POS PEMBINAAN TERPADUPENYAKIT TIDAK MENULAR

05/01/13*

Peningkatan Jumlah kematian akibat PTM 10 % dalam 10 Tahun (1997-2007)200710 %Pada 2030, diperkirakan kematian akibat PTM mencapai 70 %

FAKTOR RISIKO BERSAMA TERHADAP PTMFaktor Risiko Yang MelekatUmur, Jenis Kelamin Keturunan

Faktor Risiko LingkunganSosio EkonomiBudayaLingkungan Sosial/Fisik

Faktor risiko Penyakit Antara

ObesitasHipertensiHiperglikemiaHiperdislipidemi

Fase Penyakit Akhir

Penyakit KardiovaskularStrokeDiabetes MelitusKankerPPOK

Faktor Risiko PerilakuMerokokKonsumsi AlkoholKurang Aktifitas FisikKurang Konsumsi SeratKonsumsi lemak Tinggi

bentuk peran serta masyarakat (Kelompok Masy, Organisasi, Industri, Kampus dll)

Upaya promotif-preventif untuk Pengendalian faktor risiko PTM secara terpadu & berkelanjutanPOSBINDUSasaran langsung < 25 60 tahun

TUJUANDeteksi faktor risiko ptm oleh masy sedini mungkinTerselenggaranya penanganan faktor risiko ptm oleh masy sesegera mungkinTerselenggaranya kegiatan pemantauan FR PTM oleh masy sebaik mungkin

Kader PemantauKader PenggerakKader Konselor

Kader Pencatat

KoordinatorPosbindu PTMSUMBER DAYA PELAKSANA POSBINDU PTM

SUMBER DAYA PELAKSANA POSBINDU PTM

TUJUAN DAN SASARAN POSBINDU PTMMasyarakat SehatMasyarakat BerisikoMasyarakat Hidup dengan PTMPendukung/penunjangUpaya Deteksi Dini, Monitoring dan KonselingRujukan Faktor Risiko PTM TerkendaliKomplikasi PTM TerhindarkanKEJADIAN PENYAKIT TIDAK MENULAR DI MASYARAKAT TIDAK MENINGKAT

AZAZ PENYELENGGARAAN MUDAH, dilakukan dg cara sederhana yg terpadu di lingk tempat tinggal, tempat umum, sekolah, lingkungan tempat kerjaMURAH, dilakukan bersama secara gotong royong oleh masy dg biaya yg disepakatiDapat dipertanggung jawabkan - kader telah terlatihMerupakan bentuk kegiatan desa siagaBisa dilegitimasi dengan SK Kepala Desa/Lurah

Manfaat Penyelenggaraan Pos Pembinaan Terpadu PTM Mawas Diri Faktor risiko PTM yg kurang menimbulkan gejala secara bersamaan dpt terdeteksi & terkendali secara diniMembudayakan Gaya Hidup Sehat dalam lingkungan yg kondusifMudah Dijangkau Diselenggarakan di lingkungan tempat tinggal masyarakat/lingkungan tempat kerja dgn jadwal yang disepakatiMurah Dilaksanakan Dilakukan oleh masyarakat dgn iuran yg disepakati/sesuai kemampuan masyarakatMetodologis & Bermakna secara klinis Kegiatan dpt dipertanggung jawabkan secara medis Dilaksanakan oleh kader khusus dan bertanggung jawab yg telah mengikuti pelatihan metode deteksi dini atau edukator P2PTM

Tugas KaderMelakukan pendekatan pada toma dan aparat pemerintah setempat (membangun jejaring kerja)Melakukan survei mawas diri/pendataan dg petugas Melakukan musyawarah, penentuan jadwal & rencana kerjaMendorong masy datang ke posbindu / informasiMelaksanakan posbindu(konseling, penyuluhan, aktifitas fisik bersama) Melakukan pencatatan

KEGIATAN UTAMA POSBINDU PTM05/01/13*

Wawancara penggalian FR perilakuPenimbangan , pengukuran manual (lingkar perut, TB) & pengukuran dg body fat analyzer (IMT, Lemak tubuh, lemak perut)Pengukuran tekanan darahPemeriksaan BiokimiaMelaksanakan konselingMelakukan olah raga/aktifitas bersama Jadwal pelaksanaan kegiatan diatur berdasarkan kesepakatanbersama

