinking to improve the quality of nutritional care, i.e. safe and effective. Dietitians need self-confi dence in applying their knowledge to accomplish their works. Several studies showed that higher self-confi dence correlated with higher performance. That would have positive impact on patients outcomes.

Objectives: To fi nd out the differences in patient energy and protein intake based on dietitians selfconfidence in implementing SNCP.

Methods: An observational study was used in this study with cross sectional design involving dietitians and hospitalized patients in Dr. Sardjito Hospital Yogyakarta. Data were analyzed using independence t test, chi-square, and Anova.

Results: There was no significant difference in percentage average of patients energy intake of high self confidence compared to low self confi dence (lower 6.3%, p=0.13), as well as in protein intake (higher 1.8%, p=0.73). The percentage average of energy in nutritional intake, which energy intake was 3.0% (p=0.49) lower in good performance and protein intake was 7.1% (p=0.20) higher in good performance, had no statistical difference with dietitians performance. There was also no statistical difference between dietitians performance and dietitians self-confi dence(p=0.23).

Conclusions: There were no differences between average percentage of energy and protein intake with dietitians self-confidence and dietitians performance. There was also no difference between dietitians performance and their self-confidence.

KEYWORDS: self-confidence, dietitians performance, energy and protein intake

ABSTRAK

Latar belakang: Kejadian hospital malnutrition masih tinggi. Prevalensi malnutrisi di tiga rumah sakit di Indonesia, yaitu RSUP Dr. Sardjito Yogyakarta, RSUP Jamil Padang, dan RSUD Sanglah Bali sebesar 56,9%. Terapi diet dapat meningkatkan asupan gizi proses asuhan gizi terstandar (PAGT) membantu ahli gizi membuat keputusan dengan berpikir kritis dalam upaya meningkatkan kualitas asuhan gizi yang aman dan efektif. Ahli gizi memerlukan kepercayaan diri dalam melaksanakan tugasnya. Beberapa penelitian medis menunjukkan bahwa kepercayaan diri yang tinggi berhubungan dengan kinerja yang lebih baik. Hal tersebut dapat berdampak positif terhadap outcome pasien.

Tujuan: Untuk mengetahui perbedaan asupan energi dan protein pasien menurut tingkat kepercayaan diri dan kinerja ahli gizi dalam menerapkan PAGT.

Metode: Jenis penelitian ini adalah observasional dengan rancangan cross sectional. Subjek penelitian adalah ahli gizi dan pasien rawat inap RSUP Dr. Sardjito Yogyakarta, dengan masing-masing berjumlah 12 subjek dan 90 subjek, menggunakan teknik convenience sampling dan quota sampling. Penelitian dilaksanakan pada bulan Desember 2013 sampai Maret 2014. Analisis data secara bivariat dilakukan dengan uji t, chi-square, dan anova.

Hasil: Asupan energi pasien pada kepercayaan diri ahli gizi baik tidak berbeda dengan kepercayaan diri ahli gizi yang tidak baik (lebih rendah 6,3%, p=0,13), demikian juga dengan asupan protein (lebih tinggi 1,8%, p=0,73). Tidak ada perbedaan rerata persentase asupan energi, yaitu selisih 3,0% (p=0,49) lebih rendah pada kinerja baik dan protein 7,1% (p=0,20) lebih tinggi pada kinerja baik. Tidak ada perbedaan kinerja ahli gizi menurut tingkat kepercayaan dirinya (p=0,23).

Kesimpulan: Tidak ada perbedaan asupan energi dan protein menurut tingkat kepercayaan diri dan kinerja ahli gizi, serta kinerja menurut tingkat kepercayaan diri ahli gizi.

KATA KUNCI: kepercayaan diri, kinerja ahli gizi, asupan energi dan protein

Keywords

self-confidence;dietitians performance;energy and protein intake;kepercayaan diri;kinerja ahli gizi;asupan energi dan protein

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References

Correia MI CA. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study. Nutrition. 2003;19(10):823–5.

Correia M, Waitzberg D. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr. 2003;22(3):235–9.

Kahokehr A, Sammour T, Wang K, Sahakian V, Plank L, Hill A. Prevalence of malnutrition on admission to hospital - acute and elective general surgical patients. Eur Clin Nutr Metab. 2010;(5):21–5.

Chakravarty C, Hazarika B, Goswami L, Ramasubban S. Prevalence of malnutrition in a tertiary care hospital in India. Indian journal of critical care medicine : peer-reviewed. Indian J

Crit Care Med. 2013;17(3):170–3.

Budiningsari R, Hadi H. Pengaruh perubahan status gizi pasien dewasa terhadap lama rawat inap dan biaya rumah sakit. J Gizi Klin Ind. 2004;1:30–40.

Julianty A. Malnutrisi rumah sakit pada bangsal anak Rumah Sakit Dr. Wahidin Sudirohusodo Makassar. Sari Pediatr. 2013;15(2):65–8.

Sidiartha I. Insiden malnutrisi rawat inap pada anak balita di Rumah Sakit Umum Pusat Sanglah Denpasar. Sari Pediatr. 2008;9(6):381–5.

DeBruyne L, Pinna K, Whitney E. Nutrition and diet therapy : principles and practice, 7th ed. USA: Thompson; 2008.

Bavelaar J, Otter C, van Bodegraven A, Thijs A, van Bokhorst-de van der Schueren M. Diagnosis and treatment of (disease-related) in-hospital malnutrition: the performance of medical and nursing staff. Clin Nutr. 2008;27(3):431–8.

Kondrup J, Johansen N, Plum L, Bak L, Larsen I, Martinsen A. Incidence of nutritional risk and causes of inadequate nutritional care in hospitals. Clin Nutr. 2002;21(6):461–8.

