Analysis Of Application Of Discharge Planning In Hypertension Patients On Patient Satisfaction Level

ABSTRACT


Introduction
Hypertension is a state of symptomatic increase in blood pressure, which will be sustained in target organs, such as stroke, coronary heart disease and right vertical hypertrophy (Bustan, 2007). Increased arterial blood pressure can increase the risk of kidney failure, heart disease which is commonly called artelosclerosis as well as stroke (Cunha, 2010). Untreated hypertension often results in dangerous strokes and heart attacks (Hanss, 2006). In Rachmadi's opinion, Waluyo (2010) explains that a hospital is a health care institution, which is served by doctors, nurses and other health professionals. Patient satisfaction is the patient's perception in expressing the quality of care in the hospital. Hospitals provide quality services and patients feel satisfaction according to the needs and desires of hypertensive patients will reduce complaints given by the hospital. To be able to improve the quality of service and butterfly in hypertensive patients, first it must be known whether the services provided to patients / customers have been in accordance with the expectations of patients / customers or not (Rachmadi, 2008) Basic Health Research Results (Riskesdas, 2013) show the prevalence of hypertension at the age of di18 years in Indonesia obtained through answers diagnosed by health personnel was 9.4%, whereas those who had been diagnosed by health personnel or were taking hypertension medication themselves were 9.5%. There are 0.1% of the population who take their own medication, even though they have never been diagnosed with hypertension by health workers. The prevalence of hypertension in Indonesia is based on the results of measurements at the age of tahun18 years of 25.8%. Health coverage is only 36.8%, most (63.2%) cases of hypertension in the community are undiagnosed. The prevalence of DM, hyperthyroidism and hypertension in women tends to be higher than men.
Based on a study of 406 patients who were hospitalized in the hospital, complaints patients were not satisfied with the service as much as 13.23% of patients. Dissatisfaction is explained in that patients want information about the condition and name of the drug (73%), how the condition of the disease affects daily activities (76%), the type of treatment and how the drug works (90%), drug side effects (51%), and causes diseases and possible prevention (90%). (Suharjo, 2013). Research shows that due discharge planning to poor, 40% of patients experienced more than 65 medication errors after leaving the hospital, and 18% of patients who were discharged from the hospital were treated again in the hospital within 30 days. In addition, Setyowati (2011) in Purnamasari (2012) in his study also revealed that of the total number of nurses who had discharge planning , as many as 89.47% of nurses carried it out on the patient's return day. The results of a preliminary study on December 22, 2017 on 10 patients in Mokoyurli Regional Hospital, Buol Regency, found that 4 patients said they were satisfied and 6 patients said they were not satisfied with the hospital nursing services. The results of the interview about the implementation of the discharge planning in Mokoyurli Regional Hospital, Buol Regency, found that nurses did not provide detailed information about patients returning home, nurses only explained the drugs, instructions for administering drugs.
Hypertension is influenced by lifestyle factors, age, genetics, stress, and use of contraceptive devices. Complaints faced by hypertensive patients are dizziness, weakness, stiff neck and others. Patients even have difficulty sleeping when blood pressure rises The effects of hypertension include complications of heart disease, stroke, heart failure and even death. Related to this, Potter & Perry (2005: 87) states that one aspect that can affect the quality of nursing services and patient satisfaction is health education, effective communication and providing clear information to patients. Thedischarge planning program is basically a program to provide health education to patients that includes nutrition, activities / exercises, medicines and special instructions, namely signs and symptoms of patient disease (Potter & Perry, 2005 . Therefore, the implementation of discharge planning will certainly affect patient satisfaction with health services received from a hospital. This is evident from the research conducted by Yosafianti & Alfiyanti (2010: 114) which states that there is an effect of giving health care to preparatory patients home to patient satisfaction about nursing p-ISSN: 2667-1609 services. Hospitals are one of the competitive health service providers that must be managed by actors who have an entrepreneurial spirit who are able to create efficiency, excellence in quality and service, excellence in innovation and excel in responding to the needs of patients (Jacobalis, S. 2005). Health services by providing discharge planning are expected to increase the satisfaction of hypertensive patients in hospitals, also not just demanding health services, but they demand quality health services. Basically quality service satisfaction as an assessment of the good and bad of the hospital. It can also be seen from the four components that influence it, one of which is patient satisfaction, which is about comfort, friendliness, and speed of service. Patient satisfaction as one indicator of quality service must be a concern because it deals directly with health care users (Lusa, 2007). If the patient is not satisfied with the health education service for hypertension, the complaints and perceptions of the community towards the sick will also decrease or even get worse. Customer / consumer satisfaction can shape perceptions and can then position the company's products in the eyes of consumers. To see quality services and meet the desires of customers or the community, there are several ways to evaluate them, including complaints and suggestions, customer satisfaction surveys, and observations on customer satisfaction. Based on the background above, the researcher is interested in researching Analysis of Application of Discharge Planning in Hypertensive Patients on Patient Satisfaction Rates in Mokoyurli Regional Hospital, Buol Regency.
Method design used in the study wasanalytic cross-sectional. Population is all hypertensive patients with 35 respondents. The sample size is 35 respondents using Purposive sampling technique. Independent variable of research is Discharge Planning. The dependent variable is satisfaction. Data was collected using a questionnaire, then the data were analyzed using thetest Spearman rho, with a significance level of α ≤ 0.05. The results of the study showed that most of the respondents aged 46-55 years were 17 respondents (48.6%). The results of the study showed that at most of the respondents had high school education as many as 26 respondents (70.3%). The results of the study found that at most 21 respondents did not work (60%). The results of the study found that most respondents had sufficient satisfaction as many as 19 respondents (54.3%). The results of the study showed that at most respondents had Discharge Planning rating an adequateof 20 respondents (57.1%). The results of the study found that most many respondents had sufficient satisfaction with the assessment of adequate Discharge Planning as many as 16 respondents (45.7%). The statistical test results obtained p = 0,000 with a = 0,05, which means that H0 is rejected and H1 is accepted so that it can be interpreted that there is a relationship between Discharge planning in Patients with Hypertension on Patient Satisfaction Level in Mokoyurli Hospital, Buol Regency, with a correlation coefficient of 76.8% which means have a strong relationship.