Tahap penyelenggaraan PosbinduPersiapan- pertemuan kelompok untuk sosialisasi- penentuan jadwal pelaksanaan- menyiapkan tempat & alat- meyebarluaskan jadwal pelaksanaanPelaksanaan- melakukan pelayanan 5 meja- melakukan olah raga bersama/aktifitas lain ( demo masak/ketrampilan)Evaluasi- menilai kehadiran-identifikasi masalah & penyelesaiannya

Pengukuran Faktor Risiko Tinggi badan, Berat badan, Tekanan darah, IMT, Lemak Tubuh & Perut, Kolesterol Glukosa, Asam urat, dllKader, paramedis Kader

KaderParamedisPublic healthDokter

Sistem Pelaksanaan Posbindu Kader, paramedis WawancaraPelayanan KonselingPenyuluhan perorangan tentang pola makan, bahaya asap rokok, olahraga, stres, PHBS, dllPencatatan PelaporanPengisian KMR-PTM, Kartu pelaporan Posbindu, dllIIIIIIIVVPendaftaran, Pemberian Nomor Kode Kunjungan, dllPola makan, kebiasaan OR, merokok, dll

Peralatan / Sarana yg DiperlukanTempat kegiatan Lima set meja-kursi Pengukur tinggi badan Timbangan berat badan Pita pengukur badanAlat pengukur glokosa, kolesterol dan trigliseridBodyfat analizerTensi meterBuku Identitas PesertaKartu Monitoring faktor risiko PTM (KMR-PTM)Formulir pencatatan & pelaporan ke puskesmas dan dinas kesehatan

Anjuran Jangka Waktu Pemantauan

Faktor RisikoFaktor risikoPenderitaGula darah puasa1 tahun sekali3 bulan sekaliGula darah 2 jam stlh puasa1 tahun sekali3 bulan sekaliGula darah sewaktu1 tahun sekali1 bulan sekaliKolesterol1 tahun 2 kali3 bulan sekaliTrigliserid1 tahun 2 kali3 bulan sekaliAsam urat1 tahun 2 kali3 bulan sekaliTekanan darah1 bulan sekali1 bulan sekaliIndeks massa tubuh1 bulan sekali1 bulan sekaliLemak tubuh1 bulan sekali1 bulan sekaliLemak perut1 bulan sekali1 bulan sekali

Kriteria Klinis Faktor Risiko PTM

Faktor RisikoBaikSedangBurukGula darah puasa80 109110 125 125Gula darah 2 jam stlh puasa80 - 144145 179 180Gula darah sewaktu80 - 144145 199 200Kolesterol< 150150 189 190Trigliserid< 140140 150 150Tekanan darah< 130/80130-139/80-90 140/90Ideks massa tubuh18,5 - 22,9 23 24 > 25Lemak perut1 9 10 14 15Lemak tubuh laki-laki10 20 20,1 25 > 25Lemak tubuh perempuan20 30 30,1 35 > 35Lingkar perut L < 90 cmP < 80 cm--L 90P 80

Monitoring Faktor Risiko PTMPemantauan secara rutin & periodik Rutin Pemeriksaan kondisi kesehatan diupayakan menjadi kebiasaan meski tidak dalam kondisi sakit Periodik Pemeriksaan kesehatan dilakukan secara berkala sesuai anjuran

Pengukuran FR PTM Berat badan Tinggi badan Menghitung IMT Mengukur lingkar perut Mengukur tekanan darah

Klasifikasi Index Massa Tubuh (IMT)*IMT = Berat Badan (kg) / Tinggi Badan(m)2

KatagoriIMT (kg/m2)BB Kurang< 18,5BB Normal18,5 22,9 BB dengan Risiko23 24,9 Obesitas Tk.125 29,9 Obesitas Tk. 2> 30

Cara mengukur lingkar perut Tetapkan batas tepi tulang rusuk paling bawah bagian kiriTetapkan ujung lengkung tulang pangkal panggul Ambil titik tengah diantara keduanyaLakukan pada sisi yang lainLakukan pengukuran dimulai dari bagian kiri secara sejajar mendatar ke kanan melingkari pinggang melewati perut sampai ke bagian kiri Lakukan pengukuran pada saat akhir mengeluarkan nafas

Kuadran atas dalamKuadran atas luarKuadran bawah luarKuadran bawah dalam

RUJUKAN POSBINDU PTMLayanan Rujukan Balik (feed back)

FORMAT RUJUKANYth.Puskesmas..Di..

