BackgroundsGlobally, the most rural healthcare systems are lagging behind those of urban healthcare systems. Especially in rural and remote areas, the essential resources to provide principal health services are inadequate. It is purported that physicians have an important role in healthcare systems. Unfortunately, there is a paucity of studies on physician leadership development in Asia, especially on how to enhance physician leadership competencies in rural and remote low-resource settings. This study aimed to investigate doctors’ perceptions of existing and needed physician leadership competencies based on their experiences in primary care settings in low-resource rural and remote areas are in Indonesia.MethodsWe performed a qualitative study with a phenomenological approach. Eighteen primary care doctors, who worked in rural and remote areas of Aceh, Indonesia, purposively selected, were interviewed. Prior to the interview, participants were asked to select the top-five skills they deemed most essential for their work based on the five domains of the ‘Lead Self’, ‘Engage Others’, ‘Achieve Results’, ‘Develop Coalitions’ and ‘Systems Transformation’ (LEADS) framework. We then performed a thematic analysis of the interview transcripts.ResultsWe identified the following qualities a good physician leader in low-resource rural and remote settings should possess: (1) cultural sensitivity skills; (2) a strong character that includes courage and determination; and (3) creativity and flexibility skills.ConclusionsLocal cultural and infrastructural factors create a need for several different competencies within the LEADS framework. A profound amount of cultural sensitivity was considered the most important in addition to the ability to be resilient, versatile and ready for creative problem-solving.
McCune-Albright Syndrome (MAS) adalah suatu penyakit yang etiologinya adalah akibat mutasi gen guanine nucleotide binding alpha stimulating (GNAS1) pada masa embrionik. Mutasi gen GNAS1 ini terjadi pada masa kehamilan dan secara acak yang akan menghasilkan sebagian sel tubuh yang normal dan sebagian lainnya akan mengalami mutasi, fenomena ini yang disebut mosaicism. Sindrom ini memiliki tiga tanda klinis yaitu, displasia fibrosa, pigmentasi kulit (cafe-au-lait), dan disertai puibertas prekoks. Diagnosis MAS biasanya berdasarkan pemeriksaan klinis, radiografi, biopsi dan uji genetik. Aspek yang paling penting dari konseling kepada keluarga adalah untuk memberikan pengetahuan kepada keluarga bahwa penyakit ini tidak menular, juga tidak berhubungan dengan lingkungan atau dari kelompok etnis tertentu. Penatalaksanaan terhadap MAS adalah berdasarkan manifestasi klinis yang muncul dan membutuhkan kerjasama tim yang melibatkan bedah orthopedi, bedah plastik dan ahli endokrin.
Purpose This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings. Design/methodology/approach This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis. Findings The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program. Originality/value The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.
Konsumsi rokok dikalangan remaja dan mahasiswa meningkat setiap tahunnya. Data The Tobacco Atlas menyebutkan Indonesia memiliki jumlah perokok remaja pria terbesar (66%). Penelitian ini bertujuan untuk mengidentifikasi karakteristik serta faktor yang mempengaruhi perilaku merokok pada mahasiswa pria di Universitas Malikussaleh. Penelitian ini merupakan studi deskriptif dengan desain cross sectional. Teknik pengambilan sampel menggunakan quota sampling dengan jumlah sampel 192 orang yang telah memenuhi kriteria inklusi dan eksklusi. Data dianalisis secara univariat. Hasil penelitian didapatkan bahwa 71,4% responden berusia 20-24 tahun dan 28,5% berusia 16-19 tahun. Sementara 62,5% responden menghabiskan 1-10 batang rokok per hari, 28,6% mengkonsumsi rokok 11-20 batang per hari, 5,2% mengkonsumsi 21-30 batang rokok per hari dan 3,6% mengkonsumsi >30 batang rokok per hari. Lamanya responden segera merokok setelah bangun tidur adalah >60 menit sebanyak 53,6%, 31-60 menit sebanyak 19,8%, 6-30 menit sebesar 12% dan dalam 5 menit sebesar 14,6%. Faktor yang mempengaruhi perilaku merokok dari persentase tertinggi adalah faktor kesenangan (55,7%), stress (51,6%), stimulasi (37,5%), pegangan (37%), sosial (35,4%), kebiasaan (31,3%) dan craving (28,6%). Kesimpulannya sebagian besar responden adalah berusia 20-24 tahun dengan sebagian besar konsumsi rokok 1-10 batang per hari serta lebih dari setengah responden mengkonsumsi rokok lebih dari 60 menit setelah bangun tidur dengan faktor yang paling mempengaruhi perilaku merokok adalah faktor kesenangan dan stres.
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