Effect of Health Education with N-SMSI (Ners-Short Message Service

Intervention) on Knowledge Tuberculosis Patient about Tuberculosis

Reni Asmara Ariga

,Siti Zahara Nasution

and Rina Amelia

Faculty of Nursing, Universitas Sumatera Utara, Prof. Maaf Streer No. 3 Kampus USU, Medan, Indonesia

Faculty of Medicine, Universitas Sumatera Utara, dr. Mansyur street No. 9 Kampus USU, Medan, Indonesia

Keywords: Health Education, N-SMSI, Tuberculosis

Abstract: Tuberculosis is a common problem in public health that affects one-third in the wold wide. The importance

of providing true and true information to the patient's knowledge of TB is important in providing patient

understanding of the illness to increase the quality and efficiency of the health care provided. Increased

knowledge is done by providing health education through telenursing known as N-SMI (Ners- Short

Message Service Intervention). N-SMSI is a form of intervention by community nurses sending SMS to

Pulmonary TB patients.

1 INTRODUCTION

Tuberculosis is a common problem in public health

that affects one-third in the wold wide. Tuberculosis

(TB) is the most common causes of mortality in

2015. A total of 10.4 million people are estimated to

have TB by 2015 with 5.9 million men (56%),

women as many as 3.5 million people (34%) and

children as many as one million people (10%).

Furthermore, WHO noted in 2015, 60% of all cases

were contributed by six countries, India followed by

Indonesia, China, Nigeria, Pakistan and South Africa

(WHO, 2016). In Indonesia, coverage of

tuberculosis cases between men and women was

298,128 cases in 2016, while in North Sumatera

province the coverage of tuberculosis cases between

men and women was 17,798 cases in 2016 which is

the fifth number of province in Indonesia (Ministry

of Health, 2017).

Currently, tuberculosis is a lung disease that

becomes a treatment priority for treatment. In

addition to the burden of disease that is too high and

the deteriorating physical condition experienced can

affect the patient's attitude toward his treatment

adherence (Ukwaja, Alobul dan Onyewe, 2013). The

patient becomes non-participating and refuses for his

treatment. The patient's negative attitude is due to a

lack of patient knowledge (Uchenna, Uchukwu,

Oshi, Nwafor dan Meka, 2014). The importance of

providing true and correct information to the

patient's knowledge of TB is important in providing

patient understanding of the illness to increase the

quality and efficiency of health care provided

(Ukwaja, Alobul and Onyewe, 2013)

One of the factors influencing treatment is the

knowledge of TB like understanding TB,

transmission, prevention, medication adherence,

stigma of patient TB (Tolossa, Medhin and Legesse,

2014). Some ways to increase one's knowledge of

one with health education. TB controls that have

been done by the government, among others through

health education. The results of the research were

conducted by Bisallah, Rampal, Lye, Sidik, Ibrahim,

Iliyasu and Onylio (2018) that health education is

influence in increasing the knowledge and attitudes

about TB in HIV patients at Minna Nigeria Hospital

(p = 0,000). Poor patient knowledge of the drug,

raises the patient's risk of disobedient run of therapy.

One way to improve nursing care and the range of

health services is to use nursing technology called

telenursing known as N-SMSI (Ners-Short Message

Service Intervention). N-SMSI is one form of

community nursing intervention, where community

nurses send SMS to Pulmonary TB patients. The

SMS contains a reminder message about TB Lung.

This research aims to improve the recovery rate of

pulmonary TB patients and reduce mortality by

increasing knowledge through N-SMSI (Ners-Short

Message Service Intervention).

356

Asmara Ariga, R., Nasution, S. and Amelia, R.

Effect of Health Education with N-SMSI (Ners-Short Message Service Intervention) on Knowledge Tuberculosis Patient about Tuberculosis.

