The Participation of Drinking Medicine Controller (PMO) in

Supporting Politeness of Curement TB Paru Patients at Deli Serdang

Regency

Tukiman

, , Surya Utama

and Abdul Jalil

Departement Health Education and Behavioral Sciences, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia

Departement Health Policy Administration, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia

3Departement Demography and Biostatistics, Faculty of Public Health, Universitas Sumatera Utara, Medan, Indonesia

Keywords: The PMO participation, TB Paru Curement.

Abstract: Indonesia has been at second position at TB cases of the world with incident and prevalences, mortality and

TB co/infection rather making worries. Although there have been some programmes but the cases were still

a lot, because the problems of TB were complex. The research at developing countries showed that peer

support was the main factor to sustain the community based programme. The research design with qualitative

approach to describe PMO participation to support the curation of TB patients until recovery. The amount of

informant were 12 persons from 3 research locations: Puskesmas Bandar Khalipah area Percut Sei Tuan

District, Puskesmas Dalu Sepuluh Tanjung Morawa District and Puskesmas Pancur Batu Pancur Batu District.

Data were collected with depth interview using guiding interview. The research of research showed that PMO

was so potential in giving support to patients at TB curation process as the suggestion of medical officer. The

knowledges of their occupation as PMO, their knowledge of TB and its side effect were less. Suggested PMO

was given education about TB and training matters about their job as PMO and understanding about TB and

its side effect of the curation process.

1 INTRODUCTION

Based on Research of Basic Health year 2013, TB has

covered all province in Indonesia. The prevalences of

Indonesia populations that infected Tuberchulosis

(TB) year 2013 was 0,4%

. At North Sumatera the

prevalences of TB were 110.666 with rate

794/100.000 peoples, TB incident was 68.828 with

rate 501/100.000 peoples and the death of TB was

5.714 with rate 41/100.000 peoples, Case Detection

Rate, all 22.961 (33.3%). The amount of MDR-TB

approximately 2% of TB (2620 cases) and 20% of TB

cases with re-curement (42 cases), totally 2662 cases.

The findings of TB cases at Deli Serdang Regency

from year 2012 showed the increase amount from

2012: 2448 cases, at year 2013: 2623 cases, year

2014: 2885 cases and year 2015 incerased to 2991

cases, and until fourth three months of year 2016:



2806 cases. While the new cases (Incidence Rate)

compared with all cases were rather high at year 2013

81%, year 2014 85%, year 2015 increased to 87,7%

and had decreased year 2016 to 77,7%. The high

score of Incident Rate (IR) was one of the caused why

Indonesia was still the top country of TB patients in

the world. The new cases of TB that has no curement

completely could infected to 10 or 15 persons. While,

to get some curements needed the politeness because

the patients have to face the long term of curement. It

needed the good understanding about TB,

facility,access to facilities and social supports.

DOTS

Programme was one of the strategy that was done by

The Ministry of Health in order to curement TB in

Indonesia. But, there were not all of healthy services

units especially the private units have been done

DOTS strategy. At Deli Serdang Regency, from 34

Puskesmas; all (100%) have been done DOTS

strategy, so did the government hospital (100%)

DOTS. The clinics that amount 213, only 27% have

been done DOTS strategy, Doctors with private



practical (DPM) 244 have not been done DOTS

strategy, Lapas 3 (67%) have been done DOTS

strategy.

The supply of medicines and health facilities

that could be reached of TB patients, must be

supported by some supporting from social

environment nearly the TB patients. With social

supports, could decreased the economic expenses.

736

Tukiman, ., Utama, S. and Jalil, A.

The Participation of Drinking Medicine Controller (PMO) in Supporting Politeness of Curement TB Paru Patients at Deli Serdang Regency.

DOI: 10.5220/0010087007360741

In Proceedings of the International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches (ICOSTEERR 2018) - Research in Industry 4.0, pages

736-741

ISBN: 978-989-758-449-7

The social supporting to TB patients could get from

family, teachers, parents and medical officer.

The research of Suharyo and Kismi Mubarokah

2015 about The Model of Developing Families at

Home as Peer Support to Decreasing the Numbers of

TB Paru Patients showed that the potention of Peer

Support was so big to support the curement process,

the existing of structure and infrastructure,

controlling meal time and gave strength motivation to

tuberchlosis patients. They all done the difficult

activities that the government health units could not

reached that. So, the choosing of PMO that have good

motivation and communication and have good

empathy for good health, especially to tuberchlosis

patients.

2 METHODS

The design of this research was descriptive study

with qualitative approach to get the PMO

participation of TB curement. This research was done

at Deli Serdang Regency, including the high score of

TB patients: Puskesmas Bandar Khalipah at Percut

Sei Tuan District and the vice of TB middle cases:

Puskesmas Dalu Sepuluh Tanjung Morawa District

and Puskesmas Pancur Batu at Pancur Batu District.

