NURSING ROLE IN SUPPORTING THE DEVELOPMENT OF COMMUNITY BASED ON HEALTH TOURISM IN BALI Peran Keperawatan dalam Menunjang Pembangunan Masyarakat Berbasis Kesehatan Pariwisata di Bali Kadek Eka Swedarma, Luh Putu Eva Yanti, Ni Made Dian Sulistiowati Universitas Udayana Email:
[email protected] ABSTRAK Pendahuluan. Peran perawat dalam memberikan pelayanan keperawatan kepada wisatawan belum terlihat nyata. Penelitian ini bertujuan untuk mengidentifikasi peran perawat dalam memberikan pelayanan kesehatan pariwisata, serta memahami tentang faktor-faktor yang berhubungan dengan kemampuan perawat dalam memberikan pelayanan keperawatan baik kepada wisatawan, pelaku wisata maupun masyarakat sebagai tujuan wisata. Metode. Penelitian ini merupakan penelitian cross sectional study. Pengambilan data dilaksanakan pada 4 Puskesmas wilayah tempat wisata baik di Gianyar, Denpasar, Badung dan Bangli terhadap 32 perawat yang bertugas di Puskesmas dengan teknik purposive sampling. Hasil. Hasil penelitian menunjukkan bahwa dari 32 responden perawat di Puskesmas sebanyak 40% perawat melaksanakan tugas sebagai pemberi pelayanan keperawatan, 30% peran sebagai pendidik masyarakat 20% sebagai advokat serta 10% sebagai konselor. Sebanyak 60% kemampuan perawat sudah baik 25% cukup dan 15% kemampuan perawat masih kurang. Terdapat hubungan yang bermakna antara umur (p: 0,002, OR: 2 2), pendidikan (p: 0,001, OR: 2,3), serta kemampuan bahasa asing (p: 0,000, OR: 3,4), dengan kemampuan perawat dalam memberikan pelayanan keperawatan baik kepada wisatawan, pelaku wisata maupun masyarakat. Diskusi. Kemampuan berbahasa asing yang kurang berpotensi 3 kali menyebabkan pelayanan keperawatan yang diberikan juga kurang. Kondisi ini perlu mendapatkan perhatian baik dari dinas kesehatan, dinas pariwisata maupun pihak terkait lainnya membekali perawat dengan pendidikan serta pelatihan yang memadai mengenai perkembangan terkini tentang kesehatan wisata serta kemampuan berbahasa asing. Kata kunci: Peran Keperawatan, Kesehatan Pariwisata ABSTRACT Introduction. The role of nurses in providing nursing services to tourists is not visible. This study aimed to identify the role of nurses and the factors associated with the ability of nurses in providing nursing services both to tourists, tourism players and the community. Methods. This was a cross-sectional study from 4 health centers in the tourist region of Gianyar, Denpasar, Badung and Bangli to 32 nurses at the health center with purposive sampling technique. Results. The results showed from 32 respondent nurses at the health center as much as 40% nursing care provider, 30% community educators, advocates 20% and 10% as a counselor. 60% nurses have good ability 25% adequate and 15% of nurses ability was still lacking. There was a significant relationship between age (p: 0.002, OR: 2.2), education (p: 0.001, OR: 2.3), foreign language skills (p: 0.000, OR: 3.4), with the ability of nurses in providing nursing services both to tourists, tourism players and the community. Discussion. Foreign language skills are less potentially 3 times causing nursing services provided are also lacking. This condition should get better attention from the health department, the department of tourism and other related parties equip nurses with the appropriate education and training on health tourism and foreign language skills. Keywords: Role of Nursing, Health Tourism
be painful in certain periods (Stanhope & Lancaster 2010). Various risks of health problems can occur both on tourists and tourism stakeholders such as the incidence of diarrhea (30-60%), respiratory disorders (26%), skin disorders (8%), accidents (5%). Meanwhile, according to data from 10 cases of traveler who were treated at Sanglah Hospital in 2009 that fractures (34%), malignancy (21%), observation febrile
INTRODUCTION Increased tourist arrivals in Bali causes people as a group at risk are prone to health problems. This can occur through the presence of tourists who come the possibility of bringing a disease or otherwise perpetrator of tourism (tourist worker) or community transmit the disease to tourists. While the population at risk is the population that is likely to experience a disease or condition that will grow to 15
Jurnal INJEC Vol. 1 No. 1 Juni 2016: 15–18 to tourists, tourism players and the community a tourist destination. Samples of this study were 32 nurses on duty at the health center tourist area which includes: 6 nurses at the health center of Ubud I in monkey forest, 3 nurses at health centers of Sukawati I in Sukawati art market, 5 nurses at healht centre of Bangli I in Penglipuran village tour, 6 nurses at health centre of Kintamani I in Kintamani, 6 nurses in health centre of Kuta I in Kuta Beach, and 6 nurses health centre South Denpasar II at Sanur with purposive sampling technique. Data were obtained through a questionnaire consisting of 16 questions with the reliability test results obtained Cronbach’s alpha coefficient for this instrument was 0.86 (r = 0622–0855). The demographic data includes: age, education, gender, ability to speak English. While other variables: the role of nurses and nurse’s ability to provide nursing services both to tourists, tourism stakeholders and the public in the areas visited.
