Selasa, 30 November 2010

LAPORAN PELAKSANAAN PERTEMUAN ADVOKASI PROGRAM PERBAIKAN GIZI

LAPORAN PELAKSANAAN PERTEMUAN ADVOKASI PROGRAM PERBAIKAN GIZI

RUU Rumah Sakit

RANCANGAN
UNDANG-UNDANG REPUBLIK INDONESIA
NOMOR … TAHUN …
TENTANG
RUMAH SAKIT
DENGAN RAHMAT TUHAN YANG MAHA ESA
PRESIDEN REPUBLIK INDONESIA,


Menimbang :
a. bahwa pelayanan kesehatan merupakan hak setiap orang yang dijamin dalam Undang-Undang Dasar Negara Republik Indonesia Tahun 1945 yang harus diwujudkan dengan upaya peningkatan derajat kesehatan masyarakat yang setinggi-tingginya;
b. bahwa rumah sakit adalah institusi pelayanan kesehatan bagi masyarakat dengan karateristik tersendiri yang dipengaruhi oleh perkembangan ilmu pengetahuan kesehatan, kemajuan teknologi, dan kehidupan sosial ekonomi masyarakat yang harus tetap mampu meningkatkan pelayanan yang lebih bermutu dan terjangkau oleh masyarakat agar terwujud derajat kesehatan yang setinggi-tingginya;
c. bahwa dalam rangka peningkatan mutu dan jangkauan pelayanan Rumah Sakit serta pengaturan hak dan kewajiban masyarakat dalam memperoleh pelayanan kesehatan, perlu mengatur Rumah Sakit dengan Undang-Undang;
d. bahwa pengaturan mengenai rumah sakit belum cukup memadai untuk dijadikan landasan hukum dalam penyelenggaraan rumah sakit sebagai institusi pelayanan kesehatan bagi masyarakat;
e. bahwa berdasarkan pertimbangan sebagaimana dimaksud dalam huruf a, huruf b, huruf, huruf c, dan huruf d serta untuk memberikan kepastian hukum bagi masyarakat dan Rumah Sakit, perlu membentuk Undang-Undang tentang Rumah Sakit;

Mengingat : Pasal 5 ayat (1), Pasal 20, Pasal 28H ayat (1), dan Pasal 34 ayat (3) Undang-Undang
Dasar Negara Republik Indonesia Tahun 1945;
Dengan Persetujuan Bersama
DEWAN PERWAKILAN RAKYAT REPUBLIK INDONESIA dan PRESIDEN REPUBLIK INDONESIA M E M U T U S K A N:
Menetapkan : UNDANG-UNDANG TENTANG RUMAH SAKIT.

BAB I
KETENTUAN UMUM
Pasal 1
Dalam Undang-Undang ini yang dimaksud dengan:
1. Rumah Sakit adalah institusi pelayanan kesehatan yang menyelenggarakan pelayanan kesehatan perorangan secara paripurna yang menyediakan pelayanan rawat inap, rawat jalan, dan gawat darurat.
2. Gawat Darurat adalah keadaan klinis pasien yang membutuhkan tindakan medis segera guna penyelamatan nyawa dan pencegahan kecacatan lebih lanjut.
3. Pelayanan Kesehatan Paripurna adalah pelayanan kesehatan yang meliputi promotif, preventif, kuratif, dan rehabilitatif.
4. Pasien adalah setiap orang yang melakukan konsultasi masalah kesehatannya untuk memperoleh pelayanan kesehatan yang diperlukan, baik secara langsung maupun tidak langsung di Rumah Sakit.
5. Pemerintah Pusat yang selanjutnya disebut Pemerintah, adalah Presiden Republik Indonesia yang memegang kekuasaan pemerintahan Republik Indonesia sebagaimana dimaksud dalam Undang-Undang Dasar Negara Republik Indonesia Tahun 1945.
6. Pemerintah Daerah adalah Gubernur, Bupati, atau Walikota dan perangkat daerah sebagai unsur penyelenggara pemerintahan daerah.
7. Menteri adalah menteri yang menyelenggarakan urusan pemerintahan di bidang kesehatan.


BAB II
ASAS DAN TUJUAN
Pasal 2
Rumah Sakit diselenggarakan berasaskan Pancasila dan didasarkan kepada nilai kemanusiaan, etika dan profesionalitas, manfaat, keadilan, persamaan hak dan anti diskriminasi, pemerataan, perlindungan dan keselamatan pasien, serta mempunyai fungsi sosial.

Pasal 3
Pengaturan penyelenggaraan Rumah Sakit bertujuan:
a. mempermudah akses masyarakat untuk mendapatkan pelayanan kesehatan;
b. memberikan perlindungan terhadap keselamatan pasien, masyarakat, lingkungan rumah sakit dan sumber daya manusia di rumah sakit;
c. meningkatkan mutu dan mempertahankan standar pelayanan rumah sakit; dan
d. memberikan kepastian hukum kepada pasien, masyarakat, sumber daya manusia rumah sakit, dan Rumah Sakit.


BAB III
TUGAS DAN FUNGSI
Pasal 4
Rumah Sakit mempunyai tugas memberikan pelayanan kesehatan perorangan secara paripurna.

Pasal 5
Untuk menjalankan tugas sebagaimana dimaksud dalam Pasal 4, Rumah Sakit mempunyai fungsi:
a. penyelenggaraan pelayanan pengobatan dan pemulihan kesehatan sesuai dengan standar pelayanan rumah sakit;
b. pemeliharaan dan peningkatan kesehatan perorangan melalui pelayanan kesehatan yang paripurna tingkat kedua dan ketiga sesuai kebutuhan medis;
c. penyelenggaraan pendidikan dan pelatihan sumber daya manusia dalam rangka peningkatan kemampuan dalam pemberian pelayanan kesehatan; dan
d. penyelenggaraan penelitian dan pengembangan serta penapisan teknologi bidang kesehatan dalam rangka peningkatan pelayanan kesehatan dengan memperhatikan etika ilmu pengetahuan bidang kesehatan;

BAB IV
TANGGUNG JAWAB
PEMERINTAH DAN PEMERINTAH DAERAH

Pasal 6
(1) Pemerintah dan pemerintah daerah bertanggung jawab untuk :
a. menyediakan Rumah Sakit berdasarkan kebutuhan masyarakat;
b. menjamin pembiayaan pelayanan kesehatan di Rumah Sakit bagi fakir miskin, atau orang tidak mampu sesuai ketentuan peraturan perundang-undangan;
c. membina dan mengawasi penyelenggaraan Rumah Sakit;
d. memberikan perlindungan kepada Rumah Sakit agar dapat memberikan pelayanan kesehatan secara profesional dan bertanggung jawab;
e. memberikan perlindungan kepada masyarakat pengguna jasa pelayanan Rumah Sakit sesuai dengan ketentuan peraturan perundang-undangan;
f. menggerakkan peran serta masyarakat dalam pendirian Rumah Sakit sesuai dengan jenis pelayanan yang dibutuhkan masyarakat;
g. menyediakan informasi kesehatan yang dibutuhkan oleh masyarakat;
h. menjamin pembiayaan pelayanan kegawatdaruratan di Rumah Sakit akibat bencana dan kejadian luar biasa;
i. menyediakan sumber daya manusia yang dibutuhkan; dan
j. mengatur pendistribusian dan penyebaran alat kesehatan berteknologi tinggi dan bernilai tinggi.
(2) Tanggung jawab sebagaimana dimaksud pada ayat (1) dilaksanakan berdasarkan kewenangan
sesuai dengan ketentuan peraturan perundang-undangan


