RESEARCH METHODOLOGY
ENVIRONMENTAL SANITATION RELATIONSHIP
WITH THE INCIDENCE OF DIARRHEA IN PUSKESMAS PATI II CENTRAL OF JAVA
CHAPTER I
1 INTRODUCTION
1.1
Background
Diarrhea is the leading cause of death in the world, accounting for
5-10 million deaths / year. Until now diarrheal disease remains a problem the
world, especially in developing countries. The magnitude of the problem is
evident from the high morbidity and mortality due to diarrhea. WHO estimates
that 4 billion cases occurring in the world and 2.2 million of them died,
mostly children under the age of 5 years. Although diarrhea kills about 4
million people / year in developing countries, it turns diarrhea is still a
major problem in the developed countries. In America, every child has diarrhea
episodes 7-15 with an average age of 5 years, 9% of children hospitalized with
diarrhea aged less than 5 years, and 300-500 children die every year. In
developing countries the average per child under the age of 5 years experience
episodes of diarrhea 3 times per year (WHO, 2009).
Sanitation is one of the most important challenges for developing
countries because according to the World Healt Organisation (WHO), diarrhea
diseases kill a child in this world every 15 seconds, because access to
sanitation is still too low. This poses a major environmental health problem,
as well as detrimental to economic growth and human resource potential on a
national scale. (Anwar, 2009)
In Indonesia there are four health impact by water treatment and poor
sanitation, namely diarrhea, typhoid, polio and worms. It surveys in 2006
showed that the incidence of diarrhea in all age in Indonesia is 423 per 1000
population and occurs 1-2 times per year in children under 5 years old.
(Elegant Dyah Messwati, 2008)
In 2008 the reported occurrence of Extraordinary Events (KLB) Diarrhea
in 15 provinces with the number of patients as much as 8443 people, the number
of deaths of 209 people or Case Fatality Rate (CFR) as much as 2.48%. This is
mainly due to the low availability of clean water, poor sanitation and unclean
living behavior. (Indonesia Health Profile 2008)
Until now, the incidence of diarrhea is still a public health problem
in South Sulawesi. Although in general morbidity is still fluctuating, and also
reported by health care facilities and cadres is still often cause diarrhea
outbreaks (extraordinary events) are pretty much even cause death.
Based on data obtained from the field
P2P Makassar City Health Department in 2007, the number of patients with
diarrhea as many as 52 278 people and 14 493 or 28% of them are children.
Overall reported 10 died of diarrheal disease. For patients with diarrhea,
still according to the results of surveillance, most suffered by residents aged
between 1-4 years of age or who is still classified as a toddler. At this age,
the number of patients is as much as 7379 people. Surveillance data also
mentioned with diarrhea from South Sulawesi residents aged 5-9 years to reach
2955, age 10-14 years as 1,746 people, as many as 1,467 USIS 15-19 years, 55-59
years of age as many as 856 people, aged 60-69 years as many as 1,125 people
over the age of 70 years and as many as 554 people. (Health Sulawesi 2009).
Several attempts have been made
to reduce the number of incidence and case fatality rate of occurrence of
diarrhea include increased coverage of clean water and latrines family, health
education, detection and treatment of patients, as well as correctional or the
use of oral rehydration salts, either malalui health care units as well as
through cross-sectoral activities including posyandu has been done by the ranks
of the health department.
The data obtained in primary Batua
diarrhea Makassar gives an overview of the 10 diseases that stand out, one is
diarrhea ranks 2 nd in 2008 that as many as 1,815 people diarrhea, and in 2009
the incidence of diarrhea as many as 1,905, while in 2010 of the month January
until the month of May diarrhea as much as 407 people.
Based on the above description that
the problem of environmental sanitation effect on the incidence of diarrhea so
interested in conducting research studies in health centers Batua Makassar to
determine the relationship of environmental sanitation with diarrhea.
1.2
Problem Formulation
Based on the background mentioned
above, then the problem can be formulated as follows:
1) Is there a water
supply relationship with the incidence of diarrhea in the region of Puskesmas Pati II?
2) Is there a waste
management relationship with the incidence of diarrhea in the region of Puskesmas Pati II?