Bersama ini kami kirimkan ;Nama : Tn/Ny/Nn.Umur :.TahunAlamat::.

Dengan Kondisi masalah kesehatan:..............................................................Penanganan yang telah dilakukan :.................................................................Mohon dilakukan penanganan lebih lanjut. Demikian disampaikan dan sekiranya hasil tindak lanjut dapat disampaikan kepada kami untuk penatalaksanaan berikutnya.Terima Kasih.., //20Yang merujuk,(Nama dan TTD).

PTM akan berangsur mengalami penurunan dengan intervensi faktor risiko bersama melalui POSBINDU

MARI MENUJU MASA MUDA SEHAT HARI TUA NIKMAT TANPA PTM DENGAN PERILAKU CERDIKCek kondisi kesehatan anda secara rutin dan teraturEnyahkan asap rokok dan polusi udara lainnyaRajin aktifitas dengan gerak olah raga dan seniDiet yang sehat dan seimbang (rendah gula, garam dan lemak serta tinggi serat)Istirahat yang cukupKendalikan stresCegah Sekarang jugaAjak masyarakat ke Posbindu PTM untuk deteksi lebih dini faktor risiko PTM

Terimakasih *

*****Wire outline rectangles and angles(Basic)

Tip: These instructions include five different shapes: half frame (2), L-shape (2), rectangle (2), right triangle (2), and frame (1).

To reproduce the half frames on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Half Frame (second row, sixth option from the left). On the slide, drag to draw a half frame.Select the half frame. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 1.83.In the Shape Width box, enter 1.83.With the half frame still selected, on the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Select the second half frame, and then drag one of the adjustment handles to decrease the size slightly.Drag the half frame to the bottom of the slide.

To reproduce the L-shapes on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click L-Shape (second row, seventh option from the left). On the slide, drag to draw an L-shape.Select the L-shape. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.In the Shape Width box, enter 2.Drag the L-shape to the bottom of the slide.Select the L-shape. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate.Select the second L-shape. Drag one of the adjustment handles to decrease the size slightly. Drag the second L-shape to the right side of the slide.

To reproduce the rectangles on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Rectangles click Rectangle (first option from the left). On the slide, drag to draw a rectangle.Select the rectangle. Under Drawing Tools, on the Format tab, in the Size group, do the following:In the Shape Height box, enter 2.In the Shape Width box, enter 2.Drag the rectangle to the upper left part of the slide.Select the rectangle. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate.Select the second rectangle. Drag one of the adjustment handles to decrease the size slightly. Drag the second rectangle to the upper right part of the slide.

To reproduce the right triangles on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Right Triangle (first row, fourth option from the left). On the slide, drag to draw a right triangle.Select the right triangle. On the Home tab, in the Drawing group, click Arrange, point to Rotate, and then click Flip Horizontal. Drag the right triangle to the center of the slide.Select the right triangle. On the Home tab, in the Clipboard group, click the arrow under Paste, and then click Duplicate. Select the second right triangle. Drag one of the adjustment handles to decrease the size slightly. Drag the second right triangle to the lower right part of the slide.

To reproduce the frame on this slide, do the following:On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Frame (second row, fifth option from the left). On the slide, drag to draw a frame.Drag the frame to the right side of the slide.On the Home tab, in the Editing group, click Select, and then click Select All. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click 3-D Rotation in the left pane, and in the 3-D Rotation pane, in the Presets list, under Parallel, select Isometric Top Up (first row, third option from the left).Also in the Format Shape dialog box, click 3-D Format in the left pane, and then do the following in the 3-D Format pane:Under Depth, in the Depth box, enter 200 pt.Under Surface, click the button next to Material, and then under Special Effect click Wireframe (fourth option from the left).