BAB V
PERSYARATAN
Bagian Kesatu
Umum
Pasal 7
1) Rumah sakit harus memenuhi persyaratan lokasi, bangunan, prasarana, sumber daya manusia, kefarmasian, dan peralatan.
2) Rumah Sakit dapat didirikan oleh Pemerintah, pemerintah daerah, atau swasta.
3) Rumah sakit yang didirikan oleh Pemerintah dan pemerintah daerah sebagaimana dimaksud pada ayat (2) harus berbentuk Unit Pelaksana Teknis dari Instansi yang bertugas di bidang kesehatan, Instansi tertentu, atau Lembaga Teknis Daerah dengan pengelolaan Badan Layanan Umum atau Badan Layanan Umum Daerah sesuai dengan ketentuan peraturan perundang-undangan.
4) Rumah Sakit yang didirikan oleh swasta sebagaimana yang dimaksud pada ayat ( 2 ) harus
5) berbentuk Badan Hukum yang kegiatan usahanya hanya bergerak di bidang perumahsakitan.

Bagian Kedua
Lokasi
Pasal 8
1) Persyaratan lokasi sebagaimana dimaksud dalam Pasal 7 ayat (1) harus memenuhi ketentuan mengenai kesehatan, keselamatan lingkungan, dan tata ruang, serta sesuai dengan hasil kajian kebutuhan dan kelayakan penyelenggaraan Rumah Sakit.
2) Ketentuan mengenai kesehatan dan keselamatan lingkungan sebagaimana dimaksud pada ayat (1) menyangkut Upaya Pemantauan Lingkungan, Upaya Pengelolaan Lingkungan dan/atau dengan Analisis Mengenai Dampak Lingungan dilaksanakan sesuai dengan peraturan perundang-undangan.
3) Ketentuan mengenai tata ruang sebagaimana dimaksud pada ayat (1) dilaksanakan sesuai dengan peruntukan lokasi yang diatur dalam Rencana Tata Ruang Wilayah Kabupaten/Kota, Rencana Tata Ruang Kawasan Perkotaan dan/atau Rencana Tata Bangunan dan Lingkungan.
4) Hasil kajian kebutuhan penyelenggaraan Rumah Sakit sebagaimana dimaksud pada ayat (1) harus didasarkan pada studi kelayakan dengan menggunakan prinsip pemerataan pelayanan, efisiensi dan efektivitas, serta demografi.

Bagian Ketiga
Bangunan
Pasal 9
Persyaratan bangunan sebagaimana dimaksud dalam Pasal 7 ayat (1) harus memenuhi :
a. persyaratan administratif dan persyaratan teknis bangunan gedung pada umumnya, sesuai dengan ketentuan peraturan perundang-undangan; dan
b. persyaratan teknis bangunan Rumah Sakit, sesuai dengan fungsi, kenyamanan dan kemudahan dalam pemberian pelayanan serta perlindungan dan keselamatan bagi semua orang termasuk penyandang cacat, anak-anak, dan orang usia lanjut.

Pasal 10
1) Bangunan Rumah Sakit sebagaimana dimaksud dalam Pasal 9 harus dapat digunakan untuk memenuhi kebutuhan pelayanan kesehatan yang paripurna, pendidikan dan pelatihan, serta penelitian dan pengembangan ilmu pengetahuan dan teknologi kesehatan.
2) Bangunan rumah sakit sebagaimana dimaksud pada ayat (1) paling sedikit terdiri atas ruang:
a. rawat jalan;
b. ruang rawat inap;
c. ruang gawat darurat;
d. ruang operasi;
e. ruang tenaga kesehatan;
f. ruang radiologi;
g. ruang laboratorium;
h. ruang sterilisasi;
i. ruang farmasi;
j. ruang pendidikan dan latihan;
k. ruang kantor dan administrasi;
l. ruang ibadah, ruang tunggu;
m. ruang penyuluhan kesehatan masyarakat rumah sakit;
n.ruang menyusui;
o. ruang mekanik;
p. ruang dapur;
q. laundry;
r. kamar jenazah;
s. taman;
t. pengolahan sampah; dan
u. pelataran parkir yang mencukupi.
3) Ketentuan lebih lanjut mengenai persyaratan teknis bangunan Rumah Sakit sebagaimana dimaksud pada ayat (1) dan ayat (2) diatur dengan Peraturan Menteri.

Bagian Keempat
Prasarana
Pasal 11
1) Prasarana Rumah Sakit sebagaimana dimaksud dalam Pasal 7 ayat (1) dapat meliputi:
a. instalasi air;
b. instalasi mekanikal dan elektrikal;
c. instalasi gas medik;
d. instalasi uap;
e. instalasi pengelolaan limbah;
f. pencegahan dan penanggulangan kebakaran;
g. petunjuk, standar dan sarana evakuasi saat terjadi keadaan darurat;
h. instalasi tata udara;
i. sistem informasi dan komunikasi; dan
j. ambulan.
2) Prasarana sebagaimana dimaksud pada ayat (1) harus memenuhi standar pelayanan, keamanan, serta keselamatan dan kesehatan kerja penyelenggaraan Rumah Sakit
3) Prasarana sebagaimana dimaksud pada ayat (1) harus dalam keadaan terpelihara dan berfungsi dengan baik.
4) Pengoperasian dan pemeliharaan prasarana Rumah Sakit sebagaimana dimaksud pada ayat (1) harus dilakukan oleh petugas yang mempunyai kompetensi di bidangnya.
5) Pengoperasian dan pemeliharaan prasarana Rumah Sakit sebagaimana dimaksud pada ayat (1) harus didokumentasi dan dievaluasi secara berkala dan berkesinambungan.
6) Ketentuan lebih lanjut mengenai prasarana Rumah Sakit sebagaimana dimaksud pada ayat (1) sampai dengan ayat (5) diatur dengan Peraturan Menteri.

Bagian Kelima
Sumber Daya Manusia
Pasal 12
1) Persyaratan sumber daya manusia sebagaimana dimaksud dalam Pasal 7 ayat (1) yaitu Rumah Sakit harus memiliki tenaga tetap yang meliputi tenaga medis dan penunjang medis, tenaga keperawatan, tenaga kefarmasian, tenaga manajemen rumah sakit, dan tenaga non kesehatan.
2) Jumlah dan jenis sumber daya manusia sebagaimana dimaksud pada ayat (1) harus sesuai dengan jenis dan klasifikasi Rumah Sakit.
3) Rumah Sakit harus memiliki data ketenagaan yang melakukan praktik atau pekerjaan dalam penyelenggaraan Rumah Sakit.
4) Rumah Sakit dapat mempekerjakan tenaga tidak tetap dan konsultan sesuai dengan kebutuhan dan kemampuan sesuai dengan peraturan perundangan.

