Pengaruh structural empowerment terhadap patient safety culture yang dimediasi oleh normative organizational commitment serta efeknya terhadap penurunan Iinsiden konstipasi pada pasien jantung di RSUD Koja

Myriarda, Priscilia (2023) Pengaruh structural empowerment terhadap patient safety culture yang dimediasi oleh normative organizational commitment serta efeknya terhadap penurunan Iinsiden konstipasi pada pasien jantung di RSUD Koja. Masters thesis, Universitas Pelita Harapan.

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Abstract

Constipation is often found in hospitalized cardiovascular patients. Straining due to constipation can cause an increase in blood pressure and intra-thoracic pressure, resulting in worsening symptoms or even death in cardiovascular patients. Preventing constipation have been included in clinical pathway, but compliance of the implications in daily practice is low. This research define structural empowerment as an independent variable mediated by normative organizational commitment, patient safety culture and perceived risk on patients in predicting reduced incidence of constipation, and preventive knowledge becomes a control variable for perceived risk on patients. This research model was tested with empirical data from 123 respondents who were doctors and nurses, worked at a type B regional general hospital in Jakarta. The data was analysed statistically using the two-tailed PLS-SEM hypothesis test through disjoint two stages with the dimensions of patient safety culture and structural empowerment. The results showed that there was a positive and significant relationship between structural empowerment, normative organizational commitment, patient safety culture and reduced incidence of constipation (p value 0.000). Meanwhile, perceived risk on patient has a negative influence on reduced incidence of constipation (β = -0.241, p value 0.011). Preventive knowledge is a control variable for perceived risk on patients (β = 0.334, p value 0.020). Patient safety culture is the main partial mediation between structural empowerment and reduced incidence of constipation (β = 0.181, p value 0.011). / Konstipasi sering ditemukan pada pasien jantung yang dirawat inap. Mengejan akibat konstipasi dapat menyebabkan peningkatan tekanan darah dan tekanan intra torakal yang mengakibatkan perburukan gejala atau bahkan mengakibatkan kematian pada pasien jantung. Upaya pencegahan konstipasi telah tercantum dalam ppk atau clinical pathway, namun kepatuhan implikasinya dalam praktek sehari-hari rendah. Penelitian ini mengangkat structural empowerment sebagai variabel independen yang dimediasi oleh normative organizational commitment, patient safety culture dan perceived risk on patient dalam memprediksi reduced incidence of constipation, serta preventive knowledge menjadi variabel kontrol pada perceived risk on patient. Model penelitian ini diuji dengan data empiris dari 123 responden yang merupakan dokter dan perawat yang bekerja di satu rumah sakit umum daerah (RSUD) tipe B di Jakarta. Data kemudian diuji secara statistik menggunakan uji hipotesis two tailed PLS-SEM melalui dua tahap dengan dimensi patient safety culture dan structural empowerment. Didapatkan hasil, terdapat hubungan yang positif dan signifikan antara structural empowerment, normative organizational commitment, patient safety culture dan reduced incidence of constipation (p value 0,000). Sedangkan perceived risk on patient mempunyai pengaruh yang negative terhadap reduced incidence of constipation (β = -0,241, p value 0,011). Preventive knowledge merupakan variabel kontrol terhadap perceived risk on patient (β = 0,334, p value 0,020). Patient safety culture merupakan partial mediation yang utama antara structural empowerment dan reduced incidence of constipation (β = 0,181, p value 0,011).

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