Naber T, Schermer T, de Bree A, Nusteling K, Eggink L, Kruimel J. Prevalence of malnutrition in nonsurgical hospitalized patients and its association with disease complications. Am J Clin Nutr. 1997;66(5):1232–9.

Chasbullah I. Pengaruh pelaksanaan asuhan gizi dengan pendekatan terapi gizi medis terhadap asupan makanan dan lama rawat di Rumah Sakit Umum Kota Bekasi. J Gizi Klin Ind. 2008;5:1–8.

Sumapradja M, Fayakun Y, Widyastuti D. Proses asuhan gizi terstandar (PAGT). Jakarta: Abadi Publishing & Printing; 2011.

Lacey K, Pritchett E. Nutrition care process and model: ADA adopts road map to quality care and outcomes management. J Am Diet Assoc. 2003;103(8):1061–72.

Mcneil S, Shearer J, Johnson R, Kent S, Klein C, McClusky K. American dietetic association revised 2008 standards of practice for registered dietitians in nutrition care; standards of professional performance for registered dietitians; standards of practice for dietetic technicians, registered, in nutrition care; a. J

Am Diet Assoc. 2008;108(9):1538–42.

Sandrick K. Is nutritional diagnosing a critical step in the nutrition care process? J Am Diet Assoc. 2002;102(3):427–31.

Adib Hagbaghery M, Salsali M, Ahmadi F. A qualitative study of Iranian nurses’ understanding and experiences of professional power. Hum Resour Health [Internet]. 2004 Dec 24;2(1):9. Available from: http://human-resources-health.biomedcentral.com/articles/10.1186/1478-4491-2-9.

Davis D, Campbell C, Poste J, Ma G. The association between operator confi dence and accuracy of ultrasonography performed by novice emergency physicians. J Emerg Med. 2005;29(3):259–64.

Sergeev I, Lipsky A, Ganor O, Lending G, Abebe-Campino G, Morose A. Training modalities and self-confidence building in

performance of life-saving procedures. Mil Med. 2012;177(8):901–6.

Lemeshow S, DWH J, Klar J, Lwanga S. Besar sampel dalam penelitian kesehatan. Yogyakarta: Gadjah Mada University Press; 1997.

Lauster P. Tes kepribadian. Jakarta: Bumi Aksara; 2008.

Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27(1):5–15.

Mowe M, Bosaeus I, Rasmussen H, Kondrup J, Unosson M, Irtun O. Nutritional routines and attitudes among doctors and nurses in Scandinavia: a questionnaire based survey. Clin Nutr. 2006;25(3):524–32.

Utami N. Analisis beban kerja dan kinerja dietisien dalam melaksanakan nutrition care process di Tuang Rawat Inap Rumah Sakit Hasan Sadikin Bandung. Universitas Gadjah Mada; 2011.

Lu A, Dollahite J. Assessment of dietitians’ nutrition counselling self-effi cacy and its positive relationship with reported skill usage. J Hum Nutr Diet. 2010;23(2):144–53.

Hoifodt T, Talseth A, Olstad R. A qualitative study of the learning processes in young physicians treating suicidal patients: from insecurity to personal pattern knowledge and self-confidence. BMC Med Educ. 2007;7:21.

Muchlas M. Perilaku organisasi. Yogyakarta: Gadjah Mada University Press; 2005.

Syamsiatun N, Hadi H, Julia M. Hubungan antara status gizi awal dengan status pulang dan lama rawat inap pasien dewasa di rumah sakit. J Gizi Klin Ind. 2004;1(1):23–9.

Porter J, Morphet J, Missen K, Raymond A. Preparation for high-acuity clinical placement:confidence levels of final-year nursing students. Adv Med Educ Pr. 2013;4:83–9.

Moore H, Greenwood D, Gill T, Waine C, Soutter J, Adamson A. A cluster randomised trial to evaluate a nutrition training programme. Br J Gen Pr. 2003;53(489):271–71.

Williamson A, Hunt A, Pope J, Tolman N. Recommendations of dietitians for overcoming barriers to dietary adherence in individuals with diabetes. Diabetes Educ. 2000;26(2):272–9.

Bailey R. Human performance engineering: a guide for system designers. New Jersey: Prentice-Hall; 1990.

Bateman T, Ferris G, Strasser S. Kinerja. Jakarta: Elex Media Komputindo; 1992.

Dwiyanti D, Hadi H, Susetyowati. Pengaruh asupan makanan terhadap kejadian malnutrisi di rumah sakit. J Gizi Klin Indones.

;1(1):1–7.

Tomkins A, Watson F. Malnutrition and infection a review. Switzerland: ACC/SCN; 1989.

Kusumayanti I, Hadi H, Susetyowati. Faktor-faktor

yang mempengaruhi kejadian malnutrisi pasien dewasa di ruang rawat inap rumah sakit. J Gizi Klin Ind. 2004;1(1):8–15.

Pakaya A. Pengaruh pelaksanaan asuhan gizi dengan pendekatan terapi gizi medis (TGM) terhadap intake makanan dan status gizi pasien rawat inap RSUD Dr. M.M Dunda dan RSUD

Prof Dr. Aloe Saboe Gorontalo. Universitas Gadjah Mada; 2009.

Ross E, Kenakin T. Farmakodinamika: mekanisme kerja obat dan hubungan antara konsentrasi obat dan Eefek. Jakarta: EGC; 2003.

H o l f o r d N . P h a r m a c o k i n e t i c s a n d pharmacodynamics: rational dosing and the time course of drug action. Singapore: McGraw Hill; 2009.

DOI: http://dx.doi.org/10.21927/ijnd.2016.4(1).19-28