Advances in Social Science, Education and Humanities Research, volume 535

Proceedings of the 1st Paris Van Java International Seminar on Health, Economics,
Social Science and Humanities (PVJ-ISHESSH 2020)

The Effectiveness of PSBH (Problem Solving for

Better Health and Hospital) Method on Caring
Nurse Behavior
1st Sri Siska Mardiana 2nd Ika Widyawati
Medical faculty Department Midwifery
Muhammadiyah University of Kudus Medical faculty
Jawa Tengah Indonesia Muhammadiyah University of Kudus
srisiska@umkudus.ac.id Jawa Tengah Indonesia

Abstract—Nurse caring behavior is an important aspect in with patient satisfaction shows that 81.3% of respondents
providing nursing care, because it includes human have the perception that nurses have good caring behavior
relationships and affects the quality of service and patient and show satisfaction with nursing services. Based on the
satisfaction. Based on interviews and preliminary surveys, it above it is very important to take into account the nurse's
was found that 68% of patients were not satisfied with caring behavior as one of the benchmarks to improve the
nursing services because there were still many nurses who did quality of service in the hospital through efforts to increase
not show caring behavior. PSBH is a method of solving patient satisfaction.[3]
problems related to nursing services in hospitals. This study
aims to analyze the effect of applying the PSBH method to
Based on data from the assessment results in July 2018
nurses caring behavior in the inpatient room of RSUD dr. R. at the Regional General Hospital dr. R. Soedjati Grobogan
Soedjati Grobogan Regency and RSUD Kartini Jepara District obtained client suggestions, including nurses
Regency. Method: This research is a quasi-experimental with should be more nimble in fulfilling client calls, more
a pre-test and post-test with control group approach with 38 friendly, and more polite in dealing with clients and nurses
respondens. This study used purposive sampling with rarely introduce themselves to patients. The results of
inclusion criteria in both the treatment and control groups. interviews with several nurses in the inpatient room
The intervention was use implementation of PSBH metode on showed that between the number of nurses and patients
caring the patient. The data analysis used T test. The results was not balanced so that the nurse's workload was felt to be
of the study stated that the average caring behavior of nurses
increased in the treatment group by 2.88 from 69.24 to 72.12.
higher, there was no career path, inadequate and non-
The influence of the application of the PSBH method on transparent incentive system and less supervision from
nurses caring behavior (p value 0.000). Conclusion: Using of management. The results of interviews with the patient's
PSBH metode can increase the motivation of caring nurse family obtained data that nurses lacked communication, did
behaviour. not mention names and were less friendly. The researchers
observed in the inpatient room that nurses rarely greet
Keywords—PSBH, Metthod, Nurse, Behavior
clients, rarely communicate until interpersonal
I. INTRODUCTION relationships are established with patients and families.
Caring is the essence of nursing and is central to This phenomenon shows that nurses caring behavior has
nursing practice that is based on the values of kindness, not been implemented well in the Regional General
attention, love for yourself and others and respect for the Hospital dr. R. Soedjati Grobogan Regency and need to get
spiritual beliefs of clients. Nurse caring behavior is one of serious attention from the management of nursing, so it is
the aspects related to nursing services, because caring necessary to find the cause of the problem why caring
includes human relationships and affects the quality of behavior can not be maximally carried out in order to find
service and patient satisfaction.[1] The study of Shirley et a joint solution between nurses and management.
al. In 2012 concerning the level of patient satisfaction in PSBH (Problem Solving for Better Health and
the orthopedic ward with nurses caring at the hospital Hospital) can be a sure choice. PSBH is one of the problem
University of Science Malaysia, found that 82.7% of solving where in the process it can be applied to overcome
respondents were satisfied with nurse services such as health problems but can also be applied to solve individual
respecting patients, calm, gentle, caring, compassion and problems and various other professional activities. How to
empathy.[2] The results of research conducted by Abdul, solve problems done directly. PSBH participants are
Ariyanti Saleh, and Elly L. Sjattar in the year 2013 encouraged to generate new ideas and methods to more
concerning the relationship between nurses caring behavior effectively utilize available resources to help solve certain

Copyright © 2021 The Authors. Published by Atlantis Press SARL.