To reproduce the background effects on this slide, do the following:Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Radial.In the Direction list, click From Center (the third option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 40%.Click the button next to Color, and then under Theme Colors click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following: In the Stop position box, enter 100%.Click the button next to Color, and then under Theme Colors click Black, Text 1, Lighter 25% (fourth row, second option from the left).*3-D hexagon with 3-D text(Advanced)

To reproduce the shape effects on this slide, do the following:On the Home tab, in the Slides group, click Layout, and then click Blank.On the Home tab, in the Drawing group, click Shapes, and then under Basic Shapes click Hexagon (first row, ninth option from the left).Press and hold SHIFT, and then on the slide, drag to draw a hexagon.Select the hexagon. On the Home tab, in the bottom right corner of the Drawing group, click the Format Shape dialog box launcher. In the Format Shape dialog box, click Fill in the left pane. In the Fill pane, select Gradient fill, and then do the following:Click the button next to Preset Colors, and then click Fog (second row, fifth option from the left).In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (first row, second option from the left).Also in the Format Shape dialog box, click Line Color in the left pane. In the Line Color pane, select No line. Also in the Format Shape dialog box, click 3-D Format in the left pane. In the 3-D Format pane, do the following:Under Bevel, click the button next to Top, and then under Bevel click Angle (second row, first option from the left). Next to Top, in the Width box, enter 6 pt, and in the Height box, enter 6 pt. Click the button next to Bottom, and then under Bevel click Angle (second row, first option from the left). Next to Bottom, in the Width box, enter 6 pt, and in the Height box, enter 6 pt. Under Depth, in the Depth box, enter 23.5 pt.Under Surface, click the button next to Material, and then under Translucent click Clear (third option from the left). Click the button next to Lighting, and then under Neutral click Balance (first row, second option from the left). In the Angle box, enter 340.Also in the Format Shape dialog box, click 3-D Rotation in the left pane. In the 3-D Rotation pane, do the following:Click the button next to Presets, and then under Perspective, click Perspective Relaxed (second row, third option from the left).In the X box, enter 333.In the Y box, enter 300. In the Z box, enter 25.5. In the Perspective box, enter 70.Select the hexagon. On the Home tab, in the Drawing group, click Shape Effects, point to Glow, and then do the following:Click any of the options in the second row (8 pt glow options).Point to More Glow Colors, and then under Theme Colors click White, Background 1, Darker 35% (fifth row, first option from the left).

To reproduce the text effects on this slide, do the following:On the Insert tab, in the Text group, click Text Box, and then on the slide, drag to draw the text box. Enter text in the text box, select the text, and then on the Home tab, in the Font group, select Arial from the Font list, select 60 from the Font Size list, click the arrow next to Font Color, and then under Theme Colors click Black, Text 1, Lighter 50% (second row, second option from the left).On the Home tab, in the Paragraph group, click Center to center the text in the text box.Select the text box. Under Drawing Tools, on the Format tab, in the bottom right corner of the WordArt Styles group, click the Format Text Effects dialog box launcher. In the Format Text Effects dialog box, click Text Fill in the left pane. In the Text Fill pane, do the following:Click Solid fill.Click the button next to Color, and then under Theme Colors click Blue, Accent 1, Darker 25% (fifth row, fifth option from the left). Also in the Format Text Effects dialog box, click 3-D Format in the left pane. In the right pane, do the following:Under Depth, in the Depth box, enter 7 pt. Under Surface, click the button next to Material, and then under Standard click Warm Matte (second option from the left). Click the button next to Lighting, and then under Special click Glow (third option from the left).Also in the Format Text Effects dialog box, click 3-D Rotation, and then do the following:Click the button next to Presets, and then under Perspective click Perspective Heroic Extreme Right (third row, third option from the left).In the X box, enter 340.In the Y box, enter 10.In the Z box, enter 0.In the Perspective box, enter 90.On the slide, drag the text box on top of the hexagon.Press and hold CTRL and select the hexagon and the text box. On the Home tab, in the Drawing group, click the arrow under Arrange, point to Align, and then do the following:Click Align Selected Objects.Click Align Center.Click Align Middle.

To reproduce the background effects on this slide, do the following: Right-click the slide background area, and then click Format Background. In the Format Background dialog box, click Fill in the left pane, select Gradient fill in the Fill pane, and then do the following:In the Type list, select Linear.Click the button next to Direction, and then click Linear Down (second option from the left).Under Gradient stops, click Add or Remove until two stops appear in the drop-down list.Also under Gradient stops, customize the gradient stops that you added as follows:Select Stop 1 from the list, and then do the following:In the Stop position box, enter 46%.Click the button next to Color, and then click White, Background 1 (first row, first option from the left).Select Stop 2 from the list, and then do the following:In the Stop position box, enter 100%.Click the button next to Color, and then click Blue, Accent 1, Lighter 60% (third row, fifth option from the left).

****