DOI: 10.5220/0009902800002480

In Proceedings of the International Conference on Natural Resources and Sustainable Development (ICNRSD 2018), pages 356-360

ISBN: 978-989-758-543-2

2 METHOD

The Research is about the influence of health

education through Ners-Short Message Service

Intervention (N-SMSI) to the knowledge of

Pulmonary TB patients on pulmonary tuberculosis in

Medan using quasi-experiment method, population

of 72 people. Total sampling was used to get the

sample. The inclusion criteria in this study were the

new intensive phase intensive TB patients expressed

by the Johor Medan Community Center and the

Medan Amplas Community Health Center

(Puskesmas Medan Amplas), patients with

tuberculosis aged 21-60 years, patients with mobile

phones, were willing to be respondents.

This research was conducted for 2 months.

Starting from April to June 2018. The reason for the

study was to select the working area of Medan Johor

Health Center and Puskesmas Medan Amplas as a

research site because this location is a densely

populated location with TB patients and Puskesmas

have TB program. The questionnaire knowledge of

pulmonary TB patients used in this research with

CVI value (Content Validity Index) = 0.83.

Instruments have been tested reliability with

Cronbach's Alpha value = 0.9. The process of

collecting data is done by 1) the researcher fill out

the format of assessment of respondent

characteristics that include age, sex, occupation, and

education level, and patient's cellular contact number;

2) the researcher assessed TB patient's knowledge

about TB before N-SMSI (pre-test) on the first day;

3) Researchers conducted N-SMSI implementation

for 2 months by sending a short message containing

health education about pulmonary tuberculosis. SMS

is sent at 19300 WIB every Wednesday and

Saturday. This is because the time is a time of rest

(premiere time) and the most common time a person

uses a communication tool. SMS contains

information on TB information, such as TB

definition, TB transmission prevention, drug side

effects and coughing and sneezing ethics 4)

researchers reevaluate lung TB patients' knowledge

(post test) using a pulmonary tuberculosis patient's

TB questionnaire about pulmonary tuberculosis.

Analysis of this research data is processed by using

SPSS program.

3 RESULT

The result showed that demographic data, the

majority of age <40 years old were 43,1% (31),

66,7% (48) male majority, 54,2% (39) private

employees, the majority of private sector employees

occupy 54.2% (39), the majority of private

employment is 54.2% (39), the majority of private

employment is 54.2% (39), the majority live with

households with the wife as much as 48.6% (35), the

majority of home high humidity home conditions are

38.9% (28), the majority of high school education as

much as 62.5% (45), the majority of respondents had

contact with patients in contact with previous patients

as much as 54.2% (39). Description in table 1.

Table 1: Characteristic Of Patient Demographic

Demographhy Characteristics F %

Age

<40

31 43.1

40-60 yea

33 45.8

>60

8 11.1

Sex

Female 24 33.3

Male 48 66.7

Profession

Labor 7 9.7

Farmer 1 1.4

Civil Servant 6 8.3

employe 39 54.2

Deale

19 26.4

Families live at home

Main Family (father, mother,

chidren

)

13 18.1

Extended Family (father, mother,

children, the other famil

10 13.9

House condition

In front of hi

htwa

17 23.6

No window 27 37.5

Stuff

house 28 38.9

Education

Primary school 2 2.8

Junior Hi

h School 8 11.1

Secondary School 45 62.5

loma 10 13.9

Bachelo

7 9.7

History of contact with tuberculosis

atients

Yes 33 45.8

No 39 54.2

Culture

Bata

38 52,8

Jawa 26 36,1

Minan

8 11,1

Get TB Information

Yes 66 91,7

No 6 8,3

Total 72 100

TB Resource

Television 41 56,9

News paper/ magazine 4 5,6

Fli

Chart 22 32,8

Total 57 100

Effect of Health Education with N-SMSI (Ners-Short Message Service Intervention) on Knowledge Tuberculosis Patient about Tuberculosis

357

The results showed the knowledge characteristics of

TB patients before and after intervention, ie before

the action the majority of knowledge of the patient is

in the category of 51.4% enough. After the action,

the majority of the patient's knowledge is in the

good category of 68.1%. Description can be seen on

the graph below.