3) Is there a
relationship wastewater management with diarrhea in the region of Puskesmas Pati II?
4) Is there a
family latrine utilization relationship with the incidence of diarrhea in the
region of Puskesmas Pati II?
1.3
Objective
1) General Purpose
Knowledgeable environmental sanitation relationship with the incidence
of diarrhea in the working area Puskesmas Pati II.
2) Special Purpose
a. Knowledgeable water supply relationship with the incidence of
diarrhea in the working area Puskesmas Pati II.
b. Knowledgeable waste management relationship with the incidence of
diarrhea in the working area Puskesmas Pati II.
c. Knowledgeable wastewater management relationship with the incidence
of diarrhea in the working area Puskesmas Pati II.
d. Knowledgeable latrine utilization relationship with the incidence of
diarrhea in the working area Puskesmas Pati II.
1.4 Benefits Research
The benefits of this research are as follows:
1) The Government
The results of this study are expected to be input to the Department
of Health in improving the urban environment.
2) College
The results of this study can add to their knowledge, especially
regarding environmental health.
1.5
Community
The results of this study are expected to broaden the public about
environmental health and diseases associated with the environment.
CHAPTER II
1. LITERATURE REVIEW
1.1 Overview About Sanitation.
Understanding sanitation according to the World Health Organization
(WHO) is an attempt to control of all human physical factors that cause the
things that had tied to their physical health and stamina (Anwar David, 2002).
Environmental sanitation is monitoring the physical environment,
biological, social, economic and human health effects, which are useful
environment improved and propagated while the adverse repaired or removed.
The importance of a healthy environment has been demonstrated by WHO
with investigating - investigating all over the world in which it was found
that the death rate (mortality), the comparative figures illness (morbidity)
high and frequent endemic in places where poor hygiene and environmental
sanitation.
1.2 Causes of Infant Mortality
According to the WHO, that the countries which are developing many
chronic diseases are endemic, frequent epidemics. Infant mortality and children
are high due to: (Enjang, 2000).
1) Impurities household water supply
2) Infection due directly or indirectly with
human feces
3) Infections caused by arthropods, molluscs
and other vector-vector.
4) Pollutant milk and other foods
5) Housing is too narrow
6) Diseases associated with the human animal.
1.3
Scope of Environmental Health
More emphasis on environmental sanitation supervision or control of
the factors controlling the human environment, as found by the WHO there are 7
(seven) group of environmental health space, namely:
1) Water Problem
2) Problem goods or
objects residual water or used as human sewage and garbage.
3) Problem food and
beverage
4) The problem of
housing and other buildings
5) The problem of
air pollution, water and soil
6) Problem
oversight arthropods and rodiatis
7) Problem with
occupational health (Anwar David, 2002)
1.4 Environment Relationship With Disease
Factors
Some of the environmental problems associated with disease factors
are:
1) Changes in the
physical environment by mining activities, residential and industrial building
which resulted in the breeding grounds for disease factors.
2) Construction of
the dam will be at risk of breeding of disease factors.
3) System with
piped water supply has not reach the entire population that still needed
Conteiner for water supply reservoirs.
4) System drainage
and urban settlements are not eligible to become a perindukkan disease.
5) The waste
management system that is not qualified to make garbage nest disease factor.
6) The behavior of
some people in the management of a healthy environment, convenient and secure
is still inadequate.
7) The use of
pesticides that are not wise in the control of chemical risk factors of the
disease incidence of poisoning and environmental pollution (MOH, 2001).
1.5 Overview About Water
Water is an essential requirement for humans, because the human body
in the water ranges from 50-70% of the total weight. And the human need for
water every day at least 1, 5-2 liters for drinking, because if humans the lack
of water, it will cause death. (Slamet, 2002).
a. Terms of
clean water
According to the regulations of
the Minister of Health No. 416 / Menkes / IX / 1990 is the water that is used
for everyday purposes whose quality meets the requirements of health and can be
taken when it is cooked.
As for some clean water
requirements are eligible according PERMENKES No. 907 / Menkes / SK / VII /
2002 are as follows:
1) Physical
Conditions, clean, clear, odorless, tasteless and colorless
2) Does not contain
substances that are harmful to health such as poison, and do not contain
minerals and organic substances which high amount of provisions.