Pasal 13
1) Tenaga medis yang melakukan praktik kedokteran di Rumah Sakit wajib memiliki Surat Izin Praktik sesuai dengan ketentuan peraturan perundang-undangan.
2) Tenaga kesehatan tertentu yang bekerja di Rumah Sakit wajib memiliki izin sesuai dengan ketentuan peraturan perundang-undangan.
3) Setiap tenaga kesehatan yang bekerja di Rumah Sakit harus bekerja sesuai dengan standar profesi, standar pelayanan Rumah Sakit, standar prosedur operasional yang berlaku, etika profesi, menghormati hak pasien dan mengutamakan keselamatan pasien.
4) Ketentuan mengenai tenaga medis dan tenaga kesehatan sebagaimana dimaksud pada ayat (1) dan ayat (2) dilaksanakan sesuai dengan ketentuan peraturan perundang-undangan.

Pasal 14
1) Rumah Sakit dapat mempekerjakan tenaga kesehatan asing sesuai dengan kebutuhan pelayanan.
2) Pendayagunaan tenaga kesehatan asing sebagaimana dimaksud pada ayat (1) hanya dilakukan dengan mempertimbangkan kepentingan alih teknologi dan ilmu pengetahuan serta ketersediaan tenaga kesehatan setempat.
3) Pendayagunaan tenaga kesehatan asing sebagaimana dimaksud pada ayat (1) hanya dilakukan bagi tenaga kesehatan asing yang telah memiliki Surat Tanda Registrasi dan Surat Ijin Praktik
4) Ketentuan lebih lanjut mengenai pendayagunaan tenaga kesehatan asing pada ayat (1) ayat (2) dan ayat (3) diatur dengan Peraturan Pemerintah.

Bagian Keenam
Kefarmasian
Pasal 15
1) Persyaratan kefarmasian sebagaimana dimaksud dalam Pasal 7 ayat (1) harus menjamin ketersediaan sediaan farmasi dan alat kesehatan yang bermutu, bermanfaat, aman dan terjangkau.
2) Pelayanan sediaan farmasi di Rumah Sakit harus mengikuti standar pelayanan kefarmasian.
3) Pengelolaan alat kesehatan, sediaan farmasi, dan bahan habis pakai di Rumah Sakit harus dilakukan oleh Instalasi farmasi sistem satu pintu.
4) Besaran harga perbekalan farmasi pada instalasi farmasi Rumah Sakit harus wajar dan berpatokan kepada harga patokan yang ditetapkan Pemerintah.
5) Ketentuan lebih lanjut mengenai standar pelayanan kefarmasian sebagaimana dimaksud pada ayat (2) diatur dengan Peraturan Menteri.

Bagian Ketujuh
Peralatan
Pasal 16
1) Persyaratan peralatan sebagaimana dimaksud dalam Pasal 7 ayat (1) meliputi peralatan medis dan nonmedis harus memenuhi standar pelayanan, persyaratan mutu, keamanan, keselamatan dan laik pakai.
2) Peralatan medis sebagaimana dimaksud pada ayat (1) harus diuji dan dikalibrasi secara berkala oleh Balai Pengujian Fasilitas Kesehatan dan/atau institusi pengujian fasilitas kesehatan yang berwenang.
3) Peralatan yang menggunakan sinar pengion harus memenuhi ketentuan dan harus diawasi oleh lembaga yang berwenang.
4) Penggunaan peralatan medis dan non medis di rumah sakit harus dilakukan sesuai dengan indikasi medis pasien.
5) Pengoperasian dan pemeliharaan peralatan Rumah Sakit harus dilakukan oleh petugas yang mempunyai kompetensi di bidangnya.
6) Pemeliharaan peralatan harus didokumentasi dan dievaluasi secara berkala dan berkesinambungan
7) Ketentuan mengenai pengujian dan/atau kalibrasi peralatan medis, standar yang berkaitan dengan keamanan, mutu, dan manfaat dilaksanakan sesuai dengan ketentuan peraturan perundang-undangan.

Pasal 17
Rumah Sakit yang tidak memenuhi persyaratan sebagaimana dimaksud dalam Pasal 7, Pasal 8, Pasal 9, Pasal 10, Pasal 11, Pasal 12, Pasal 13, Pasal 14, Pasal 15 , dan Pasal 16 tidak diberikan izin mendirikan, dicabut atau tidak diperpanjang izin operasional Rumah Sakit.


BAB VI
JENIS DAN KLASIFIKASI
Bagian Kesatu
Jenis
Pasal 18
Rumah Sakit dapat dibagi berdasarkan jenis pelayanan dan pengelolaannya.

Pasal 19
1) Berdasarkan jenis pelayanan yang diberikan, Rumah Sakit dikategorikan dalam Rumah Sakit Umum dan Rumah Sakit Khusus.
2) Rumah Sakit Umum sebagaimana dimaksud pada ayat (1) memberikan pelayanan kesehatan pada semua bidang dan jenis penyakit.
3) Rumah Sakit Khusus sebagaimana dimaksud pada ayat (1) memberikan pelayanan utama pada satu bidang atau satu jenis penyakit tertentu berdasarkan disiplin ilmu, golongan umur, organ, jenis penyakit, atau kekhususan lainnya.

Pasal 20
1) Berdasarkan pengelolaannya Rumah Sakit dapat dibagi menjadi Rumah Sakit publik dan Rumah Sakit privat.
2) Rumah Sakit publik sebagaimana dimaksud pada ayat (1) dapat dikelola oleh Pemerintah, pemerintah daerah, dan Badan Hukum yang bersifat nirlaba.
3) Rumah sakit publik yang dikelola Pemerintah dan Pemerintah Daerah diselenggarakan berdasarkan pengelolaan Badan Layanan Umum atau Badan Layanan Umum Daerah sesuai dengan ketentuan peraturan perundang-undangan.
4) Rumah Sakit publik yang dikelola Pemerintah dan pemerintah daerah sebagaimana dimaksud pada ayat (2) tidak dapat dialihkan menjadi Rumah Sakit privat.

Pasal 21
Rumah Sakit privat sebagaimana dimaksud dalam Pasal 19 dikelola oleh Badan Hukum dengan tujuan profit yang berbentuk Perseroan Terbatas atau Persero.

Pasal 22
1) Rumah Sakit dapat ditetapkan menjadi Rumah Sakit pendidikan setelah memenuhi persyaratan dan standar rumah sakit pendidikan.
2) Rumah Sakit pendidikan sebagaimana dimaksud pada ayat (1) ditetapkan oleh Menteri setelah berkoordinasi dengan Menteri yang membidangi urusan pendidikan.

Pasal 23
1) Rumah Sakit pendidikan sebagaimana dimaksud dalam Pasal 22 merupakan Rumah Sakit yang menyelenggarakan pendidikan dan penelitian secara terpadu dalam bidang pendidikan profesi kedokteran, pendidikan kedokteran berkelanjutan, dan pendidikan tenaga kesehatan lainnya.
2) Dalam penyelenggaraan Rumah Sakit Pendidikan dapat dibentuk Jejaring Rumah Sakit Pendidikan.
3) Ketentuan lebih lanjut mengenai Rumah Sakit pendidikan diatur dengan Peraturan Pemerintah.