(14%), DHF (8%), Cardiovascular (7%), Gastroenterisis (6%), Stroke (4%), alcohol intoxication (3%), snakebite (2%) and malaria (2%). In addition to tourists of various cases also occur in communities where tourist destinations such as respiratory diseases, diarrhea, and impaired psychosocial (Parwati 2011). The Ministry of Health has sought to disseminate related to prevention and preparation prior to the visit to the country of destination or arrival of tourists through travel health programs with reference to the WHO International Health Regulations program year 2005 (WHO 2010). Efforts to improve the health of the tour would require the role of all aspects of health services in fields such as medicine, nursing, nutrition, health, environment and public health. Based on the interview to the nurse at the health center of Ubud Gianyar working area of the object as well as a nurse at the health center Kuta working area of water attractions, of the 10 people interviewed 80% said it had not understood about the role or duties of nurses in health tourism, as well as not knowing the dominant factors related the ability of nurses in providing nursing services both to tourists, tourism players and the community as a tourist destination so as to support the development of health tourism in Bali. This study aimed to identify the role of nurses in delivering health care tourism, as well as the understanding of the factors associated with the ability of nurses in providing nursing services both to tourists, tourism players and the community as a tourist destination.
RESULT Based on the table 1 can be explained that the majority of respondents to the Nursing Diploma education level (65%), mostly aged 25–35 years (65%) and female (81.25%). While most of the foreign language skills of the respondents said that they still less (59,38%), nurses as health care providers most large amount compared with other role (40%), while most of the ability of nurses in providing nursing services to travelers, as well as tourism players most of the people with both categories (60%). Results table 2 shows that both men and women largely have the ability to provide good nursing care, there is no meaningful relationship. Most of the educational level of both DIII of nursing and Ners have good ability as well, statistically education DIII potential nursing service has 2.3 times less compared with the nurses education (p value: 0.001). The age of 36–45 years were 2.2 times less potentially have the capability compared with the age of 25–35 years (p value : 0.002). Meanwhile, foreign language skills are lacking,
METHODS This study was a cross sectional study. The collection of quantitative data was done by distributing questionnaires to nurse at the health center to determine the role of the nurse related to health care to tourists, tourism players and the community a tourist destination of the aspects of promotive, preventive, curative and rehabilitative services as well as the dominant factor associated with the ability of nurses in providing health services 16
Nursing Role in Supporting the Development (Kadek Eka Swedarma, dkk.) Table 1. Characteristics of nurses (n = 32) Variable characteristics Level of education Diploma III of nurses Bachelor of nurses /Ners Age 25–35 th 36–45 th Sex male female Foreign language skills Good Less The roles of nurses Care provider Educator Advocat Conselor Nursing ability Good Enough Less Total
N 21 11 21 11 6 26 13 19 12 9 7 4 20 7 5 32
% 65 35 65 35 8.75 81.25 40.62 59.38 40 30 20 10 60 25 15 100
Table 2. Factors related to the ability of nurses (n=32) Variabel Sociodemography/nurse ability Sex Male Female Total Education DIII of Nurse Ners Total Age 25–35 36–45 Total Foreign language skill Good Less Total
Good n (%)
Less n (%)
Ods Ratio (OR)
(95% CI)
P Value 0.617
4 (80.00) 23 (88.46) 27 (84.37)
2 (20.00) 3 (11.54) 5 (15.63)
17 (80.95) 10 (90.90) 27 (84.37)
4 (19.05) 1 (9.10) 5 (15,63)
18 (85.71) 9 (81.81) 27 (84.37)
3 (14.29) 2 (18.19) 5 (15.63)
12 (92.30) 15 (78.94) 27 (84.37)
1 (7.70) 4 (21.06) 5 (15.63)
Ref. 2,35
(1.223-11.388)
0.001*
Ref. 2,24
(0.739-1.471)
0.002*
Ref. 3,46
(3.415-12.497)
0.000*