3) Terms
biological, does not contain pathogenic organisms
4) Terms of
radioactive: free of alpha rays and beta rays
5) Terms quantity
that is in rural areas to live in a healthy enough to obtain 60 liters / day /
person, while the urban area of 100-150 liters / day / person.
b.
Water-Related Diseases
Broadly speaking the disease in respect of water seen on the mode of transmission
can be classified into 4 types:
1) Water Borne
Disease
Types of diseases that are transmitted or caused as a result of
contamination by human feces urine, which is then the water consumed by humans
who do not have immunity to the disease include: cholera, typhoid, Basillari
Disentry, Weings Disease.
2) Water Washed
Disease
Ditrasmisikan yag diseases with feces contaminated water input into
the body directly (fecal oral) as a result of the provision of clean water for
washing tools or objects (hand) are used less in quantity and quality. Type of
disease in this group is bacterial ulcers (ulcer) Scabies (Scabies), trchoma
(infected in the eye).
3) Water Based
Disease
Diseases caused by pathogenic organisms in the water portion of their
life cycle. Diseases that fall into this group are schistosimiasis (Bilhazia)
worms Guines.
4) Insects Water
Related
Diseases caused by insects (insects) that breed or obtain food around
the water so that the incident-incidence can be attributed to a suitable nearby
water sources, such as malaria and onchocersiasis.
c. Sources
and Characteristics of Water
1) Water Source
Some of the clean water that can be used for the benefit of the
activity with the provisions should be suitable qualified in terms of
processing nest construction, maintenance and quality control, order processing
ease clean water source can be derived from:
a) Drinking water
company
b) Groundwater
(wells pump, drill wells and artesian)
c) Rainwater.
2) Characteristics of Water Resources
a. Drinking water
company (PAM) in terms of quality relativ already qualified (physical,
chemical, and bakterilogis)
b. Groundwater:
water quality is strongly influenced local geological circumstances
c. Rainwater:
usually acidic, CO2-free, high, low mineral, low awareness. (MOH, 1998).
C. Overview About
Waste Management
According to the WHO definition,
garbage is something that is used, not used, not liked, or something that is
discarded from human activities and does not happen by itself. (Budiman
Chandra, 2007)
According kasnoputranto, that
waste is a solid substance or object which occurs due to the relationship with
human activity is not used anymore, dislikes and disposed of in sanitary
manner. Many experts propose other restrictions, but in general contain the
same principle, namely:
a. The existence of
an object or solid substance or material
b. The existence of
a relationship directly or indirectly to human activity
c. Object or
material is not used anymore, not in the sense of groove and disposed of
disposal in a way that is accepted by the public (Ariyanto and Goddess, Depok,
2002)
d. Based on the
types of waste can be divided into various types, among others:
1. Based on the chemical substances where garbage is divided into:
a. Inorganic waste
is waste that generally can not rot for example metal or iron, zinc and plastic
shards.
b. Organic waste is
waste that is generally unable to decompose, such as food scraps, leaves,
fruits and so on.
2. Based on whether or not to burn
a. Combustible
rubbish such as paper, rubber, wood, plastic, rags and so on.
b. Garbage is not
flammable, it cans, iron-iron and so on.
3. Based on the characteristics of the waste
a. Garbage is the
remains of processing or food that had rotted.
b. Rubbish is
processing residual materials which are difficult to decompose. Rubbish is no
flammable such as wood, paper, and there are no flammable such as tin, iron and
so on. (Notoatmodjo, 1997).
There are three main things that need to be dperhatikan in waste
management, among others: (1) It must be closed so it does not become a
breeding insects or other animals such as rats, flies and cockroaches. (2)
Transportation or garbage collection (colection) or garbage collected in bins
while collected and then transported and disposed. In the collection and
transportation of waste can be done individually, government and private.
2.
Overview About Wastewater
According Metcalfn and Eddy Wastewater is a combination of fluid and
debris, liquid waste originating from residential areas, urban and industry
together with the groundwater, surface water and rain water that may exist.
