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  • viii

    DAFTAR ISI

    HALAMAN JUDUL ................................................................................................ i

    HALAMAN PENGESAHAN ................................................................................. ii

    SURAT PERYATAAN ......................................................................................... iii

    SURAT PERYATAAN PERSETUJUAN PUBLIKASI KARYA ILMIAH ........ iv

    PRAKATA ............................................................................................................... v

    DAFTAR ISI ........................................................................................................ viii

    DAFTAR GAMBAR ............................................................................................ xii

    DAFTAR SINGKATAN ..................................................................................... xiii

    DAFTAR TABEL ................................................................................................ xiv

    DAFTAR LAMPIRAN ........................................................................................ xvi

    INTISARI ............................................................................................................ xvii

    BAB I PENDAHULUAN ................................................................................... 1

    1.1 Latar Belakang .................................................................................. 1

    1.2 Rumusan Masalah ............................................................................ 3

    1.3 Tujuan Penelitian .............................................................................. 3

    1.4 Manfaat Penelitian ............................................................................ 4

    1.4.1 Manfaat Teoritis ...................................................................... 4

    1.4.2 Manfaat Praktis ....................................................................... 4

    BAB II TINJAUAN PUSTAKA .......................................................................... 5

    2.1. Tinjauan Pustaka .............................................................................. 5

    2.1.2. Hipertiroid ............................................................................... 5

    2.1.1.1. Definisi ...................................................................... 5

    2.1.1.2. Etiologi ...................................................................... 5

    2.1.3. Patofisiologi ............................................................................ 9

    2.1.4. Faktor Risiko ......................................................................... 10

    2.1.4.1. Faktor Jenis Kelamin dan Umur ............................. 10

    2.1.4.2. Faktor Keturunan atau Riwayat Kesehatan

    sebelumnya ............................................................. 10

  • ix

    2.1.4.3. Faktor Merokok ...................................................... 10

    2.1.4.4. Faktor Makanan ...................................................... 11

    2.1.4.5. Faktor Hormon ........................................................ 11

    2.1.5. Manifestasi Klinis ................................................................. 11

    2.1.6. Tatalaksana Terapi Hipertiroidisme ...................................... 12

    2.1.6.1. Terapi Obat Antitiroid ............................................ 12

    2.1.6.2. Penyekat Beta (Beta Blocker) ................................. 14

    2.1.6.3. Iodine Radioaktif .................................................... 14

    2.1.7. Pemeriksaan Kelenjar Tiroid ................................................ 15

    2.1.7.1. Uji Langsung Fungsi Tiroid .................................... 15

    2.1.7.2. Uji yang Berkaitan dengan Konsentrasi dan

    Pengikatan Hormon dalam Darah ........................... 16

    2.1.7.3. Tes Kontrol Homeostatik ........................................ 17

    2.2. Kepatuhan minum obat ................................................................... 17

    2.3. Faktor-faktor yang mempengaruhi kepatuhan ................................ 18

    2.3.1. Usia ....................................................................................... 18

    2.3.2. Tingkat Pendidikan ............................................................... 19

    2.3.3. Frekuensi Penggunaan Obat.................................................. 19

    2.3.4. Pengetahuan .......................................................................... 20

    2.3.5. Dukungan Keluarga .............................................................. 20

    2.3.6. Dukungan Tenaga Kesehatan ................................................ 21

    2.4. Kuisioner ........................................................................................ 21

    2.5. Kerangka Teori ............................................................................... 23

    2.6. Kerangka Konsep ........................................................................... 23

    2.7. Hipotesis ......................................................................................... 23

    BAB III METODE PENELITIAN ...................................................................... 24

    3.1 Rancangan Penelitian ..................................................................... 24

    3.2 Variabel Penelitian ......................................................................... 24

    3.2.1 Variabel Bebas ...................................................................... 24

    3.2.2 Variabel Terikat .................................................................... 24

    3.3 Definisi Operasional ....................................................................... 24

  • x

    3.4 Subyek Penelitian ........................................................................... 25

    3.4.1 Populasi ................................................................................ 25

    3.4.2 Sampel ................................................................................ 25

    3.4.3 Besar Sampel......................................................................... 26

    3.5 Instrumen dan Bahan Penelitian ..................................................... 26

    3.6 Cara Kerja ....................................................................................... 27

    3.6.1 Cara Pengambilan Sampel .................................................... 27

    3.6.2 Penyusunan Kuisioner........................................................... 27

    3.6.3 Uji validitas dan Reliabilitas dengan menggunakan

    rumus Alpha Cronbach ........................................................ 28

    3.7 Alur Penelitian ................................................................................ 30

    3.8 Tempat dan Waktu Pelaksanaan ..................................................... 30

    3.8.1 Ruang Lingkup Tempat ........................................................ 30

    3.8.2 Ruang Lingkup Waktu .......................................................... 30

    3.9 Analisis Data .................................................................................. 31

    BAB IV HASIL DAN PEMBAHASAN ............................................................. 32

    4.1. Hasil Penelitian ............................................................................... 32

    4.1.1. Analisis Univariat ................................................................. 32

    4.1.2. Analisis Bivariat .................................................................... 36

    4.2. Pembahasan .................................................................................... 42

    4.2.1. Karakteristik Pasien Menurut Jenis Kelamin ..................... 42

    4.2.2. Karakteristik Pasien hipertiroid Menurut Umur ................. 42

    4.2.3. Karakteristik Pasien Hipertiroid Menurut Tingkat

    Pendidikan Responden. ...................................................... 43

    4.2.4. Karakteristik Pasien Hipertiroid Menurut Status

    Pernikahan Responden ....................................................... 43

    4.2.5. Karakteristik Pasien Hipertiroid Menurut Lama

    Penyakit yang di Derita Responden. ................................... 44

    4.2.6. Karakteristik Pasien Hipertiroid Menurut Pekerjaan

    Responden. ......................................................................... 44