Discussion
The statistical test results obtained p = 0,000 with a = 0.05, which means that H0 is rejected and H1 is accepted so that it can be interpreted that there is a relationship between Discharge planning in Patients with Hypertension on Patient Satisfaction Level at Mokoyurli Hospital in Buol Regency, with a correlation coefficient of 0.768 which means having a relationship the strong one.
Hypertension is a chronic increase in blood pressure> 140/90 mmHg (Tanto Chris, 2014) Hypertension can be defined as persistent blood pressure where the systolic pressure is above 140 mmHg and diastolic is above 90 mmHg (Smeltzer, 2009). Hypertension is abnormal blood pressure which is measured and measured at least on three different occasions, normal blood pressure varies with age so that each diagnosis of hypertension must be age-specific (Corwin, 2009). Customer satisfaction is the level of one's feelings after comparing the product performance that he feels with his expectations (Murni Sumarni, 2002). According to Tjiptono and Candra, (2004) so that satisfaction can be interpreted as an effort to fulfill something or make something adequate. Based on the description of some of the experts mentioned above, it can be concluded that satisfaction is a feeling of pleasure, satisfaction of an individual because between expectations and reality in using and the services provided are fulfilled.
Based on the results of the study, it was found that there was a relationship between Discharge planning in Hypertension Patients and Patient Satisfaction Level in Mokoyurli Regional Hospital, Buol Regency, with a correlation coefficient of 0.768 which meant having a strong relationship. A discharge planner is in charge of planning, coordinating, monitoring and providing follow-up actions and processes. This discharge planning places nurses in an important position in the patient care process and in the hospital discharge planner team, nurses carry out discharge planning with sufficient levels and produce sufficient satisfaction as well, this can have an impact on overall service to patients as hospital customers. Quality improvement Discharge planning is needed to increase satisfaction of service to patients. Providing the best service to ensure the continuity of quality care in hypertensive patients at the hospital.

Conclusion
1. The results of the study found that at most respondents had sufficient satisfaction as many as 19 respondents (54.3%), and at least had less satisfaction levels as much as 4 respondents (11.4%). 2. The results showed that more than half of the respondents hadassessments Discharge Planning adequateof 20 respondents (57.1%), and at least had lessratings Discharge Planning of 5 respondents (14.3%). 3. Statistical test results obtained p = 0,000 with a = 0,05, which means H1 is accepted so that it can be interpreted that there is a significant relationship between Discharge planning in Patients with Hypertension on Patient Satisfaction Level in Mokoyurli Regional Hospital, Buol Regency, with a correlation coefficient of 0.768 which means having a strong relationship .