Azrul Anwar defines waste water is used water or dirt does not clean the
used water contains many substances that endanger human life and other animals
that appear as the result of human actions.
a. Sources of wastewater
In day-to-day waste water sources known are:
1. Waste water from
households (domestic sewage)
2. Waste water from
the company (comersial waste) as a hotel and restaurant.
3. Waste water from
industry (industrial waste) example of a textile mill, copper and food
industries.
4. Waste water
originating from other sources such as rain water mixed with sewage.
b. The terms of the proposition wastewater disposal.
Target sound disposal of waste water must meet the following
requirements:
1) Do not contaminate water sources
2) Does not cause waterlogging
3) Does not cause odor
4. Do not give rise
to a shelter and breeding grounds for mosquitoes and other insects (Anwar
David, 2000).
2.1 Characteristics of wastewater
Characteristics of wastewater needs to be known, as this will determine
the appropriate processing methods, so as not to pollute the environment.
Broadly speaking, the characteristics of the waste water is classified into:
1) Physical
Largely composed of water and a small portion is composed of solid
materials and suspension. Especially the domestic wastewater, usually dull like
wrinkles soap, smelling, sometimes containing the remains of colored paper,
washing rice and vegetables and so on.
2) Chemical
Building water containing substances of organic chemicals derived from
clean water mixed with various organic substances derived from high shower of
urine and garbage, and so forth.
3) Bacteriological
The content of pathogenic bacteria and organisms are also in
wastewater depends on where the source is but they do not play a role in the
process of wastewater treatment.
Untreated waste
water first will cause various health problems of society and the environment,
among others:
a. Being a media
transmission or spread of diseases, especially cholera, abdominal typhus, and
dysentery baciler.
b. Become a
pathogenic microorganism growth media.
c. Being home to a
mosquito or a mosquito larvae live.
d. Is a source of
pollution of surface water, soil, and other environmental.
e. Detrimental to
health
In accordance with the substances contained in the residual waste if
the waste water is not managed, it will cause disruption community health and the environment, among others:
1) Being transmission or media attacks as primarily
a disease of cholera, typhus abdominalis, bacterial dysentery.
2) Being a breeding ground for pathogenic
microorganisms.
3) Being a mosquito breeding place or places
berkebang live mosquito virus.
4) Creates an unpleasant smell and bad odor.
5) It is the source of surface water contamination
and other environmental soil.
6) Reducing human productivity because people are
not comfortable working with and forth (Notoatmojo, 1997).
3. Overview About Family toilet
Family toilet is a toilet which
is known to be used to dispose of human waste or feces and urine when where
excreta disposal are not eligible can cause a variety of gastrointestinal
diseases such as diarrhea, cholera.
Good sewage should meet the following requirements:
a. Do not pollute
the soil surface around the latrine
b. Do not pollute
the surrounding surface water
c. Does not
contaminate the surrounding ground water
d. Can not be
reached by insects, especially flies, cockroaches, and other animals.
e. Odorless
f. Easily used and
maintained
g. simple design
h. cheap
i. Can be accepted
by its user.
In order for these requirements can be met, it is necessary to note
the following:
1) Should the toilet closed, building latrines
protected from heat and rain, insects and other animals, sheltered from sight.
2) Building latrines should have a solid floor, a
strong foothold and so on.
3) Building latrines available wherever possible
cleaning tools such as water or cleaning paper (Notoatmodjo, 1997).
The following different types of
latrines are as follows:
a. Pit Privy
(Cupluk)
This toilet was made by making holes in the ground with a diameter of
80-120 cm, depth 2.5 to 8 meters walls reinforced with coal. Can the wall so
they do not collapse, the use of 5-15 years old.
b. Aqua-Privy
(cupluk watery)
Consisting of a watertight tub, filled in the ground as disposal. For
this latrine in order to function properly need water intake every day, whether
in use or not. Excreta disposal with a minimum distance from the water source
more than 10 m.
c. Water seated
latrine (goose Trine)
This is not a pit latrine tesendiri but only modification closetnya
alone. In this latrine closetnya formed swan neck so that it will always be
filled with water. The function of this water use as a stopper so that the
stench does not smell all subjects latrine. (Entjang beautiful, 2000)
4.