Bagian Kedua
Klasifikasi
Pasal 24
1) Dalam rangka penyelenggaraan pelayanan kesehatan secara berjenjang dan fungsi rujukan, rumah sakit umum dan rumah sakit khusus diklasifikasikan berdasarkan fasilitas dan kemampuan pelayanan Rumah Sakit.
2) Klasifikasi Rumah Sakit umum sebagaimana dimaksud pada ayat (1) terdiri atas :
a. Rumah Sakit umum kelas A;
b. Rumah Sakit umum kelas B
c. Rumah Sakit umum kelas C;
b. Rumah Sakit umum kelas D.
3) Klasifikasi Rumah Sakit khusus sebagaimana dimaksud pada ayat (1) terdiri atas :
a. Rumah Sakit khusus kelas A;
b. Rumah Sakit khusus kelas B;
c. Rumah Sakit khusus kelas C.
4) Ketentuan lebih lanjut mengenai klasifikasi sebagaimana dimaksud pada ayat (1) diatur dengan Peraturan Menteri.


BAB VII
PERIZINAN


Pasal 25
1) Setiap penyelenggara Rumah Sakit wajib memiliki izin.
2) Izin sebagaimana dimaksud ayat (1) terdiri dari izin mendirikan dan izin operasional.
3) Izin mendirikan sebagaimana dimaksud pada ayat (2) diberikan untuk jangka waktu 2 (dua) tahun dan dapat diperpanjang untuk 1 (satu) tahun.
4) Izin operasional sebagaimana dimaksud pada ayat (2) diberikan untuk jangka waktu 5 (lima) tahun dan dapat diperpanjang kembali selama memenuhi persyaratan.
5) Izin sebagaimana dimaksud pada ayat (2) diberikan setelah memenuhi persyaratan sebagaimana diatur dalam Undang-Undang ini.

Pasal 26
1) Izin Rumah Sakit kelas A dan Rumah Sakit penanaman modal asing atau penanaman modal dalam negeri diberikan oleh Menteri setelah mendapatkan rekomendasi dari pejabat yang berwenang di bidang kesehatan pada Pemerintah Daerah Provinsi.
2) Izin Rumah Sakit penanaman modal asing atau penanaman modal dalam negeri sebagaimana dimaksud pada ayat (1) diberikan setelah mendapat rekomendasi dari instansi yang melaksanakan urusan penanaman modal asing atau penanaman modal dalam negeri.
3) Izin Rumah Sakit kelas B diberikan oleh Pemerintah Daerah Provinsi setelah mendapatkan rekomendasi dari pejabat yang berwenang di bidang kesehatan pada Pemerintah Daerah Kabupaten/Kota.
4) Izin Rumah Sakit kelas C dan kelas D diberikan oleh Pemerintah Daerah Kabupaten/Kota setelah mendapat rekomendasi dari pejabat yang berwenang di bidang kesehatan pada Pemerintah Daerah Kabupaten/Kota.

Rabu, 24 November 2010

AVICENA: HUBUNGAN PENYAKIT DENGAN FAKTOR PERILAKU DAN SOSI...

AVICENA: HUBUNGAN PENYAKIT DENGAN FAKTOR PERILAKU DAN SOSI...: "BAB I PENDAHULUAN Timbulnya suatu penyakit dalam masyarakat tidak serta merta karena penyakit tersebut muncul begitu saja. Apalagi bila seb..."

PENGGOLONGAN OBAT

II. Pembahasan

A. Pengertian Obat
Menurut PerMenKes 917/Menkes/Per/x/1993, obat (jadi) adalah sediaan atau paduan-paduan yang siap digunakan untuk mempengaruhi atau menyelidiki secara fisiologi atau keadaan patologi dalam rangka penetapan diagnosa, pencegahan, penyembuhan, pemulihan, peningkatan kesehatan dan kontrasepsi.
Menurut Ansel (1985), obat adalah zat yang digunakan untuk diagnosis, mengurangi rasa sakit, serta mengobati atau mencegah penyakit pada manusia atau hewan.
Obat dalam arti luas ialah setiap zat kimia yang dapat mempengaruhi proses hidup, maka farmakologi merupakan ilmu yang sangat luas cakupannya. Namun untuk seorang dokter, ilmu ini dibatasi tujuannya yaitu agar dapat menggunakan obat untuk maksud pencegahan, diagnosis, dan pengobatan penyakit. Selain itu, agar mengerti bahwa penggunaan obat dapat mengakibatkan berbagai gejala penyakit. (Bagian Farmakologi, Fakultas Kedokteran, Universitas Indonesia)
Obat merupakan sediaan atau paduan bahan-bahan yang siap untuk digunakan untuk mempengaruhi atau menyelidiki sistem fisiologi atau keadaan patologi dalam rangka penetapan diagnosis, pencegahan, penyembuhan, pemulihan, peningkatan, kesehatan dan kontrasepsi (Kebijakan Obat Nasional, Departemen Kesehatan RI, 2005).
Obat merupakan benda yang dapat digunakan untuk merawat penyakit, membebaskan gejala, atau memodifikasi proses kimia dalam tubuh.
Obat merupakan senyawa kimia selain makanan yang bisa mempengaruhi organisme hidup, yang pemanfaatannya bisa untuk mendiagnosis, menyembuhkan, mencegah suatu penyakit.

B. Penggolongan Obat
Obat-obat yang beredar di pasaran Indonesia, digolongkan oleh Direktorat Jendral Pengawasan Obat dan Makanan (Ditjen POM) dalam empat penggolongan umum, yaitu : Obat narkotika , Obat keras , Obat bebas terbatas , Obat bebas. Penggolongan ini dimaksudkan untuk memudahkan pengawasan terhadap peredaran dan pemakaian obat-obat tersebut. Setiap golongan obat diberi tanda pada kemasannya pada bagian kemasan yang segera terlihat.


1. Obat Bebas

Merupakan obat yang dapat digunakan tanpa resep dokter. Ditandai dengan lingkaran berwarna hijau dengan tepi lingkaran berwarna hitam. Obat bebas umumnya berupa suplemen vitamin dan mineral, obat gosok, beberapa analgetik-antipiretik, dan beberapa antasida. Obat golongan ini dapat dibeli bebas di Apotek, toko obat, toko kelontong, warung. Contoh : parasetamol, vitamin atau multivitamin (Livron B Plex)

2. Obat Bebas Terbatas (daftar W = Waarschuwing = peringatan )

Merupakan obat-obatan yang dalam jumlah tertentu masih bisa dibeli di apotek, tanpa resep dokter. Ditandai dengan lingkaran berwarna biru dengan tepi lingkaran berwarna hitam. Obat-obat yang umunya masuk ke dalam golongan ini antara lain obat batuk, obat influenza, obat penghilang rasa sakit dan penurun panas pada saat demam (analgetik-antipiretik), beberapa suplemen vitamin dan mineral, dan obat-obat antiseptika, obat tetes mata untuk iritasi ringan. Obat golongan ini hanya dapat dibeli di Apotek dan toko obat berizin. Contoh : Antimo (obat anti mabuk), Neozep, Decolgen, Visine,