of nursing services both to tourists, tourism actors (guide) and the community. Neither the psychomotor abilities include physical skills of nurses in doing or getting things done. Age more productive in influences on the provisions of nursing services. These conditions have a nurse on a lot of energy and motivation in conducting nursing services. Nurses quite well in providing health education, especially at the community as a travel destination so that the community empowerment process will be
3.4 times potentially have the capability of nursing care less as well (p value: 0.000). DISCUSSION On the results of this study, it was found that from the perspective of education, cognitive ability to understand the nurse refers to the knowledge, understanding, analysis, synthesis and evaluation. The cognitive aspect is itself predominantly of how nurses master 17
Jurnal INJEC Vol. 1 No. 1 Juni 2016: 15–18 protection and health promotion for tourists as well. Meanwhile foreign language skills are absolutely controlled by the nurse on duty, especially in the areas of tourism. In fact most of the nurses who served in the tourist areas yet to master a foreign language so that affect the communication process, especially for foreign tourists so that the process of nursing care has not run optimally.
realized. Expanding the concept of indirect travel medicine is very beneficial for rural communities in tourist destinations. Health problem is a very important indicator both to society and to the tourists who visit there. Everything that is well prepared will have an impact on tourist visits back. By screening conducted rural communities will be protected from disease states tourist visitors, as well as the supervision of health issues eg food hygiene will certainly reduce pain complaints of tourists. The real example is the preparation / provision of health kits in nature. When there are tourists who suffered injuries such as snake bites, in a swift officers is able to perform first aid. Besides, health education is needed by the public as stakeholders in tourism so that there is provision for them in conducting its tourism. In developing tourism, good destination development, tourism area, as well as objects and tourist attraction in general follow the flow or the life cycle of tourism. The objective is to determine the position of tourism that will developed (Wahab 2011). The tourism activity is inseparable from the health risks, for the prevention of various health risks is the key factor shaping a positive image of Bali tourism. Need to be aware also that there is a possibility of tourists who come to bring dangerous diseases to the destinations visited. Because it required intensive monitoring of the main entrance of destination by the parties concerned. In addition, aspects of the health service to tourists provide a significant impact on the confidence of tourists to come to Bali. Tourist destinations are expected to provide optimal health care to the unfortunate traveler. Starting from the first treatment admission, during hospital care until finally managed to recover. The hope is that with a healthy image of Bali tourism can provide
CONCLUSIONS The ability of nurses in providing nursing care is generally good. There is a significant relationship between age, education and foreign language skills on the ability of nurses in providing nursing services both to tourists, tourism stakeholders and society as a travel destination, where foreign language skills are a factor of times less potentially perform nursing services that are less well. RECOMMENDATIONS This condition should get better attention from the health department, the department of tourism and other related parties equip nurses with the appropriate education and training on the latest developments on health tourism and foreign language skills. REFERENCES Parwati, T. 2011. Kasus Utama yang Dialami Traveller di Bali. BALI. Stanhope, M., & Lancester, J. 2010. Community & Public Health Nursing (5th ed.). St LOUIS: MOSBY. Wa h a b S a l a h . 2 011. M a n a j e m e n Kepariwisataan. JAKARTA. WHO. 2010. International Travel and Health. Retrieved from http://www.who.int/ith/ ITH2010chapter1.pdf
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