Overview About Sanitation Housing
4.1 Definition of sanitary housing
Sanitary housing is a public health effort menitiberatkan and
supervision of a physical structure, in which people use as a shelter that
affect the health of humans. Sanitation facilities include ventilation,
temperature, humidity, pembuagan means garbage, human waste disposal facilities
and the provision of clean water (Anwar, 1990).
Housing sanitation focuses on controlling the various environmental
factors in ways that minimize the emergence of the disease can be avoided.
Means sanitation is an effort to control environmental factors in order to
prevent the onset of disease and infection which is caused by the environmental
factors, so that the optimal level of public health. (MOH, 2002)
4.2 Healthy Houing
Healthy housing is home resting place, shelter and keep property safe
and quiet. Therefore, the function has several homes must meet health
requirements and also does not conflict with existing regulations because the
house has a close relationship with its inhabitants. Where the house with poor
conditions would give a bad influence also to the inhabitants.
In general criteria for a healthy home is (MOH, 2002)
a. Meet
physiological needs, among others, the lighting, penghawaan and sufficient
space, avoid disturbing noise.
b. Meet the
psychological needs include adequate privacy, healthy communication between
family members and residents.
c. Meet the
requirements of the prevention of disease transmission among residents with
clean water supply, waste management and household tinjah, fektor free of
disease and rats, the density of occupants who are not excessive, enough
sunlight in the morning, sheltered from the contamination of food and
beverages, in addition to lighting and sufficient penghawaan .
d. Meet the
requirements of both the prevention of accidents arising from circumstances
outside and inside the home, among others, the requirements of the border road,
the construction of which is not easy to collapse, non-flammable, and do not
tend to make the occupants skids.
4.3 Overview About Diarrhea.
a. Definition of diarrhea
Diarrhea is the state of the frequency of bowel movements more than
four times in infants and more than three times in a child, watery stool
consistency, can be green or it can be mixed with blood or mucus mucus alone.
b. Etiology
The cause of diarrhea can be divided into several factors:
1) Factors infection
a. Enteral infection: infection of the digestive tract which is a
major cause of diarrhea in children. Covers enteral infection as follows:
b. Bacterial infection: vibrio, E. coli, Salmonella, Shigella,
Campylobacter, Yersinia, Aeromonas, and so on.
c. Virus infection: enterovirus (ECHO virus, Coxsackie, Poliomyelitis)
Adenovirus, Rotavirus, Astrovirus and others.
d. Parasitic infections: worms (Ascaris, Trichuris, Oxyuris,
Strongyloides): protozoa (Entamoeba histolytica, Giardia lamblia, Trichomonas
hominis). Fungi (Candida albicans).
2) Parenteral
infection infection outside the digestive tract of food such as: acute otitis
media
(AOM), tonsillitis / tonsilofaringitis, bronchopneumonia, encephalitis
and so on. This situation is mainly found in infants and children under 2 years
old.
c. Factors malabsorption
1) carbohydrate
malabsorption: disaccharides (lactose intolerance, maltose and sucrose);
monosaccharides (glucose intolerance, fructose, and galactose). In infants and
children are the most important and common (lactose intolerance).
2) fat
malabsorption
3) malabsorption of
protein
4) factors eat
Stale food, toxic,
allergic to food.
d. Psychological factors
Fear and anxiety (rarely, keep it just may occur in older children).
Pathophysiology
As a result of both
acute and chronic diarrhea will occur:
1) The loss of
water and electrolytes (dehydration) which resulted in acid-base balance
disorders (metabolic acidosis, hypokalemia).
2) Impaired
nutrient starvation (input less, spending increases).
3) Hypoglycemia
4) Impaired
circulation, Blood.
d) clinical
manifestations
At first the patient whiny,
insecure, body temperature usually increases, reduced appetite or no, then
arise diarrhea. Liquid stools, possibly accompanied by mucus or phlegm and
blood. The longer the stool color turns greenish-forage because it is mixed
with bile. The anal area sekitrnya blisters arise because often defeksi and
feces increasingly acidic as a result of the more lactic acid from lactose that
is not absorbed by the gut during diarrhea.