The Informan of this research was The Drinking

Medicine Controller (PMO), with some reasons that

they are the causes of curement successful of drinking

medicine process; and the curement sustainably until

recovered. They are the vey close family of TB

patients and participated of giving some motivations

to drink medicines sustainably minimal at 6 months.

The qualitatives data were collected by depth

interviews to PMO about PMO jobs, the knowledges

about TB, reminding patients to make sustainable

curement, the re-test of mucus, to push the patients

done curements completely, accompany patents to

puskesmas, facing constraints and the action against

side-effect of medicines. The qualitative data that

have been collected, made into transcript without

made conclusions and doing analysis of contents.

3 RESEARCH RESULT AND

DISCUSSIONS

3.1 Knowledge of Informan about the

Jobs as a PMO

The knowledge aspects in this research was about

the informan’s knowledge about the tasks of an PMO,

what kinds of the tasks or jobs that they must be done

to accompany TB patients to drink their medicines

and the information’s sources of that tasks. There was

the answere of the informan, when they asked about

the tasks of a PMO:

“Only reminding you to drink your medicine, Pak;

and to ask him to drink his medicines, don’t I?

“(informan 3)

“Hmm, according time, the job are to reming patients

drinking their medicines,prepare the tools and must

say please drink the medicines regularly” (informan

The information of a PMO more complete coming

from 3 (three) informans below:

“The doctor only giving some advices as making

mask at home and the distance between TB patients

and another family group approximately 2 meters to

avoid infections. The patient’s tools must be

seoarated from others. (informan 7) We are all called

there, all closed family of TB patient and giving some

advices. (7)

The medical staff of puskesmas said that, before

the medicines were empty, never stop drinking

medicine until 6 months (informan 9)

We come again the next day to puskesmas, to ask

for medicines. But our mother must has test of her

mucus to get her medicines. The medicines must be

drank regularly, not interrupted,and keep her

healthy. (informan6)

“The foods must be concerned” (informan 11)

The descriptions showed that an informan know his

jobs to remind the patients to drink their medicines

until recover and not to stop curement until 6 months,

and check

the mucus at laboratorium and keep

healthy. The opinions of informans were so important

for a PMO because at first month until second

months, the TB patients felt the body was well and no

needed to drink some medicines again, but the

bacteries in their body were not dead yet. When the

medicines stopped drinking, at several times the

bacteries of TB were active again. When it was

happened, the patients could not be cured by regular

TB medicines TB category 1 (TB sensitive), but must

be cured by TB Resisten Obat (RO). The TB RO

The Participation of Drinking Medicine Controller (PMO) in Supporting Politeness of Curement TB Paru Patients at Deli Serdang Regency

737

medicines of curement must more long term 18-24

months, the medicines were more with more side

effects too and injected of 6 months one week 5 days,

and the cost of curement was increased. Although

until now the curement of TB RO still has the

subsidiary from government coming from the foreign

institutions. When the donation would be stopped, the

expenses of government in health effort would be

harder and heavier. The result showed that the

informan knowed their jobs as PMO to remind

patients wearing mask at home. This information

came from doctors. But, in case that DOTS system

has no masker preparation,so the doctor’s advice

could not be done. The way to avoid infections only

keep the distance with patient. This way could be

done if the patient’s house was not full, but if the

house was full,the way was impossible to be done.

While the other informan said that the PMO must

suggested to give the nutritious foods to make the

more quick recovery. A problem that needing care

was still PMO getting confused and not knowing

about their jobs as follows:

“I don’t know about PMO” (informan 5).

But if it was connected with Hapsari (2010), some

PMO jobs were not done yet; the tasks of PMO for

TB patients are: (a) Ready to give some advices at

clinic (b) Doing some controls at drinking medicines’

case (c.) Reminding patients to re-test thei mucus (d)

Giving support to the patients to have regular

curement until recover (e) Identifying low side-

effects of medicines, and give some advices to

patients of driking medicines (f) Recommending

patients to see the doctor if the side-effect harder; and

(g) Doing some visits to the patient’s house.

3.2 The Informan Knowledge about TB

Disease

The informan knowledge about TB disease, started

from TB disease, TB causes, the symptoms of TB, the

curement and term of curement and its prevention.