3. Obat Keras (daftar G = gevaarlijk = berbahaya)

Merupakan obat yang pada kemasannya ditandai dengan lingkaran yang didalamnya terdapat huruf K berwarna merah yang menyentuh tepi lingkaran yang berwarna hitam. Obat keras merupakan obat yang hanya bisa didapatkan dengan resep dokter. Obat-obat yang umumnya masuk ke dalam golongan ini antara lain :
• Antibiotik : amoksisilina, ampisilina, super tetra, tetracycline, trisulfa, ripamfisin, khlorampenicol, dan lain-lain.
• Anti mual : metoklopramid HCL dan lain-lain.
• Pencahar : bisacodil (dulcolax, dan lain-lain).
• Obat sakit perut : Hyosine N-butilbromide (buscopan, dan lain-lain).
• Obat asma : aminophyline, salbutamol, dan lain-lain.
• Penghilang nyeri : asam mefenamat (ponstan, mectan, dan lain-lain).
• Antihistamin : dimenhidrinat (antimo, dan lain-lain), Dexchlorphynrimine maleat (CTM, dan lain-lain).
• Anti jamur : Nistatin, mekonazol.
• Pemucat kulit : hidroquinon, dan lain-lain.
• Anti rematik : ibuprofen, diclofenac, piroxicam, dan lain-lain.
• Kortikosteroid : dexamethasone, prednisone, dan lain-lain.
• Obat lambung : cimetidine, ranitidine, dan lain-lain.
• Obat Asam urat : allopurinol, dan lain-lain.
• Obat Kencing manis : glibenclamid, dan lain-lain.
• Obat tekanan darah tinggi : captopril, reserpin, HCT, dan lain-lain.

Obat-obat tersebut jika dikonsumsi tanpa pengawasan dokter akan menimbulkan efek samping terhadap tubuh (jantung, hati, lambung, ginjal, dan lain-lain), baik karena dosis yang berlebihan maupun karena waktu pemakaian yang terlalu lama maupun terlalu pendek dan tergantung jenis obat yang dikonsumsi. Efek samping tersebut baik ringan, seperti gatal-gatal, pusing, mual-mual, nyeri ulu hati, sampai yang berat, diare, sampai yang berat berupa menurunnya kesadaran, koma bahkan kematian. Saat ini obat-obat daftar G tersebut dapat ditemui di beberapa outlet yang secara kewenangan tidak dibenarkan menjual obat tersebut. Hal ini terjadi karena masih lemahnya mekanisme kontrol terhadap peredaran obat tersebut mulai dari pabrik, distributor maupun di tingkat pengecer, terbatasnya tenaga pengawas terhadap peredaran obat-obatan tersebut, kebutuhan masyarakat yang cukup tinggi terhadap obat-obatan tersebut, dan harga yang lebih miring dibanding jika dibeli di outlet resmi (apotik) tanpa menyadari bahaya yang akan timbul.

4. Obat Narkotika (daftar O = opium)

Merupakan zat atau obat yang berasal dari tanaman atau bukan tanaman baik sintesis maupun semi sintesis yang dapat menyebabkan penurunan atau perubahan kesadaran, hilangnya rasa, mengurangi sampai menghilangkan rasa nyeri, dan dapat menimbulkan ketergantungan (UURI No. 22 Th 1997 tentang Narkotika). Obat ini pada kemasannya ditandai dengan lingkaran yang didalamnya terdapat palang (+) berwarna merah. Obat Narkotika bersifat adiksi dan penggunaannya diawasi dengan ketat, sehingga obat golongan narkotika hanya diperoleh di Apotek dengan resep dokter asli (tidak dapat menggunakan kopi resep). Contoh dari obat narkotika antara lain: opium, coca, ganja/marijuana, morfin, heroin, obat anti depressan (seperti diazepam, clobazam, lithium), obat anti ansietas (seperti benzodiasepin, alprazolam) atau anti-psikotik (seperti chlorpromazine, haloperidol) dan lain sebagainya. Dalam bidang kesehatan, obat-obat narkotika biasa digunakan sebagai anestesi/obat bius dan analgetik/obat penghilang rasa sakit. Macam-macam narkotika:

a. Opiod (Opiat)
Bahan-bahan opioida yang sering disalahgunakan :
• Morfin
• Heroin (putaw)
• Codein
• Demerol (pethidina)
• Methadone
b. Kokain
c. Cannabis (ganja)

5. Obat tradisional/Jamu
Obat Tradisional merupakan bahan atau ramuan bahan yang berupa bahan tumbuhan, bahan hewan, bahan mineral, sediaan sarian (gelenik) atau campuran dari bahan tersebut yang secara turun menurun telah digunakan untuk pengobatan berdasarkan pengalaman.

III. Penutup
A. Kesimpulan :
Obat merupakan sediaan atau paduan bahan-bahan yang siap untuk digunakan untuk mempengaruhi atau menyelidiki sistem fisiologi atau keadaan patologi dalam rangka penetapan diagnosis, pencegahan, penyembuhan, pemulihan, peningkatan, kesehatan dan kontrasepsi. Dalam peredarannya, obat dibagi menjadi lima golongan yang memiliki fungsi, dan aturan pemakaiannya masing-masing. Oleh karena itu, sebagai konsumen kita harus memahami dan mengetahui jenis obat dan cara pemakaiannya secara tepat agar tidak menimbulkan dampak negative bagi kita.

B. Daftar Pustaka

Muchid, Abdul dkk. 2006. Pedoman Penggunaan Obat Bebas Dan Bebas Terbatas. Jakarta : Direktorat Bina Farmasi Komunitas Dan Klinik Ditjen Bina Kefarmasian Dan Alat Kesehatan Departemen Kesehatan.

Sanjoyo, Raden. 2007. Obat (Biomedik Farmakologi). Yogyakarta : FMIPA Universitas Gadjah Mada

Hasto. 2010. Kenali Lebih Baik Jenis-jenis Obat (2). http://www.tabloidnova.com, diunduh pada tanggal 29 September 2010

Ardyanto, T.D. 2006. Obat Bebas, Obat Keras. http://www.tonangardyanto.blogspot.com, diunduh pada tanggal 29 September 2010

Veteriner, Mariana. 2008. Sekilas Mengenai Dimenhidrinate. http://www.marianaveteriner.blogspot.com, diunduh pada tanggal 28 September 2010

Senin, 22 November 2010

Understanding Psychology within the Context of the Other Academic Disciplines

William E. Herman
Professor
Department of Psychology
State University of New York
College at Potsdam
Potsdam, New York, U.S.A. 13676-2294
Paper presented at the 23rd Annual Conference on the
Undergraduate Teaching of Psychology: Ideas & Innovations
Sponsored by the Psychology Department at
Farmingdale State College (a SUNY campus)
held on
Saturday, March 21, 2009
At the
Doubletree Hotel, Tarrytown, New York
Abstract
This paper is designed to assist undergraduate and graduate students as they study the field of
psychology. As a course supplement, it intends to guide students in their learning throughout the
semester and beyond the scope of the present semester in the form of lifelong learning. This
learning tool will help students in organizing psychological terms, concepts, and ideas as well as
connecting psychological constructs to existing schemas from previous academic courses. A
contextual approach will be used that situates psychology historically and structurally within the
academic traditions of the humanities, social sciences, and natural sciences. The field of
psychology is understood by examining four current viewpoints (psychoanalytic, behavioristic,
humanistic, and cognitive) that can be employed to critically compare and contrast theoretical
perspectives. The information and ideas presented here will supplement a course textbook,
classroom lectures and activities, outside readings, and other learning activities. The document
is also designed for readers who need a quick overview, reference, or review of the field of
psychology because they are new to the field, new to a particular course, or lacking a strong
background in the field. This scholarly effort is dedicated to all of those who strive to develop a
comprehensive and in-depth knowledge of psychology in an effort to apply these ideas to
practical situations in their professional careers and personal lives.
Key Terms: teaching psychology, learning psychology, organization of knowledge


