vi

DAFTAR ISI

HALAMAN JUDUL........................................................................................ i

HALAMAN PENGESAHAN.......................................................................... ii

HALAMAN PENGESAHAN.......................................................................... ii

SURAT PERNYATAAN................................................................................. iii

PRAKATA....................................................................................................... iv

DAFTAR ISI.................................................................................................... vi

DAFTAR SINGKATAN ................................................................................. ix

DAFTAR TABEL............................................................................................ x

DAFTAR GAMBAR ....................................................................................... xi

DAFTAR LAMPIRAN.................................................................................... xii

INTISARI......................................................................................................... xiii

BAB I PENDAHULUAN........................................................................... 1

1.1. Latar Belakang.......................................................................... 1

1.2. Rumusan Masalah .................................................................... 4

1.3. Tujuan Penelitian...................................................................... 4

1.3.1. Tujuan Umum................................................................ 4

1.3.2. Tujuan Khusus .............................................................. 4

1.4. Manfaat Penelitian.................................................................... 4

1.4.1. Manfaat Teoritis............................................................ 4

1.4.2. Manfaat Praktis ............................................................. 5

BAB II TINJAUAN PUSTAKA.................................................................. 6

2.1. Outcome Pasien ........................................................................ 6

2.1.1. Definisi Outcome Pasien............................................... 6

2.1.2. Faktor-faktor yang Mempengaruhi Outcome Pasien

(Perbaikan Visus).......................................................... 6

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2.2. Penerapan Clinical Pathway Katarak Senilis dengan Operasi

Fakoemulsifikasi....................................................................... 7

2.2.1. Penerapan...................................................................... 7

2.2.2. Clinical Pathway .......................................................... 8

2.2.2.1. Definisi Clinical Pathway .............................. 8

2.2.2.2. Tujuan Clinical Pathway ................................ 9

2.2.2.3. Komponen Clinical Pathway ......................... 10

2.2.2.4. Pengembangan Clinical Pathway................... 10

2.2.2.5. Hambatan Clinical Pathway ............................ 11

2.2.3. Katarak Senilis.............................................................. 11

2.2.3.1. Definisi Katarak Senilis................................... 11

2.2.3.2. Etiologi Katarak Senilis.................................. 12

2.2.3.3. Patogenesis Katarak Senilis............................ 12

2.2.3.4. Tanda dan Gejala Katarak Senilis.................... 13

2.2.3.5. Tipe Katarak Senilis ........................................ 13

2.2.3.6. Stadium Katarak Senilis ................................. 16

2.2.3.7. Penatalaksanaan Katarak Senilis .................... 17

2.2.4. Operasi Fakoemulsifikasi ............................................. 19

2.3. Pengaruh Penerapan Clinical Pathway Katarak Senilis

terhadap Outcome (Perbaikan Visus)....................................... 20

2.4 Kerangka Teori ......................................................................... 22

2.5. Kerangka Konsep ..................................................................... 23

2.6. Hipotesis ................................................................................... 23

BAB III METODE PENELITIAN ................................................................ 24

3.1 Jenis Penelitian dan Rancangan Penelitian............................... 24

3.2 Variabel dan Definisi Operasional ........................................... 24

viii

3.2.1 Variabel......................................................................... 24

3.2.1.1 Variabel bebas ................................................ 24

3.2.1.2 Variabel terikat ............................................... 24

3.2.2 Definisi Operasional ..................................................... 24

3.3 Populasi dan Sampel................................................................. 25

3.3.1 Populasi Penelitian........................................................ 25

3.1.1.1. Populasi target ................................................. 25

3.1.1.2. Populasi terjangkau ........................................ 26

3.3.2 Sampel Penelitian ......................................................... 26

3.3.3 Besar Sampel ................................................................ 27

3.4 Instrumen Penelitian................................................................. 28

3.5 Cara Penelitian.......................................................................... 29

3.6 Tempat dan Waktu ................................................................... 30

3.7 Analisis Hasil............................................................................ 30

BAB IV HASIL PENELITIAN DAN PEMBAHASAN............................... 31

4.1. Hasil Penelitian......................................................................... 31

4.2. Pembahasan .............................................................................. 35

BAB V KESIMPULAN DAN SARAN ....................................................... 38

5.1. Kesimpulan............................................................................... 38

5.2. Saran ......................................................................................... 39

DAFTAR PUSTAKA ...................................................................................... 40

LAMPIRAN..................................................................................................... 43

ix

DAFTAR SINGKATAN

CME : Cystoid Macular Edema

CP : Clinical Pathway

DM : Diabetes Mellitus

EBM : Evidence Based Medicine

EKEK : Ekstraksi Katarak Ekstra Kapsular

EKIK : Ekstraksi Katarak Intra Kapsular

GDS : Gula Darah Sewaktu

IOL : Intra Ocular Lens

SICS : Small Incision Cataract Surgery

x

DAFTAR TABEL

Tabel 4.1. Tabel Karakteristik Sampel Berdasarkan GDS, Tekanan Darah,

Jenis kelamin................................................................................. 32

Tabel 4.2. Tingkat Outcome pada Mata Kanan Pasien Sebelum dan

Sesudah Penerapan CP.................................................................. 33

Tabel 4. 3. Tingkat Outcome pada Mata Kiri Pasien Sebelum dan Sesudah

Penerapan CP ................................................................................ 33

Tabel 4. 4. Hasil Expected Count Tabulasi Silang (Crosstabs) Penerapan

Clinical Pathway Terhadap Outcome pada Mata Kanan .............. 34

Tabel 4. 5. Hasil Expected Count Tabulasi Silang (Crosstabs) Penerapan

Clinical Pathway Terhadap Outcome pada Mata Kiri .................. 34

Tabel 4. 6. Hasil Uji Chi-Square pada Mata Kanan........................................ 34

Tabel 4. 7. Hasil Uji Chi-Square pada Mata Kiri............................................ 34

xi

DAFTAR GAMBAR

Gambar 2. 1. Kerangka Teori........................................................................... 22

Gambar 2.2. Kerangka Konsep........................................................................ 23

xii

DAFTAR LAMPIRAN

Lampiran 1. Data Hasil Pemeriksaan Visus Mata Kanan dan Mata Kiri

Pasca Operasi Fakoemulsifikasi pada Rekam Medis ............... 43

Lampiran 2. Hasil Uji Statistik Penerapan Clinical Pathway terhadap

Outcome Pasien Katarak Senilis Pasca Operasi

Fakoemulsifikasi....................................................................... 48

Lampiran 3. Ethical Clearance ..................................................................... 50

Lampiran 4. Surat Permohonan Ijin Pengambilan Data ............................... 51

Lampiran 5. Surat Jawaban Ijin Pengambilan Data...................................... 52

Lampiran 6. Format Kegiatan ....................................................................... 53

Lampiran 7. Surat Keterangan ...................................................................... 54

Lampiran 8. Dokumentasi Penelitian............................................................ 55