Vomiting may occur before or
after the diarrhea and can also be caused due to gastric inflammation or due to
interference wet acid and electrolyte balance. If the patient has a lot of
fluid and electrolyte loss, dehydration symptoms begin to appear: ie weight
loss, reduced turgor, eyes and large fontanel becomes concave (in infants), the
mucous membranes of the lips and mouth and the skin appears dry. Based on the
amount of fluid lost dehydration can be divided into mild, moderate, and
severe. When based on plasma tonicity divided into dehydration hypotonic,
isotonic, and hypertonic.
e. Management
The main medical management or
treatment directed at controlling the underlying disease. Certain drugs (eg,
prednisone) can reduce the severity of diarrhea and sickness. For diarrhea with mild dehydration, oral fluid
and electrolyte solution can be given to the patient dehydration. For moderate
dehydration due to diarrhea with sources of non-infectious, non-specific drugs
such as diphenoxylate (Lomotil) and loperamit (Imodium) are also given to
reduce motility. Antimicrobial preparations administered when infectious
preparations have been identified or if the diarrhea is very heavy (Ngastiyah,
2005). Intravenous fluid
therapy may be given to small children or the elderly. (Suddart & Brunner
2001)
4.4 Framework Concept Research
a. Concept Framework Research
Based on the literature that
the incidence of diarrhea purpose is affected by environmental sanitation is
composed of water supply, waste management, waste water pengelolahan and use of
latrines. We know that sanitation is an environmental monitoring physical,
biological, social, economic and human health effects, which are useful
environment improved and propagated while the adverse repaired or removed. The
expected result of good environmental sanitation, which depends on the
improvement of the quality of the environment by improving water sanitation,
provision of household toilets, waste water management and waste management.
The creation of good environmental sanitation will degrade or reduce the
incidence of diarrhea in the community. This is related to the utilization of
environmental sanitation, which had a positive impact in the lives and will
avoid the disease.
The overview of the
conceptual framework of this study can be seen in the following chart:
Figure 1. The mindset
of the study variables.
Specification:
Variables
examined
Variables that
are not investigated
b. Operational Definition and objective criteria
1) Diarrhea
The definition of diarrhea in this study was the occurrence of
consecutive stools more than three times a day along with a change in stool
consistency and shape of the patient in question becomes diluted.
Objective criteria:
Suffer: if
respondent diarrhea diagnosed by a doctor.
Not suffer: if not
diagnosed by a doctor diarrhea.
2) Water supply
The meaning of the
provision of clean water in this research is the availability of water used by
the respondent and family members in everyday life.
Objective criteria:
1. taps
a) Qualified health:
1. Do not polluted surface water
2. There is tasteless, odorless and colorless
3. Not eligible if not satisfy at least one of
the above criteria.
2. Dugwell
a) Qualified health:
1. The walls are plastered with a watertight well at least 4 feet
deep.
2. Having the lips with a minimum height of 70 cm from the soil
surface.
3. The
water is tasteless, odorless, and colorless.
4. Have a slap (floor) and there is
a sewer.
b) Not eligible if not satisfy at least one of
the above criteria.
3. Drill wells
a) Qualified health:
1. The depth of 12 m
to 40 m
2. In the coastal area of the drilling depth
of over 100 meters
3. The water is tasteless, odorless
and colorless
b) Not eligible if not satisfy at least one of
the above criteria.
c) waste management
What is mean maintenance trash in this study means for storing temporary
waste before disposal into landfills.
Objective criteria:
Qualify: if bins
are made of materials that are not easily damaged, have the cover and easy to
clean.
Did not fulfill the
requirement: if it does not fit the above criteria.
d) Waste water management
The definition of waste water treatment in this study was a waste
water drainage system, which is held in the form of channels and have waste
water collection coming from the bathroom, kitchen and laundry.
Objective criteria;
Qualify: if you have a hole and have the cover, has a channel and flow
smoothly, hole spacing waste water reservoir with drinking water source ≥ 10
meters.
Not eligible: if it does not fit the above
criteria.
e) Utilization of family latrines
The definition of family latrine utilization in this study is a family
used to dispose of feces.
Objective criteria;
Qualified: when having shelter and shaped pit hole with a cover or a
swan neck shape is used and cleaned at least twice a week.
