Abstrak
Osteoartritis (OA) lutut merupakan penyakit sendi yang umumnya diderita oleh lansia, dimana lansia akan merasakan nyeri, kaku, dan gangguan fungsional, yang apabila tidak ditangani dengan tepat akan dapat memengaruhi kualitas hidup lansia. Salah satu penanganan OA adalah dengan kepatuhan melakukan latihan fisik, sehingga diperlukan edukasi latihan fisik OA berbasiskan efikasi diri. Tujuan penelitian ini adalah mengembangkan edukasi berbasiskan efikasi diri yang dapat memengaruhi perilaku aktivitas fisik pada lansia OA lutut. Metode penelitian ini menggunakan desain kuasi eksperimen pre dan post edukasi. Pengembangan edukasi menerapkan Intervention Mapping (IM), melalui enam tahapan, yaitu menentukan masalah, menentukan tujuan program, mendesain program, merencanakan program, implementasi, dan evaluasi. Lokasi penelitian dilakukan di Kota Jakarta Timur, yang melibatkan 20 Posyandu Lansia. Populasi adalah lansia dengan kondisi OA lutut, dengan jumlah subjek penelitian 195 lansia, dipilih cluster random sampling pada empat grup intervensi. OA lutut pada lansia didasarkan pada pemeriksaan rontgen. Pengumpulan data menggunakan instrumen Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC), instrumen self efficacy for exercise, kuesioner Self Reported Questioners (SRQ-20), dan self reported aktivitas fisik dengan log book. Analisis data yang dilakukan univariat, bivariat, dan multivariat dengan uji Different in Different (DID) untuk melihat delta dari perubahan aktivitas fisik sebelum dan sesudah diberikan edukasi latihan fisik OA. Pengukuran dilakukan sebanyak empat kali yaitu sebelum intervensi, satu bulan, dua bulan, dan tiga bulan sesudah intervensi. Hasil penelitian didapat bahwa edukasi latihan fisik berbasiskan efikasi diri pada lansia osteoarthritis lutut adalah latihan fisik yang terdiri dari pemanasan, enam gerak inti, pola berjalan, dan materi efikasi diri. Terdapat pengaruh edukasi latihan fisik OA sebesar 32% terhadap aktivitas fisik, dimana terlihat delta perbedaan efek intervensi pada grup berbasiskan efikasi diri lebih tinggi 0,6 hari dibandingkan grup tidak berbasiskan efikasi diri. Didapat pengaruh edukasi latihan fisik OA terhadap aktivitas fisik sebesar 22% pada metode edukasi, dimana terlihat perbedaan efek intervensi pada metode edukasi kelompok lebih tinggi 0,5 hari dibandingkan metode edukasi individu. Kepatuhan aktivitas fisik secara berurutan dari yang tinggi ke yang rendah adalah kelompok efikasi diri, individu efikasi diri, kelompok tidak efikasi diri, dan yang terakhir individu tidak efikasi diri. Disarankan agar Puskesmas dan Posyandu Lansia dapat menerapkan edukasi latihan fisik OA berbasiskan efikasi diri untuk mengatasi masalah OA lutut pada lansia. Peningkatan kapasitas kader Posyandu Lansia perlu terus dilakukan secara rutin, untuk dapat mengatasi masalah kesehatan pada lansia.
Osteoarthritis (OA) of the knee is a joint disease commonly suffered by the elderly, that causing pain, stiffness, and functional limitation, and will affect their quality of life if not treated properly. One of the treatment of OA is with adherence physical exercise, thus based-on-self-efficacy-physical-exercise education is needed. The purpose of this study is to develop based-on-self-efficacy education that can affect physical activity behavior in the elderly OA knee. This research method uses quasi-experimental design of pre and post education. Educational development implements Intervention Mapping (IM), through six stages, namely determining problems, determining program goals, designing programs, planning programs, implementation, and evaluation. The location of the study was conducted in the city of East Jakarta, which involved 20 Elderly Posyandu. The population is elderly with OA knee condition, with the number of study subjects 195 elderly, selected cluster random sampling in four intervention groups. Osteoarthritis conditions in subjects using X-ray examination of the knee. Data collection using Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC), self efficacy instrument for exercise, emotional mental health questionnaire (SRQ-20), and self reported physical activity with log book. Data analysis conducted univariate, bivariate, and multivariate with Different in Different (DID) test to see the delta of changes in physical activity before and after OA physical exercise education. Measurements were taken four times that consists before the intervention, one month, two months, and three months after the intervention. The results obtained that physical exercise education based on self-efficacy in the elderly osteoarthritis of the knee is a physical exercise consisting of warm-up, six core physical exercises, walking patterns, and induction of self-efficacy. There was a 32% effect of OA physical exercise education on physical activity, where the delta difference in the intervention effect in the self-efficacy based group was 0.6 days higher than the non-self-efficacy based group. Obtained the effect of OA physical exercise education method on physical activity by 22%, where the difference in the effect of intervention in the group was 0.5 days higher than individuals. The regularity of physical activity in order from high to low is the self-efficacy group, the self-efficacy individual, the non-self-efficacy group, and finally the non-self-efficacy individual. It is recommended that Puskesmas and Posyandu for the elderly can apply OA physical exercise education based on self-efficacy to minimalize knee OA problems in the elderly. Increasing the capacity of Elderly Posyandu cadres needs to be done regularly, to solve health problems in the elderly.