Tesis

Perbandingan tingkat kualitas sputum dan kepositifan bakteriologis sputum sebelum dan setelah individually-guided active cycle breathing technique dan video-guided active cycle breathing technique pada tuberkulosis paru = Comparison of sputum quality and sputum bacteriological positivity before and after individually-guided active cycle breathing technique and video-guided active cycle breathing technique in pulmonary tuberculosis.

Latar belakang: Diagnosis TB paru bakteriologis ditegakkan dengan pemeriksaan sputum sehingga spesimen yang diperiksa harus representatif dalam menggambarkan sekresi saluran napas bawah. Hal tersebut dapat digambarkan dengan kualitas sputum yang baik saat diperiksa sehingga diharapkan memiliki tingkat kepositifan yang lebih tinggi dalam konfirmasi penyakit secara bakteriologis. Saat ini masih dirasakan kesulitan pada beberapa kasus dalam pengumpulan sampel sputum yang representatif untuk prosedur diagnosis sehingga dibutuhkan metode alternatif ekpektorasi sputum pada pasien TB paru, seperti metode active cycle breathing technique (ACBT). Metode: Desain penelitian ini yaitu uji klinis randomisasi pre-post study dengan membandingkan kualitas sputum sebelum dan setelah individually-guided ACBT dan video-guided ACBT. Setelah itu dilakukan perbandingan efektifitas kedua teknik tersebut dalam tingkat kepositifan sputum secara bakteriologis. Hasil: Analisis perbandingan diantara kedua kelompok perlakuan menyatakan bahwa intervensi individually-guided ACBT menyebabkan peningkatan kualitas sputum, kepositifan BTA dan biakan MTB yang bermakna dibandingkan dengan intervensi video-guided ACBT. Kesimpulan: Individually-guided ACBT merupakan teknik yang lebih efektif dibandingkan dengan video-guided ACBT terhadap tingkat kualitas sputum dan kepositifan bakteriologis sputum pasien TB paru. Kata-kata kunci Active cycle breathing technique, sputum, tuberkulosis.


Background: Sputum specimen is an integral part for bacteriological diagnosis of pulmonary tuberculosis so the sputum should represent lower respiratory tract secretion. It could be described by good sputum quality so hopefully it will have higher positivity rate in bacteriological confirmation of the disease. Nowdays, it still felt quite hard in few cases for getting good sputum specimen for diagnostic procedure so it is needed a new method for increasing sputum expectoration in tuberculosis patient, such as active cycle breathing technique (ACBT) method. Method: It is a clinical trial pre-post study to compare quality of expectorated sputum before and after individually-guided ACBT and also video-guided ACBT. After that, both intervention will be compared by their effectivity regarding bacteriological sputum positivity level. Results: Comparative analysis between the two treatment groups stated individually-guided ACBT intervention lead to significantly improved quality of sputum, positivity of AFB smear and MTB culture compared to video-guided ACBT. Conclusion: Individually-guided ACBT is more effective than video-guided ACBT in terms of sputum quality level and bacteriological sputum positivity in pulmonary TB patients.
Keywords Active cycle breathing technique, sputum, tuberculosis.