The answers of informan:

“I don’t know, but it takes 6 months to drink

medicines until recover. The symptoms are coughs

constantly….that’s all” (informan 4)

“The symptoms were coughs. Then drinking

medicine for 6 months, our father was TB patient, so

we separated our dning tools.” (informan 11)

“The causes of TB was Diabetes Melitus (DM),

our mother was a DM patient. Since that time, she got

TB paru disease(informan6) “because of the dirt air

and drinking ice (informan 12)

The understanding of informan about TB was still

unright. There were some informans knowing about

the causes of TB was DM, but it was wrong. The DM

patients have more risk to get TB disease, but the DM

was not the causes of TB. The informan knowledge

about the causes of TB was an important concept that

must be known because this knowledge would

affected to control TB patient and affected them to

make regular curement and avoid infection to peoples

around them. Related with the TB infection through

the air (the TB patient’s mucus). When the TB patient

coughs or spoiled, they sprayed some bacteries to the

air.The bacteries still in the infected air until some

hours and some days until the wind blowed it. The

infection happened if someone inhaled the infected

droplet contains of TBC bacteries and come to the

alveoli.(Kemenkes, 2012). According to Widoyono

the main symptoms of TB disease are cough with 2-3

weeks or more, with additional symptoms were cough

with mucus, mucus with bloods, bloods cough, hard

to breath, cheast pain, weaks, loss weight, relieving

more than a month. (Widoyono, 2008). So did the TB

infection through the air (from mucus of TBC

patients). When the TB patients coughing, spoiingl or

even talking, they sprayed amounts of TBC bacteries

to the air. The infections droplet could stay some

hours to some days until they flow by the wind. The

infection happened if someone inhaled the infected

droplet and get into the alveoli (Kemenkes, 2012).

3.3 The Informan Knowledge about the

Side Effect of TB Medicine

The knowledge aspect that would be showed in this

research was about the informan knowledge of TB



medicines side-effect that would be happened start

from low side-effect, middle side-effect until hard

side-effect. The informan answered:

“I don’t know, but our father said that he want to

spoil, and his stomach was hot when he take some

medicines, he was getting headache and felt sleepy all

day” (informan 3)

“So, the medical officer never told it to grandma

or mother, but we think never. First, we did not

suspicious. Our grandmother’s urine was red too.

There was one of the side-effect.” (informan 7)

Based on this research, some informans only

knew a little about the side-effect of TB medicines,

with observed the side-effect of TB medicines. The

research result as followed:

“never knew, never heard that.” (informan 1)

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

738

“I don’t know, but I know that he always

coughing at home” (informan 2)

The informan unknowing about the side-effect of

TB medicines caused the patients did not care about

the symptoms after drinking medicines.

3.4 The Informan Actions to Remind

Patients of Regular Curement

Some actions in this research were: the actions of

informan to remind TB patients take regular curement

and regularly drinking medicines; as followed:

“We always keep telling her, “mom, please drink

the medicines regularly until recover. If interrupted,

you must rewind it from the first time”. “Our mother

do not want like our father that has TB disease and

infected our mother.” (informan 6)

“Every morning, we remind him to drink his

medicines. Sometimes, I take the medicines and gave

it to him.” (nforman 5).

All informan said that they alwas reminding all

TB patients to drink medicines and cured regularly,

according to suggestion of medical officer. Some of

medicines drink at morning time, some at night.

Several patients rather difficult to drink it because the

medicines were big and bitter. But,the informan

always have some tricks to pursue them. So, they

could be recoverd from TB disease.

3.5 The Informan Actions of

Reminding Mucus Re-check

The informan actions of reminding patients to re-

check their mucus to puskesmas getting as followed:

“Just say “Mom, tomorrow we will check your

mucus, the medical staff has told that when I take your

medicines”. I told herwhen I come from Puskesmas”

(informan 6)

“When taking medicines, the medical office told

that it was the time to check the mucus, and then

would see the schedule.” (informan 11)

This research showed that generally some

informan reminding the TB patients to re-check the

mucus after told by medical officer at puskesmas.

Then the PMO dedication to TB patients are: 1) to

insure the sustainability of curement 2) to avoid the

patients from interrupted of drinking medicines and

3) to decrease probability of medicines immune.

3.6 The Informan Actions of

Information to Accompany Patients

to Puskesmas

The informan actions to accompany TB patients

to Puskesmas for curement and getting medicines or

re-check their mucus, the answers a followed:

“I accompanied him to go for curement and all

kind of curement actions at Puskesmas” (informan 3)

“Taking some medicines and giving the mucus to

Puskesmas. Grandmother was old, so I take her

medicines and told to grandmother what the medical

officer said and command. Grandma was more obey

with the medical officer command than me.”

(informan 7)

“I accompanied him when curement and getting

his medicines.” (informan 11)

The speech showed that some informans were

participated to TB patient’s recory. They accompany

patients to cuement process, taking their medicines,

re-check of their mucus. The participation of PMO:

Make sue that patients drinking medicines suitable

with the rules until recover, accompany patients when

visit to puskesmas, giving moral support to the

patients, reinding patients to get regular and complete

curement, identifying some side-effect symptoms of

medicines and calling the medical services unit,

giving some advices to the patients and their family

about TB disease. (Novita,2015).

