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172 Jurnal Dunia Kesmas Volume 8. Nomor 3.Juli 2019

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172 Jurnal Dunia Kesmas Volume 8. Nomor 3.Juli 2019 STRATEGI MENGATASI KENDALA BERHENTI MEROKOK PADA KLIEN DI PUSKESMAS RAMAN UTARA KABUPATEN LAMPUNG TIMUR Oritasari1, Samino2, Vera Yulyani2 Email: [email protected] ABSTRAK Proporsi penduduk usia > 15 tahun yang merokok setiap hari di Provinsi Lampung adalah 22,0% dan kadang-kadang merokok adalah 3,8%. Proporsi merokok tertinggi di Kabupaten Tanggamus (53,1%), sedangkan di Kabupaten Lampung Timur sebesar 16,2% masih dibawah rata-rata Provinsi Lampung. Menurut WHO (2008), 70% perokok memiliki keinginan untuk berhenti merokok, sebagian besar hanya berdasarkan komitmen sendiri tanpa bantuan pihak lain sehingga kemungkinan berhasil berhenti hanya 3 – 5% saja, oleh karena itu penulis tertarik untuk meneliti bagaimana strategi mengatasi kendala berhenti merokok. Tujuan penelitian adalah untuk mengetahui Strategi Mengatasi Kendala Berhenti Merokok Pada Klien Di Puskesmas Raman Utara Kab. Lampung Timur Tahun2018.Jenis penelitian kulitatif positivisme dengan pendekatan studi kasus. Informan kunci adalah pengelola program PTM puskesmas dan informan adalah klien yang sudah berhasil berhenti merokok dan yang belum berhasil berhenti merokok termasuk keluarganya. Teknik pengambilan sampel dengan snowball sampling. Jumlah informan sebanyak 17 orang. Analisis menggunakan model Miles andHuberman.Hasil penelitian diketahui bahwa strategi klien dalam mengatasi adiksi nikotin dengan mengurangi jumlah rokok perharinya, menunda waktu merokok saat pagi hari, melaksanakan aktifitas fisik. Strategi klien dalam menangani efek putus nikotin sulit konsentrasi adalah dengan menyarankan untuk beristirahat sejenak dariaktifitasnya, mengkonsumsi makanan sehat seperti buah dan sayuran segar, strategi meningkatkan motivasi berhenti merokok harus ada keinginan yang kuat untuk berhenti merokok disamping itu perlu dukungan dari keluarga, teman dan petugas kesehatan untuk meningkatkan keberhasilan berhenti merokok. Kata Kunci : Strategi, Kendala berhenti merokok, Klien ABSTRACT The proportion of people aged > 15 years old who smoke every day in Lampung province is 22.0% and sometimes smoking is 3.8%. The highest proportion of smoking in Tanggamus Regency as much (53.1%), while in East Lampung Regency as much 16.2% is under average of Lampung Province. Based on WHO (2008), 70% of smoker had the willingness to quit smoking, most of them based on their individual commitment without other‟s help, so the probability to success in quitting smoking was only 3-5% only, therefore the researcher was interested in researching how the strategy to overcome the obstacles to quit smoking. This research purpose was to know The Strategy to Overcome the Obstacles to Quit Smoking on Clients in Raman Utara Health Centre of East Lampung Year of2018.Positivism qualitative research type with case study approach. Key informant was Health Centre PTM program manager and the informant was client who succeeded to quit smoking and those who did not succeed to quit smoking including their families. Sample collecting technique was with snowball sampling. The total of informant as many 17 people. The analysis used Miles and Huberman model.The research result was known that the client strategy in overcoming nicotine addiction was by reducing the number of cigarettes per day, putting off the smoking time in the morning, doing the physical activity. The client strategy in overcoming the effect of nicotine giving up of difficult to concentrate was by suggesting to take a rest for a while from the activity, consuming the healthy food such as: fresh fruits and vegetables, the strategy of improving the 1. Puskesmas Pekalongan LampungTimur 2. Fakultas Kesehatan Masyarakat Universitas Malahayati 172 Jurnal Dunia Kesmas Volume 8. Nomor 3.Juli 2019 motivation of quit smoking should be followed by strong desire to quit smoking besides that, they need to be supported by family, friends and health staffs to improve the success of quitting smoking. Keywords: Strategy, the obstacles of quitting smoking,client PENDAHULUAN (2008) dalam Kemenkes RI (2016), 70% Prevalensi perokok Indonesia perokok memiliki keinginan untuk menduduki peringkat ketiga (4,8%) berhenti merokok, sebagian besar hanya setelah Cina (35%) dan India (11,2%). berda sarkan komitmen sendiri tanpa Data dari Global Adult Tobacco Survey bantuan pihak lain sehingga (GATS) 2011, menunjukkan bahwa kemungkinan berhasil berhenti hanya 3 prevalensi perokok sebesar 36,1%, – 5% saja. Kendala utama berhenti sedangkan Riskesdas 2010 menunjukkan merokok dikelompokkan dalam 3 faktor bahwa rata-rata jumlah rokok yang utama yaitu biologis/fisiologis (adiksi dikonsumsi adalah 10 batang per hari nikotin, efek putus nikotin), pada laki-laki dan 6 batang per hari psikologis/perilaku dan lingkungan sosial padaperempuan. (dukungan keluarga). Perilaku merokok telah Proporsi penduduk usia > 15 mempredisposisikan terjadi peningkatan tahun yang merokok setiap hari di kematian akibat penyakit tidak menular Provinsi Lampung adalah 22,0% dan yaitu 41,7% pada tahun 1995 menjadi kadang-kadang merokok adalah 3,8%. 