This is an open access article distributed under the CC BY-NC 4.0 license -http://creativecommons.org/licenses/by-nc/4.0/. 454
 Advances in Social Science, Education and Humanities Research, volume 535

health problems, the results offered will have a major control groups. The sampling method used purposive
impact on the progress of nursing performance at the sampling . 11,12 This study used 38 respondents in the
Hospital.[4]Through the stages that exist in the PSBH intervention group and 38 respondents in the control group.
method including; 1) defining the problem (Define the This study conducted in July-August 2018 in RSUD
Problem), 2) prioritizing the problem (Prioritize the Grobogan dan RSUD Jepara, Central Java and used
Problem), 3) finding a solution (Define the Solution), 4) instrument questioner which modified to determine the
preparing a plan of activities carefully (creat a good action motivation of caring nurse behaviour. In the intervention
plan), 5) implementing the activity ( take action) nurses group, respondents given training for 8 hours every day for
caring problems will be able to be overcome properly.8 2 consecutive days related to the PSBH method. The
The PSBH approach was first introduced in the United training began with the presentation by speakers and then
States in 1993. Currently PSBH has developed in 30 was given a Role Play related to PSBH. After that, a group
countries, including in Africa, India and Mexico. In was formed to conduct a discussion to resolve cases using
Indonesia there are around 125 hospitals that have the PSBH method. The data analysis used T-test.
developed the PSBH approach, for example Cipto III. RESULT AND DISCUSSION
Mangunkusumo Hospital (Jakarta), Pondok Indah Hospital The results of the study include data on the
(Jakarta), Tugu Rejo Hospital Semarang and Banyumas characteristics of respondents, differences in motivation of
Hospital.[5] caring nurse behaviour before and after the intervention,
II. RESEARCH METHODS differences in motivation of caring nurse behaviour
between the intervention and control groups.
This is a quasi-experimental with one group pre-test
post test design by comparing between intervention and
TABLE I. THE CHARACTERISTICS OF RESPONDENT
No The Characteristics of Group
Respondent Control (n=38) Intervention (n=38)

Frequency % Frequency %

1 Age
20-25 years old 17 44,7 15 39,5
26-30 years old 16 42,1 15 39,5
>30 years old 5 13,2 8 21,0
2 Gender
Men 14 36,8 15 39,5
Women 24 63,2 23 60,5
3 Education
Nursing Diploma 25 65,8 24 63,2
Nursing Degree 13 34,2 14 36,8
4 Employee Status
Permanent 18 47,4 20 52,6
Contract 20 52,6 18 47,4
5 Marital Status
Married 15 39,5 22 57,9
Single 23 60,5 16 42,1
6 Working periode
1-3 years 20 52,6 18 47,4
>3 years 18 47,4 20 52,6

Based on the characteristics of the respondents on the factors. Individual factors include demographic factors
results of the study the average characteristics are almost which include age, sex, length of service, marital status and
the same. So if seen from the individual factors that employment status.[8]There are several things that are
influence caring behavior in both groups is the same. The included in psychological factors that distinguish in caring
most age is productive age, namely 25-30 years. At this age behavior including attitudes, perceptions and motivation of
individuals tend to be more active in carrying out their nurses to do caring which can be influenced by internal
work. If you get the right direction and without any factors and external factors. Based on the results of
pressure at work, the individual will show more interviews and observations of respondents in both groups
achievement in his work. The more mature a person will showed almost the same attitude towards caring behavior.
show the maturity of the soul and be able to think Caring behavior is an important thing that supports nursing
rationally, wisely, and be able to control emotions, and be care but its implementation is influenced by the perceptions
open to new things.[7] and motivations of each individual. In theory, an
Caring behavior can be influenced by several factors understanding of good attitudes when performing nursing
including individual factors of nurses and psychological actions is important because attitudes affect the
factors of nurses and also influenced by organizational performance results of nurses.[9]

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TABLE II. THE DIFFERENCES OF CARING NURSE BEHAVIOUR BETWEEN THE INTERVENTION AND CONTROL GROUP BEFORE AND
AFTER THE INTERVENTION
Caring nurse behavior Group
Variable Intervention (n=38) Control (n=38)
Mean SD Mean SD
before 69,24 2,28 68,55 2,62
After 72,12 2,39 69,10 2,60