Figure 1: Knowledge of Tb patients before Health

Education through NSMSI

Figure 2: Knowledge of Tb patients after Health Education

through NSMSI

The result of statistical test by using Wilcoxon

Signed Test found that p = 0,000, there is influence

of health education through NSMI to TB patient's

knowledge about TB. Description in table 2

Table 2: Influence of Health Education through N-SMSI

to Patient Knowledge Tb Patient

Mean N

P-Value

Pre 5,57 72

0,000

Post 9,10 72

4 DISCUSSION

4.1 Knowledge of Tubeculosis Patient

before N-SMSI

Result of research based on knowledge characteristic

before NSMSI intervention got knowledge on

enough category 37 people counted 51,4% and less

24 people counted 33,3%. The several factors affect

the knowledge. One of which is information gained

previously. In this study the patient had obtained

previous TB information as much as 91.7%. The

study conducted by Tolossa, Medhin and Legesse

(2014) that 94.9% of patients have heard of previous

TB. Having had prior knowledge then will

understand and understand. If it has obtained

information repeatedly then the information will be

stored and when faced with the same information

then there will be a process of recalling the brain and

can have experience with previous information

(Notoatmodjo, 2012).

4.2 Knowledge of Tubeculosis Patient

after N-SMSI

Result of research based on knowledge characteristic

after NSMSI intervention got knowledge on good

category 49 people counted 68,1% and enough 22

person 30,6%. Such The several factors affect the

knowledge, one of which is the age of the

respondent. The result showed that majority of age

<40 years old was 45,8% (33). Age affect of

people’s ability and paradigm. Increased age will

also develop the capability to catch and the

paradigm so the knowledge gets better and the older

the more experienced, the more information

encountered and more and more things done so

increase his knowledge (Notoatmodjo, 2012). The

study conducted by Bisallah, Rampal, Lye, Sidik,

Ibrahim, Iliyasu and Onylio (2018) that the average

age of TB patients is 38 years old. Notoadmodjo

(2012) argues that a people who have the high

education will be the easier to accept or adjust to

new things, because education affects the learning

process. The results obtained that the majority of

high school education respondents as much as

ICNRSD 2018 - International Conference on Natural Resources and Sustainable Development

358

62.5% (45). The research conducted by Bisallah,

Rampal, Lye, Sidik, Ibrahim, Iliyasu and Onylio

(2018) that the average education level of 226

respondents is at the Secondary 84 level of 37.2%

(Tolossa, Medhin and Legesse, 2014).

4.3 Effect N-SMSI on Knowledge of

Tubeculosis Patient

Result used Wilcoxon Signed Test get that p = 0,000

that there is influence of health education through

NSMI to knowledge of patient TB about TB.

Knowledge was outcome knowing after people

make sense the object. Knowledge is a necessery

needed domain for actions (Notoatmodjo, 2012;

Mirowsky and Ross, 2017). The result of study by

Liu et al. (2015) that there is an increase in

knowledge after being educated either peer-led or

teacher-led in the prevention of tuberculosis in

schools in China. Knowledge enhancement is made

through telenursing based NSMI. Telenursing in

Asia can improve the quality of nursing care by

providing broad access to consultation and

improving client knowledge (Durrani and Khoja,

2015). One telenursing service has the form of

services such as assessment and intervention,

education, supportive care, dischanger follow up and

management of disease. In this study the researchers

conducted an education about tuberculosis disease

that includes the definition, causes, signs and

symptoms of disease transmission by using NSMSI

for 2 months. Application of NSMSI is very

effective. This is because the provision of care

services nursing care is not only limited to the health

center but the provision of care services can be done

at any time to discuss the complaint of disease

complaints. At the time of implementation NSMSI

respondents were very cooperative. When

researchers submitted health education materials

many enthusiastic respondents inquired and

discussed about their improved condition.

5 CONCLUSION

NSMS (Ners-Short Message Service Intervention) is

a maintenance management model. N-SMSI (Ners-

Short Message Service Intervention) can improve

the knowledge of Pulmonary TB patients about TB.

The action is so important that not only the patient

knows, but the patient becomes aware of the

conditions experienced and obedient to the

treatment that is run. Patient knowledge is very

important. This is because if the patient does not

know about the disease it will cause impact not only

for patients, especially for his family such as

transmission TB to people who contact with TB

patients. If this happens it will be difficult to break

the chain of TB transmission that occurs in the

community.

ACKNOWLEDGEMENTS

This research is financed by TALENTA USU of

2018 Year.

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