Understanding Psychology within the Context
of the Other Academic Disciplines
A traditional problem for college/university students is that they are expected to be more
competent and flexible learners than many of their former high school peers. This implies that they can quickly absorb large amounts of complex information, transfer such knowledge appropriately, and understand such content at deeper levels of cognitive understanding. For example, students enrolled in their first undergraduate psychology course and those taking graduate psychology courses have offered the following legitimate concerns over the years:
1. They easily become overwhelmed by so many new terms and concepts.
2. They confuse terms and concepts due to cognitive overload and/or the different and specialized use of such terms and concepts as compared to usage in previous courses.
3. They fail to remember, organize, and connect what they have previously learned in a class or are currently learning in a course.
4. They lack an organized model of how the field of psychology could be understood.
5. They are missing an understanding of exactly how their current course instructor
conceptualizes the field and that the conceptual vantage point of their current instructor could be radically different than teachers in previous courses.
It seems reasonable to assume that any learning tool that might help large numbers of students in even a few of the problem learning areas listed above could have a dramatic positive impact upon learning outcomes. The author of this paper has successfully employed just such a learning tool and offers this approach to an audience who obviously cares deeply about the teaching of psychology.
While historians have their dates and chemists have the Periodic Table of the Elements to organize knowledge and impart important ideas to students, what can psychologists offer students and fellow professionals to structure psychological knowledge? This paper offers a professional paper the author has written and shared with students for nearly three decades that assists students as they construct their own knowledge of psychology. Such a teaching/learning approach also assures students from the start of the course that they know how the instructor interprets the field of psychology.
The first order of business is to situate the field of psychology within the established academic traditions or domains of the humanities, social sciences, and natural sciences. All college students have had educational experiences in these domains, but few students have paused to compare and contrast how the courses they have previously taken are similar or different related to method of evidence for seeking truth, how the nature of what is being studied drives the search for new knowledge, and what societal reward systems can do to advance particular disciplines. Since all students have completed some courses in these three traditions,
they possess cognitive schemas that are well worth tapping into when studying psychology, or
for that matter other disciplines.
Next, students are introduced to the course instructor’s personal conceptualization of the field
of psychology according to the psychoanalytic, behavioristic, humanistic, and cognitive
perspectives in psychology. Students are succinctly shown how these four viewpoints have
evolved in the history of the field and how different psychologists today might employ various
theoretical viewpoints to explain, predict, and study human behavior. The course instructor
helps students match up or classify theoretical ideas presented in the textbook during the semester with this model. For example, students are shown how the ideas of Freud and Erikson best fit under the psychoanalytic view which emphasizes unconscious/conscious motivation; the dynamic personality model of the id, ego, and superego; and the important influences of early childhood upon later development and through the adult years.
Most students are deeply appreciative when a course instructor attempts to teach a discipline while at the same time teach the structure of the discipline as Jerome Bruner (1960) had suggested many decades ago. This approach is easily adaptable by those who teach in sub-specialties other than those of the author who primarily teaches educational psychology and developmental psychology courses.
As readers ponder the five (5) student concerns regarding learning cited earlier in this paper, they should note that these key learning elements involve human memory, but much more than what students generally think of in terms of remembering. The memory process is usually a necessary, but not sufficient condition, for the type of higher-level learning outlined here that implies understanding, application, and evaluation. Memory is a complex process that also involves forgetting, confusing, organizing, connecting, and retrieving relevant subject matter.
Successful students are likely to already know this, but it is never too late to learn about the complexities of memory, how your personal memory system operates and is structured, and how it can be further improved. Students are urged to strive for the lofty goal of discovering the connections between “bits” of psychological knowledge and organizing such knowledge into coherent structures that will assist in later recall and result in deeper levels of understanding.

