Hipertensi berkaitan dengan penurunan usia harapan hidup, peningkatan
resiko stroke, penyakit jantung koroner dan penyakit organ target lainnya (misalnya retinopati, gagal ginjal). Berdasarkan beberapa hasil survei yang telah dilakukan menyebutkan bahwa banyak pasien penderita hipertensi yang tidak melaksanakan kontrol dengan baik terhadap penyakitnya sehingga masalah ini sangat berpotensi untuk meningkatkan angka morbiditas dan motilitas akibat komplikasi penyakit hipertensi. Penelitian ini bertujuan untuk mengetahui faktor- faktor apa saja yang mempengaruhi pasien penderita hipertensi menjadi tidak patuh dalam melaksanakan terapi obat. Penelitian ini dilakukan di rumah sakit umum H. Adam Malik Medan, Sumatera Utara, pada bulan Juni-Juli 2009. Design penelitian ini adalah cross- sectional dengan sampel pasien rawat jalan penderita hipertensi yang memenuhi kriteria inklusi dan tidak memenuhi kriteria eksklusi, pengambilan sampel dilakukan secara purposif sampling. Data penelitian diperoleh melalui kuisioner dan wawancara langsung terhadap pasien. Analisis data dilakukan secara bertahap mencakup analisis univariat, analisis bivariat menggunakan uji chi-square, dan analisis multivariat menggunakan uji regresi logistik berganda metode Backward Wald pada pogram SPSS Version 13.0. Hasil penelitian ini menginformasikan kepada kita bahwa faktor-faktor ketidakpatuhan pasien rawat jalan penderita hipertensi adalah tidak cukupnya pasien mendapatkan informasi(Wald =6,978;OR =15,298; Cl 95% =2,02 - 115,77), adanya pengobatan lain yang dijalani oleh pasien (Wald =6,043;OR = 0,091; Cl 95% =0,013 0,615), faktor usia (Wald =5,282 ;OR =9,334 ; Cl 95% =1,389 62,712), pendidikan (Wald =5,016 ;OR =0,050 ;Cl 95% =0,004 0,688), lamanya telah menderita penyakit (Wald =4,235 ;OR =0,173 ;Cl 95% =0,033 0,920), tingkat kesembuhan yang telah dicapai (Wald =4,199 ;OR = 21,189 ; Cl 95% =1,142 393,056), rutinnya melakukan pemeriksaan ulang (Check Up) (Wald =3,975 ;OR =10,283 ;Cl 95% =1,040 -101,655), adanya reaksi obat yang merugikan (Wald =3,899 ;OR=0,176 ;Cl 95% =0,013 0,615), mahalnya biaya pengobatan (Wald =4,094 ;OR =0,026 ;Cl 95% =0,001 0,892).
Universitas Sumatera Utara ABSTRACT Hypertension related to reduction of age for life expectation, stroke risk improvement, coronary heart disease and the other organ target disease (example, retinophaty, kidney failure). Based on several research survey, many patients not in good control condition with their treatment, so this problem be potential to increase the value of morbidity and mortility from hypertension disease. This research is objective to study non-compliance factors which influence patients of hypertension disease not obedient to carry out their drug therapy. This research conducted in H. Adam Malik Hospital Center, in North Sumatera, on June-July 2009. This researchs design is cross-sectional and all of the patients who had hypertension disease are used as sample. It is fulfill inclusion criteria and it is not fufill exclusion criteria. Samples are taken by purposive sampling. Data are obtained through quisionere and direct interview with patients. Data are analized step by step including univariate analysis, bivariate analysis by using Chi-Square Test, and multivariate analysis by using Backward Wald method on binary logistic regression at SPSS Version 13.0 programme. The result of this research showed that the factors which related to non- compliance with patients of hypertension disease are perceived lack of information (Wald =6.978;OR =15.298; Cl 95% =2.02 115.77), patients carry out the other treatment (Wald =6.043;OR =0.091; Cl 95% =0.013 0.615), age factor (Wald =5.282 ;OR =9.334 ; Cl 95% =1.389 62.712), education (Wald = 5.016 ;OR =0.050 ;Cl 95% =0.004 0.688), duration of hypertension (Wald = 4.235 ;OR =0.173 ;Cl 95% =0.033 0.920), status of cure (Wald =4.199 ;OR = 21.189 ; Cl 95% =1.142 393.056), carry out check up (Wald =3.975 ;OR =10.283 ;Cl 95% =1.040 -101.655), adverse drug effects (Wald =3.899 ;OR= 0.176 ;Cl 95% =0.013 0.615), perceived economic problems (Wald =4.094 ;OR =0.026 ;Cl 95% =0.001 0.892).
Key Words : noncompliance factors, hypertension disease, binary logistic regresi- on test, chi-square test.