Based on the table II, the average caring behavior of .[14] Motivation also affects performance. Motivation is
nurses in the treatment group prior to the application of the the strength of someone who gives birth to the intensity
PSBH method was 69.24 with a standard deviation of 2.28. and perseverance that is done voluntarily. Motivation is an
While the average score in the control group was 68.55 energy that is found in human beings which gives rise to,
with a standard deviation of 2.28. The average score in the directs, and organizes behavior. This behavior arises
treatment group and the group shows the category of because of internal factors and external factors. Behavior is
moderate caring behavior where the average score is seen as a reaction or response to a stimulus.
categorized> 40 = bad caring behavior, score 41-70 = Encouragement is activated by the need (need). Needs
moderate caring behavior, 70-100 = good caring behavior). arouse impulses, and these impulses ultimately activate or
Caring is a nurse's attitude in doing her work that has bring up behavioral mechanisms.[16]
been inherent in a nurse. The practice of caring in nursing In general, motivation in both groups was sufficient in
shows that nurses work with heart and soul. Caring in carrying out their work as nurses. However, based on the
nursing care is part of the nurse's performance in caring for interview the nurse said many factors influence the
patients.[12] Caring behavior is very important in motivation of nurses when doing nursing care, including
providing nursing care because it can have an impact on the workplace environment, the rules that apply and the
increasing client satisfaction. In theory there are three rewards provided. This is consistent with theories that
variables that affect nurse performance including affect a person's motivation, namely external factors.[17]
individual variables, psychological variables, The workplace or organizational environment influences
organizational variables.[13] nurses' caring behavior. This is what distinguishes nurses
Based on these results an increase in nurses caring caring behavior in the treatment group and the control
behavior scores in the treatment group was 2.88. These group. The interview results showed that nurses'
results indicate an increase in caring behavior into a good motivation in caring generally is influenced by
caring behavior category. While the average score in the organizational policies or rules that apply in hospitals,
control group was 68.55 with a standard deviation of 2.60. including the existence of SPO (Standard Operating
In the control group an increase in the average score of Procedures) and rewards (reward system). In general,
0.05 was found in the increase in respondents' answers to based on interviews the nurses in the treatment group felt
the questionnaire representing "anticipatory measures" and less satisfied with the reward (reward system) prevailing in
"monitoring and follow-up of patient health". However, the hospital, in contrast to the results of the interview in
these results do not show an increase in the caring behavior general the nurses in the control group said they were quite
category, which is still in the moderate category. (Average satisfied with the existing reward system. In both groups
score> 40 = bad caring behavior, score 41-70 = moderate said the existence of SPO (Standard Operating Procedure)
caring behavior, 70-100 = good caring behavior). for all nursing actions greatly affected the compliance of
Nursing nurses caring behavior in the treatment group nurses in taking nursing actions according to the procedure.
after the intervention PSBH (Problem Solving for Better Based on research there is the influence of organizational
Health and Hospital) has a higher average value which factors on caring behavior.[13]
indicates an increase in the category of caring behavior to PSBH (Problem Solving for Better Health and
be better than in the control group where the results show Hospitals) can have a positive impact on nurses caring
no increase in the caring behavior category (medium behavior because the stages carried out in PSBH provide
category). The results of interviews with nurses said that an opportunity for individual nurses to be able to identify
the existing SPO (Standard Operating Procedure) made problems that occur in their own work environment and
nurses confident with the actions taken because there were determine possible solutions and preparation of POA (Plan
regulations. Monitoring from hospital supervisors also of Action) and action monitoring. The implementation of
influences nurses' behaviour.[15] the PSBH (Problem Solving for Better Health and
Factors that influence the performance of nurses Hospital) program is highly dependent on the commitment
namely nurses caring behavior include organizational that exists to each individual nurse both the leader and the
factors. Organizational culture factors in this case are executor of nursing. The PSBH program provides nurses
found in the components of management practice having with an opportunity to innovate (new and creative ideas), a
an important role in changing nurses caring behavior. The simple and clear process, using available resources and
influence of management in this component is in the does not require a lot of money. The principle in this
quality control stage of nursing care services (controlling) program is that "only you will solve your problem", there

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is no reason not to carry out your activities, and successful tanggal 27 januari 2014.
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[13] Mazidawati. Effect of The Implementation of Problem Solving
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wash hands with the baby's mother. Then the socialization [14] Nursalam. Manajemen Keperawatan Aplikasi dalam Praktek
Keperawatan Profesional (5rd ed.). Jakarta. Salemba Medika.
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[16] Sugandi, P.. Efektivitas Problem Solving for Better Health
Caring behavior is the core of nursing services. Caring
(PSBH) terhadap Kelengkapan Dokumentasi Asuhan
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Kasus: Penerapan Health Education di RSU Kabupaten
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Tangerang sebagai Hasil dari Problem Solving for Better Health
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Jakarta, hal. 55, 2019.
IV. CONCLUSION
Nurse caring behavior prior to intervention in the
control group included moderate caring behavior category,
with an average score of 68.55 and in the treatment group
included moderate caring behavior category with an
average score of 69.24. Nurse caring behavior after
intervention in the treatment group increased to good
caring behavior category, with an average score of 72.12
with an average score increase of 2.88 points. Using of
PSBH methods can increase the motivation of caring nurse
behavior.
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