Psychology in the Larger Context
Imagine that it was possible to classify every college/university course into only one of the three following academic traditions: humanities, social sciences, and natural sciences. Consider the knowledge distinctions involved with learning related to taking a course or majoring in a discipline within these hallmarks. What does being a student of the humanities really mean? What does it mean to be a natural scientist or study the natural sciences? What
does it mean to be a social scientist or study the social sciences? What similarities and
distinctions exist between these three academic traditions?
One way to respond to these crucial questions would be to define what is meant by the
humanities, natural sciences, and social sciences. Prior to this step, students should already have
some basic ideas from an inclusion versus exclusion standpoint based upon their previous
academic training. Table 1 below is an attempt to organize disciplines or fields of study (think
perhaps of high school and college/university classes you have taken) according to this
paradigm. You should already recognize the names of most of these disciplines, but some of
them might be confusing or actually fit under more than one heading.
Table 1
Academic Disciplines and the Three Traditions
It can be logically assumed that the disciplines listed under each heading share several
common characteristics and disciplines under the same heading share more in common with each
Humanities Social Sciences Natural Sciences
Art
Music
Philosophy
Religion
Modern Languages
Ancient History
Literature
Speech
Journalism
Theater/Drama
Psychology
Sociology
Political Science
(Politics)
Economics
Geography
Modern History
Cultural Anthropology
Gerontology
Biology
Chemistry
Physics
Mathematics
Geology
Computer Science
Genetics
Astronomy
Zoology
Botany
Understanding Psychology Page 7
other than with disciplines listed under other headings. For example, biology and chemistry have
more in common with each other than do biology and music. Psychology as a social science
shares a great deal with the disciplines of sociology, politics (also known as political science),
economics, cultural anthropology, modern history, etc. Another example might be seen by the
fact that a social psychology course might be offered through a Department of Psychology and at
other institutions the same course (at least according to title) might be offered by a Department
of Sociology. Methodological approaches to studying phenomena and discovering knowledge
are often easily shared across different disciplines under each heading. This frequently
encourages interdisciplinary studies where social scientists from different disciplines might
collaborate to conduct research. The collaborative nature of research can often be spotted by a
careful reading of the biographical information included in the Author Notes or even the
institutional affiliations of authors.
Some disciplines are intriguing because they have a foot in more than one academic
tradition. A discipline like anthropology is often split between those who follow the more
traditional social science orientations of cultural anthropology and anthropologists who employ a
more laboratory (hard science) approach such as in physical anthropology. Historians are also
deeply rooted in the humanities, if they are studying ancient cultures where the only remaining
artifacts in the form of art, literature, and languages constitute the data being analyzed.
Historians who study more modern events like the Cold War find that survey data in the form of
public opinion polls during this historical time period may or may not support research
hypotheses. The complexities of academic disciplines will not always allow for the rigid
categorization into distinctive academic traditions, but more often than not, such categorization
will lead you into the proper direction.
Understanding Psychology Page 8
The Oxford English Dictionary defines social science as “the study of human society and
social relationships.” Many social scientists employ methods of studying variables and
phenomena that are primarily quantitative or empirical (numerical) in nature such as birth order,
age, or intelligence test score. Other more qualitative approaches are used when a variable
seems to defy numerical measurement such as caring for others, emotional states, or parenting
style. When studying such variables, social scientists adopt methodologies such as survey
measures, interview formats, ethnographic field studies, case studies, biographies, and oral
histories. Some social science researchers conduct experiments using both quantitative and
qualitative measures in the same study, since the underlying nature of the variable drives the
method used to measure a variable.
Each social science discipline to some degree strives to compete with other disciplines
inside and outside the social sciences for the discovery of new knowledge, funding, and prestige.
A larger proportion of the available financial resources at the university level normally is
devoted to departments that can attract large numbers of high quality students, make scientific
breakthroughs, hold government patents, etc. These are the famous “turf” battles on campus that
can be seen by students in terms of the shrinking or expanding course offerings each semester
and where specialized faculty might be available to some students and unavailable to others
because they are working on research grants or traveling abroad.
Although each social science discipline shares a great deal with other social science
disciplines, each has the potential to make unique contributions to the knowledge base in which
we can better understand human behavior in various contextual circumstances and develop/refine
useful techniques to study human behavior. Disciplines bring different fruits of knowledge to
the table. Oftentimes, the focus upon a particular aspect of how human beings interact with the
Understanding Psychology Page 9
environment demands a particular method of discovery. In addition to methodological
specializations, each social science discipline possesses a distinctive historical tradition, unique
theoretical perspectives, philosophical vantage points, and special interests.
The Oxford English Dictionary defines natural science as “the branch of knowledge that
deals with the natural or physical world.” A quick glance at the disciplines listed under the
natural sciences suggests a degree of precision in measurement not normally found in the
humanities or the social sciences. The scientific approach to discovery reigns supreme here and
measurement is relatively more refined compared to the other two academic traditions. These
disciplines are frequently called the “hard sciences.” Objectivity is frequently valued over
subjectivity, because to be subjective implies a source of bias.
The humanities have been thought of as the branch of knowledge that investigates
particularly human constructs and human concerns other than those attributed to natural
processes. An examination of the humanities points to the fields of study that explore unique
qualities of the human being. These academic pursuits focus substantial exploration upon
subjective human experience and celebrate ideas like creativity, individual uniqueness, and
personal meaning. Arguments here are often not able to be settled based upon some sort of
empirical data that proves, for example, that one religion is better than another. The
argumentation shifts to questions like a particular religion is better for whom and for what
overall purpose. These are quintessential human questions that continue to be posed and the fact
that the answers have shifted over time might suggest that human thought is evolving (ascending
or descending) depending upon your point of view. Note that forms of logical reasoning are at
the heart of the humanities and the persuasiveness of the argument rests upon the form of
reasoning and persuasive argumentation.
Understanding Psychology Page 10
It is now again time to take a deep breath and realize that you have taken classes in these
disciplines. When you tackle a new course, such as psychology, I encourage you to bring the
knowledge that you already have accumulated regarding the natural sciences, social sciences,
and humanities to bear upon what you are learning in a psychology course. Such a learning
strategy suggests that you know more than you think regarding the strengths and weaknesses of
the scientific method of discovering knowledge.
You might also notice that some of your past and current coursework is missing from
Table 1. For example, the areas of business, nursing, medicine, social work, education, and other
professional training are not listed in Table 1. Some would argue that such coursework includes
the interdisciplinary application of ideas from many disciplines listed in Table 1 and most
professional knowledge lacks its own distinctive knowledge base. Others would debate this view
and claim that professional knowledge is substantial, specialized, and separate from these
disciplines. As you can see, the quest for ownership of knowledge and sometimes–– even
methodology is a highly politicized issue that often divides rather than unites scholars and
academics. As a student, you need to be aware of such issues as you pursue your education.
One of the hallmarks of a liberal arts institution is that students are firmly grounded in many
disciplines (remember those general education graduation requirements here) in addition to
professional preparation.
The Discipline of Psychology
The Greek roots tell us that psychology is the “study of” (ology) the soul (psyche) or
mind. Unfortunately, this type of a definition does not address the fact that many different
methods are used to study such phenomena and it also fails to inform us regarding exactly what
Understanding Psychology Page 11
is to be studied—is it the mind; soul; spirit; or center of thought, emotion, and behavior?
Obviously, this definition predates the evolving discipline of psychology as we know it today.
What follows is an attempt to briefly highlight the development of the field of
psychology in just a few pages. Obviously, any attempt to do justice to this goal would entail
volumes. The hope is that much of this content might be familiar to readers who have taken an
introductory psychology class. Readers are directed to the book A Brief History of Modern
Psychology (Benjamin, 2007) for a very readable and more expansive history of the field.
Most historians of psychology agree that the discipline grew out of philosophy (one of
the humanities). For example, Evans (1999) stated that “in 1900, most psychology programs still
were to be found in departments of philosophy” (p. 14). Keller (1937) suggested that Aristotle
was the father of psychology; Descartes was the father of modern psychology; and Fechner was
the father of quantitative (or experimental) psychology. The German influence of Gustave
Fechner and Wilhelm Wunt, who were both trained as physicians, deserves recognition in the
historical development of psychology. Wunt is credited with establishing the first psychological
laboratory in the world at the University of Leipzig in Germany in 1879.
The field of psychology departed from the ranks of the humanities within the academic
traditions of philosophy by adopting scientific methods. The scientific nature of psychology as
the backbone of the field can be thought of in several different ways. Let’s examine some of
these ideas related to the scientific method.
 Application of a broad definition of the scientific method of discovery.
 Use of measurement techniques that promote as much objectivity and precision as
possible. (Note: Quantitative measures are highly valued, but this does not rule out the
proper use of survey measures, interviews, qualitative methods, ethnography, etc.).
Understanding Psychology Page 12
 Generated hypotheses (educated guesses) based upon available theories, past research,
and careful observation.
 Cautious use of representative sampling procedures in order to generalize the results and
rule out alternative explanations of the findings such as individual idiosyncrasies.
 Control, selection, and manipulation of variables in order to discover if hypotheses are
supported or not supported.
 Objectivity is employed whenever possible to guard against predetermined ideas, wishful
thinking, and a selective interpretation of evidence.
 Public dissemination of the results of research investigations is accomplished through
publications in professional journals/books, presentations at professional meetings, and
inclusions in computerized databases.
 Replication of the results in future studies assures us that knowledge is valid and can be
generalized or to what extent it can be generalized.
(Note: These ideas have been adapted from Biehler & Snowman, 1990)
Readers might be asking about now: “How is psychology defined?” A review of several
published psychology textbooks offered the definitions below:
 “Psychological science is the study of mind, brain, and behavior.” (Gazzaniga,
Heatherton, & Halpern, 2010, p. 5)
 “…psychology is the science of behavior and mental processes.” (Zimbardo, Johnson, &
McCann, 2009, p. 4)
 “Psychology is the study of mental processes, behavior, and the relationship between
them.” (Sternberg, 2004, p. 2)
Understanding Psychology Page 13
 “Psychology is defined today as the scientific study of mind (mental processes) and
behavior” (Roediger, Capaldi, Paris, Polivy, & Herman, 1996, p. 3)
 “Psychology is the science of behavior and experience.” (Laird & Thompson, 1992, p. 3)
 “Psychology is the science of behavior and mental processes.” (Morris, 1990, p. 2)
 “Psychology is the scientific study of the behavior and mental processes of humans and
other animals.” (Crooks & Stein, 1988, p. 5)
 “Psychology is the study of the behavior of organisms.” (Dworetzky, 1982, p. 4)
Although these introductory psychology textbook descriptions of the field of psychology
do not represent a consensus regarding the definition of psychology, some patterns can be
observed. Notice how the terms “science” and “behavior” emerge in nearly every definition.
When the term “science” is not found in such definitions we find a broader term “study of”
which should make us think that perhaps the very term “science” can be thought of in broad as
well as narrow terms. The use of the terms “humans,” “animals,” and “organisms” reflect the
decision to be specific or more general and therefore inclusive, since humans and animals are
both living organisms. The influence of cognition (thinking) in the field can be seen with
references to the mind and mental processes. It should be obvious that even though
psychologists tend to differ somewhat in their precise definition of the field of psychology a
student who adopts broad definitions of science, behavior, and organisms (human and animals) is
not likely to be misled. Understanding that some psychologists are likely to define terms more
narrowly than others is crucial to understanding the field.
Different Viewpoints within Psychology
Most believe that the history of psychology is best understood by movements known as
structuralism, functionalism, behaviorism, Gestalt psychology, psychoanalysis, existential
Understanding Psychology Page 14
psychology, humanistic psychology and cognitive psychology. You might recall reading about
some of these trends or schools of thought in the field in an introduction to psychology textbook.
During the approximately 130 years since the first psychological laboratory was opened in
Leipzig, Germany, the morphology of what has been called the study of psychology has radically
changed based upon philosophical beliefs, methodologies refined for use, and what has been of
interest to investigate. Unfortunately, some of these trends are more useful to historians of
psychology than students who wish to quickly understand psychology today. Some of these
movements have been incorporated into other trends and some have outlived their current day
usefulness. For example, no psychologist today would claim to be a structuralist or a
functionalist. A case could also be made for the inclusion of other currently popular
specializations within the field such as biopsychology and social psychology.
The focus of this paper is to present students and other interested readers with a tool to
better understand the current discipline of psychology. It is most important for students to grasp
psychology as it relates to the courses that I regularly teach such as educational psychology,
adolescent psychology, and child development. This is an obvious bias that I’m willing to be
very up-front about while at the same time reminding readers that many people in the field might
agree with my analysis of the field and other psychologists might vehemently disagree. Here lies
an important maxim for students: It is crucial that you understand how the instructor of a
psychology course conceptualizes the field in order to experience academic success in the class.
Psychology is both a discipline (field of academic study) and a professional enterprise
where people apply psychology in therapeutic, educational, military, and other work settings.
Psychologists often hold some theories and ideas in higher esteem than others, interpret the same
research results in different ways, hold different philosophical beliefs regarding human nature,and enjoy arguing for or against particular viewpoints in the field. In a nutshell, psychologists
often see the world differently than other psychologists. If civility, communication, and reason
can be maintained, such debates can lead to an advancement of the field.
Psychology is not the only profession that houses professionals who harbor differing
opinions and fundamental beliefs. Examine the field of medicine. Doctors are likely to take
very different approaches while dealing with an injury, disease, prevention, or a disorder based
upon whether the doctor was trained as an M.D., D.O., or chiropractor. These medical
approaches may sometimes agree and at other times disagree in their approach to health care in
such terms as therapeutic techniques, dispensing of medication, and fundamental beliefs about
human health. Psychologists are also trained according to different schools of thought and often
value particular viewpoints over others in the field. The approach a psychologist takes to
investigating, conceptualizing, analyzing, and modifying behavior is also likely to depend upon
such training.
I wish to propose that most of the content we are covering in my classes can be reduced
to four current-day models (viewpoints) in psychology. This is not meant to diminish the value
or utility of viewing the field in a different manner, but remember that my main goal here is to
help you organize the massive amount of information included in my courses. This paper will
outline the psychoanalytic, behavioristic, humanistic, and cognitive views in psychology.
I am not alone in my conceptualization of the current field of psychology according to
these four viewpoints. Nye (2000) described contemporary psychological thought according to
four influential persons: Sigmund Freud (psychoanalytic view), B.F. Skinner (radical
behaviorism), Carl R. Rogers (humanistic view), and Albert Ellis (cognitive view). This