49,9% pada tahun 2001 dan 59,5% Proporsi merokok tertinggi di Kabupaten pada tahun 2007 dan tahun 2012 Tanggamus (53,1%) Kabupaten mencapai 61%, dan 21% dari jumlah Lampung Barat sebesar 36,0% dan kematian tersebut disebabkan akibat terendah di Kabupaten Lampung Selatan penyakit terkait rokok, yakni jantung (6,3%), sedangkan di Kabupaten koroner, stroke, kanker, dan penyakit Lampung Timur sebesar 16,2% masih paru obstruktif kronis (Achadi et al., dibawah rata-rata Provinsi Lampung. 2005). Pendapat tersebut kemudian Jumlah puskesmas di Provinsi Lampung dikuatkan oleh penelitian yang dilakukan yang sudah melaksanakan layanan UBM oleh Sajinadiyasa et al. (2010) yang baru berjumlah 31 dari 304 puskesmas menyebutkan penyakit tidak menular yang ada (10,19%). Jumlah tersebut yang berhubungan dengan rokok adalah tersebar di 15 kabupaten/kota dengan kanker, penyakit kardiovaskuler dan jumlah per kabupaten/kota antara 1 – 3 penyakit paru seperti bronkitis, puskesmas. Kabupaten/kota dengan empisema/PPOK dan pneumonia. jumlah puskesmas layanan UBM Berhenti merokok bukan hal mudah, terbanyak adalah Kabupaten Lampung karena efek adiksi nikotin. Reseptor Timur dan Kota Bandar Lampung (Dinas opioid otak memegang peranan penting Kesehatan Provinsi Lampung, dalam reward system untuk berhenti 2017)Kabupaten Lampung Timur telah merokok. memilki tiga Puskesmas dengan layanan Menurut Cary Lerman, Tobacco UBM, yaitu Puskesmas Raman Utara, Use Reserach Center, menyatakan Puskesmas Purbolinggo dan tahun 2017 bahwa kemampuan seseorang untuk puskesmas pada tahun 2017 yaitu di berhenti merokok dipengaruhi oleh Puskesmas Raman Utara dengan 16,5% faktor adiksi nikotin, efek putus nikotin, disusul dengan Puskes mas Purbolinggo psikologi dan perilaku, serta lingkungan dengan tingkat keberhasilan klien sosial. Berhenti merokok bisa berhenti merokok sebesar 10,5% dan menyebabkan gejala putus nikotin terakhir Puskesmas Mataram baru (withdrawal Syndrome) berupa dengan tingkat keberhasilan 6% karena perubahan emosi. Beberapa perokok baru terbentuk di bulan Agustus2017. bisa melaluinya, sedangkan sebagian Berdasarkan Laporan Kegiatan terpaksa berhenti merokok karena tidak UBM Puskesmas Raman Utara selama menemukan pengganti kenikmatan lain. Bulan Januari – Oktober 2017 terdapat (Kemenkes RI, 2016)Menurut WHO 127 klien yang mengikuti konseling UBM, Jurnal Dunia Kesmas Volume 8. Nomor 3. Juli 2019 173 dari 127 klien tersebut 29,1% (37 klien) kesibukan dengan berolahraga dipagi kambuh, 54,3% (69 klien) gagal dan hari, ...” (A1) hanya 16,5% (21 klien) sukses berhenti Bagi yang tidak berhasil berhenti merokok. merokok sudah berupaya meningkatkan Sampai saat ini layanan UBM di keinginan berhenti merokok dengan cara Puskesmas Raman Utara merupakan makan permen, makanan ringan, cari puskesmas terbaik dalam layanan UBM kesibukan ke sawah, beresin rumah, di Kabupaten Lampung Timur, untuk itu tetapi klien akhirnya tetap tidak dapat penulis tertarik untuk meneliti menahan keinginan merokoknya. Klien bagaimanakah strategi mengatasi yang tidak berhasil berhenti merokok kendala berhenti merokok pada klien di cara meningkatkan motivasi dalam diri Puskesmas Raman Utara Kabupaten sendiri yaitu dengan makan makanan LampungTimur. ringan, mencari kesibukan, makan permen, seperti yang diungkapkanoleh: METODE “ ...Tidak merokok ya yaitu paling yaitu Penelitian ini merupakan lari ke makanan kecil makanan penelitian kualitatif dengan pendekatan ringan,permen,dan cari kesibukan ke studi kasus dan penentuan informan sawah,beresin rumah,,,tapi cuma dengan snowball sampling, informan bertahan berapa minggu aja kunci adalah pengelola program PTM bu,,selanjutnya ya ngerokok lagi...(A7) puskesmas sedangkan informan inti ada klien yang sudah berhasil berhenti Strategi penanganan Efek Pustus merokok dan klien yang belum berhasil nikotin padaklien. berhenti merokok, disamping itu setiap Berdasarkan hasil wawancara informan inti diambil masing-masing pada klien yang berhasil berhenti satu orang dari keluarga untuk melihat merokok cara mengatasi reaksi psikis dukungan keluarga. Teknik seperti rasa cemas, mudah tersinggung, pengumpulan data menggunakan sulit konsentrasi, gangguan tidur adalah wawancara semi terstruktur dengan cara membaca buku, baca baca, (Semistructure Interview). Analisis data makan cemilan, tarik nafas panjang, menggunakan model Miles and minum air mineral berikut kutipan Huberman dimana dilakukan pada saat wawancaranya: pengumpulan data berlangsung, dan “ ...ada bu,gelisah gitu bu,,Saya cari setelah selesai
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