  • xi

    4.2.7. Karakteristik Pasien Hipertiroid Menurut Keikutsertaan

    Asuransi Kesehatan. ........................................................... 44

    4.2.8. Hubungan Antara Kepatuhan Penggunaan Obat

    Terhadap Keberhasilan Terapi Pada Pasien Hipertiroid

    di Rumah Sakit Umum Daerah Tugurejo Semarang. ......... 45

    4.2.9. Hubungan Antara Kepatuhan Penggunaan Obat

    Terhadap pengetahuan. ....................................................... 46

    4.2.10. Hubungan Antara Kepatuhan Penggunaan Obat

    Terhadap Peran Tenaga Kesehatan Pada Pasien

    Hipertiroid di Rumah Sakit Umum Daerah Tugurejo

    Semarang. ........................................................................... 46

    4.2.11. Hubungan Antara Kepatuhan Penggunaan Obat

    Terhadap Dukungan Keluarga Pasien Hipertiroid di

    Rumah Sakit Umum Daerah Tugurejo Semarang. ............. 47

    BAB V KESIMPULAN DAN SARAN ............................................................. 48

    5.1. Kesimpulan ........................................................................... 48

    5.2. Saran...................................................................................... 48

    DAFTAR PUSTAKA ............................................................................................ 49

    LAMPIRAN ........................................................................................................... 54

  • xii

    DAFTAR GAMBAR

    Gambar 2. 1 Kerangka Teori ................................................................................. 23

    Gambar 2. 2 Kerangka Konsep ............................................................................. 23

    Gambar 3. 1 Alur Penelitian.................................................................................. 30

  • xiii

    DAFTAR SINGKATAN

    -blocker : Beta Blocker

    FT3 : Free Thyroxine 3

    FT4 : Free Thyroxine4

    FT3I : Free Triiodotironin Index

    IIH : Iodine Induced Hyperthyroidsm

    PTU : Propylthiouracil

    RAI : Radio ActiveIodium

    RAIU : Radio Active Iodium Uptake

    RT3U : Resin TriiodotironinUptake

    T3 : Triiodotironin

    T4 : Tiroksin

    TB : Tubercolosis

    TBG : Thyroxine Binding Globulin

    TRAbs : Thyroid Stimulating Antibodies

    TSH : Thyroid Stimulating Hormon

  • xiv

    DAFTAR TABEL

    Tabel 4. 1 Distribusi frekuensi karakteristik pasien hipertiroid menurut

    jenis kelamin. .................................................................................. 32

    Tabel 4. 2 Distribusi frekuensi karakteristik pasien hipertiroid menurut

    umur . .............................................................................................. 32

    Tabel 4. 3 Distribusi frekuensi karakteristik pasien hipertiroid menurut

    tingkat pendidikan responden ......................................................... 33

    Tabel 4. 4 Distribusi frekuensi karakteristik pasien hipertiroid menurut

    status pernikahan responden ........................................................... 34

    Tabel 4. 5 Distribusi frekuensi karakteristik Pasien hipertiroid menurut

    lama penyakit yang diderita responden. ........................................ 34

    Tabel 4. 6 Distribusi frekuensi karakteristik Pasien hipertiroid menurut

    pekerjaan responden. ..................................................................... 35

    Tabel 4. 7 Distribusi frekuensi karakteristik Pasien hipertiroid menurut

    keikutsertaan asuransi kesehatan responden. ................................. 36

    Tabel 4. 8 Distribusi frekuensi kepatuhan penggunaan obat pada pasien

    hipertiroid di Rumah Sakit Umum Daerah Tugurejo Semarang. ... 36

    Tabel 4. 9 Distribusi frekuensi keberhasilan terapi pada pasien hipertiroid

    di Rumah Sakit Umum Daerah Tugurejo Semarang. ..................... 37

    Tabel 4. 10 Hasil analisis hubungan antara kepatuhan penggunaan obat

    terhadap keberhasilan terapi pada pasien hipertiroid di Rumah

    Sakit Umum Daerah Tugurejo Semarang. ...................................... 37

    Tabel 4. 11 Hasil analisis hubungan antara kepatuhan penggunaan obat

    terhadap pengetahuan pasien hipertiroid di Rumah Sakit Umum

    Daerah Tugurejo Semarang. ........................................................... 38

    Tabel 4. 12 Hasil analisis hubungan antara kepatuhan penggunaan obat

    terhadap peran tenaga kesehatan pada pasien hipertiroid di

    Rumah Sakit Umum Daerah Tugurejo Semarang. ......................... 40

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    Tabel 4. 13 Hasil analisis hubungan antara kepatuhan penggunaan obat

    terhadap dukungan keluarga pasien hipertiroid di Rumah Sakit

    Umum Daerah Tugurejo Semarang. ............................................... 41

  • xvi

    DAFTAR LAMPIRAN

    Lampiran 1 Kuesioner ........................................................................................... 54

    Lampiran 2 Surat Studi Pendahuluan penelitian ................................................... 61

    Lampiran 3 Surat ijin penelitian ............................................................................ 62

    Lampiran 4 Surat Persetujuan Subyek Penelitian ................................................. 63

    Lampiran 5 Ethical Clearance .............................................................................. 64

    Lampiran 6 Uji validitas dan Reabilitas ................................................................ 65

    Lampiran 7 Identitas Koresponden ....................................................................... 72

    Lampiran 8 Hasil Pemeriksaan ............................................................................. 73

    Lampiran 9 Hasil Analisis Bivariat ....................................................................... 76