But, there are some informans didn’t accompany

TB patients of their curement to puskesmas, some

answers are: “He take his medicines by himself, I keep

our store. He can do it by himself” (informan 4)

“No,I did not accompany him because he went to

puskesmas before go to work. I keep his children a

home.”” (informan 1)

Based on the answers, the conclusions are, some

informans not spending their time fully to accompany

TB patients to see the doctor or to go to puskesmas

because of their own business, just like working,

trading,etc. Athough, the patients could get the

medicines by theirselves to get them.

3.7 The Informan Actions of

Information to Push the Patients

Curement until Recovery

The action of informan to push the patients

curement until recovered and the way to give some

motivations to TB patients for drinking some

The Participation of Drinking Medicine Controller (PMO) in Supporting Politeness of Curement TB Paru Patients at Deli Serdang Regency

739

medicines regularly to TB patients, and some

constraints.

The answers are:

“We said that if you want to recover, please

regularly drinking medicines and not being

interrupted. If interrupted, you must be re-drink from

first time. We always give some motivantions and

always reminding her to drink her medicines. After

she drinks medicinies, she feels her body well and her

cough constantly become missing and no blood again

in her mucus.” (informan 7)

“We always keep him to getting spirit and

motivation. My father really want to recover so it was

not so difficult to remind him of drinking medicines.”

(informan 9)

“I said that he don’t some again, not going out at

night and the medicines must drink regularly until

recover.”(informan 1)

All informans had given motivations to TB

patients to drink their medicines until recover.

3.8 The PMO Constraints of Doing

Their Jobs

The PMO constraints of doing thei jobs, are:

“He was stubborn and so introvert. It made me so

hopeless.” (informan 1)

“Our mother could not drink the medicines

because they are so big in size” (informan 6)

Based on the answers of informan, some of TB

patients not obey to drink medicines because they

were so big in size. But as PMO officers, always have

the way to solve it. They alwas controlling the

patients to drink their medicines, taking their

medicines, drinkingmedicines while eating bananas,

and some other ways.

But, some TB patients slowly and friendly in

drinking medicines so the PMO officer jobs were

lighter, as follows:

“Nothing, he always cooperated to drink

medicines” (informan 2)

“No constraint, always want to drink medicines.”

(informan 4)

“There was no difficult to drink medicines.”

(informan 5)

Not all of TB patients was difficult to drink

medicines and make curement. Some of them always

want to drink medicines and regularly has curement.

3.9 The Informan Action to Hard

Side-effect of TB Patients

Medicines

The informan actions to had side-effects of TB

patients medicines and who will response of it. The

answers are:

“First, my father did not tell us about his pain, but

during some times, the sick was decrease and

disappeared slowly” (informan 10)

“If he could not resisted his sickness, we

accompany him to puskesmas, our family have

participated to keep himself”(informan 5).

According to the answers, all informana gave

almost the same, if side-effect happened, they will re-

curement and the family have participated to the

patients curement. All informan did not know about

the side-effect of TB medicines. The ideal situation,

PMO must knew it, so the curement would be run

well. The family had been participated as PMO well.

They helped to made the patients obey to drink their

medicines.All TB patients were controlled by their

family in drinking their medicines and helping them

to recover. The Patients that have good PMO have

probability to have regularly curement 5,23 times

bigger than the patients that have bad PMO. It was

significant. PMO is related with regular treatment of

TB patients with DOTS strategy. (Juwita R.H, 2009).

If we see the participation and potention of PMO

based on this research findings showed that PMO was

vey potential to TB patients recovery at Deli Serdang

Regency. All PMO were nucleus family or close

family,and they all really want the patients recover.

Some supports are relted to drinking medicins

regularly and check the mucus regularly. But there are

still some PMO did not have enough knoeledge about

TB, so they could not support the patients completely

and unsustain. Needed some training to PMO,

especially dropping information about TB deeply of

causes, symptoms, curement, curement terms, side-

effect of medicines and curement process and avoid

infections. With the high obey, it could be easier to

cure TB disease and could decrease the number of IR

TB at Deli Serdang Regency.

ACKNOWLEDGEMENTS

Thanks to Public Devotion and Research Directorate

Research Empowerment General Directorate and

Research Development Ministry, Technology and

Higher Education as the foundation of this research

through DRPM Kemenristekdikti with the scheme of

ICOSTEERR 2018 - International Conference of Science, Technology, Engineering, Environmental and Ramiﬁcation Researches

740

Superior Basic Research Higher Education Fiscal

Year 2018 Number 1341/UN5.2.3.1/PPM/2018.

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