Not eligible: if it does not fit the above
criteria.
4. Research Hypothesis
1) There is a water
supply relationship with the incidence of diarrhea in the working area Puskesmas Pati II.
2) There is a waste
management relationship with the incidence of diarrhea in the working area Puskesmas Pati II.
3) There wastewater
management relationship with the incidence of diarrhea in the working area Puskesmas Pati II.
4) There latrine
utilization relationship with the incidence of diarrhea in the working area Puskesmas Pati II.
CHAPTER III
RESEARCH METHODS
1. Design Research
This type of research is analytic
survey with cross sectional study approach is the independent variable and the
dependent variable is taken at the same time period to determine the
relationship of environmental sanitation with diarrhea in the area Puskesmas Pati II.
2. Place And Time Research
This research was conducted in Puskesmas Batua Makassar held in September - December 2014.
3. Population and Technique Samples
a. The population in this study
were all patients in the Village of New Tello checked himself in Puskesmas Pati
II in January to in May of 2014 as many as 407 people.
b. The sample is part of the population to be learned, so the samples
in this study were taken by purposive sampling that sampling is done for a
particular purpose. And the sample size is determined by the following formula.
The formula:
n = N
1 + N (d2)
Specification:
N : Total Population
n : Total Sample
d : Level Believeness/ Desired Accuracy
N = 407
d = 10% = (0,1)
Then :
n = 407 = 407 =
407
1
+ 407 (0,12) 1 + 4,07 5,07
n = 80
In this study will use the samples to the following criteria:
a) Inclusion Criteria
Is a general characteristic of the research subjects at a reasonable
target population and the population studied. In this study inclusion criteria
were:
1) Patients Diarrhea
controlled in Puskesmas Pati II
2) Can read and
write
3) Available as
respondent
b) The exclusion criteria
1) Not willing to
become respondents
2) Not able to read
and write
D. Data Collection Techniques
In this study, the research data collection as follows:
a. Primary data
The data in this study were obtained by means of interviews with
respondents using koesioner accompanied by observations with the use of a
checklist sheet.
b. Secondary Data
Secondary data in this study is that the data obtained from agencies
associated with this research.
E. Data Processing
1. Editing
The editing process is done after the data is collected and carried
out by checking the completeness of the data, check the continuity of data and
uniformity of data.
2. Coding
Done to facilitate the processing of the data, all the answers or the
data needs to be simplified that provide specific symbols for each answer
(encoding).
3. Tabulation of data
Done to facilitate the processing of data into a table according to
the properties owned in accordance with the purpose of research, the table is
easy to analyze the table it can be a simple table or cross table.
F. Data Analysis
Once the data is collected and tabulated in the table according to the
variables to be measured. Data analysis was done through the editing stage,
coding, tabulation and statistical tests. The statistical test used was
Univariate and Bivariate with and using computerized services (SPSS version
11.5).
1. Univariate Analysis
Conducted of each variable and the results of research in the form of
frequency and percentage distribution of each variable.
2. bivariate analysis
Conducted on two variables are allegedly associated with
cross-tabulation between all of the dependent variable and the independent
variables using Chi-Square with the formula:
Σ (0 - E) ²
× ² =
E
In which:
O = observation value (value
obtained)
E = expected value (expected
value)
α = 5% level of confidence
interpretation:
a. The hypothesis
is accepted, if X ² count> X ² table or
b. The hypothesis
is accepted, if the p-value <α (0.05)
G. Research Ethics
In conducting the study, researchers looked at the need for the
recommendations of the institution on the other side to apply for permission
from the institution where the research in this regard is the Puskesmas Pati II
After approval then
conduct research with attention to ethical issues of research include:
1. Informed consent (approval sheet)
This consent form will be given to the respondents who studied that
met the inclusion criteria and with the title of the research and the benefits
of research. When the subject
refused, the researcher will not impose the will and respecting the rights of
the subject.
2. anonimity (no name)
To maintain confidentiality researchers will not fasten the name of
the respondent, but the respondent is given a code.
3. Confidentiality (confidentiality)
Confidentiality of information is guaranteed by the researcher and the
respondent only the specific data that will be reported as a result of
research.
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