reference book (now in its 6th edition) is a concise resource for learning both about the major
ideas that have shaped psychology and the personal backgrounds of such individuals.
Hitt (1969) analyzed the basic arguments regarding the nature of human beings and wrote
about two models of human behavior. The dual and distinctive nature of understanding behavior
outlined in this paper pitted phenomenology (a field closely linked to humanistic psychology)
against behaviorism. His analysis concluded that (1) acceptance of one model over the other
would have profound implications for everyday life, personal behavior, and dealing with others;
(2) each view has credibility; (3) each model could have practical implications for a particular
problem being studied; and (4) scientists in each camp should listen to opposing viewpoints.
It deserves to be noted that Hitt wrote this when cognitive psychology was just beginning
to re-emerge as a potent force with in the field. Many psychologists have used Ulrich Neisser’s
(1967) landmark book Cognitive Psychology where he re-organized the field by uniting a wide
range of explorations in such topics as an important signpost for the return to power for cognitive
psychology. The Freudian and Neo-Freudian perspectives as a separate model are also absent
from Hitt’s analysis of viewpoints of human behavior.
Ernest Hilgard (1977) identified three waves of influence as “forces” within the field of
psychology that have had a major impact upon education and other fields as follows: First
Force: Behaviorism, Second Force: Psychoanalysis, and Third Force: humanistic psychology.
Although Hilgard addressed an education-oriented audience with such comments in this
particular article, his influence on the entire field of psychology has been long felt. His popular
textbook book Introduction to Psychology (1953) lived on as a viable teaching tool and influence
in psychology courses for decades under additional co-authors (see Hilgard, Atkinson, &
Atkinson, 1975). It is even available today in the form of the 14th edition as Atkinson and


Hilgard’s Introduction to Psychology (Smith, Nolen-Hoeksema, Fredrickson, & Hilgard, 2003).
This builds the case for Hilgard being a creditable spokesperson in the field of psychology.
Historically speaking these four viewpoints in psychology have reached high-water
marks at different points in time. A chronological organization of the waves of influence can be
thought of as follows: First Force (behaviorism), Second Force (psychoanalysis), Third Force
(humanistic psychology), and Fourth Force (cognitive psychology). It should be noted that in
both academic circles and professional practice all four views are discernable today.
The first task at hand is to highlight how these four viewpoints are distinctive. Table 2
below provides such an overview on several crucial philosophical points of great interest to those
who study human behavior. Although this obviously oversimplifies these complex views, such a
chart might help you more readily recognize some of these distinctive qualities.
Table 2
Aspects of Human Nature within Psychological Viewpoints
Psychological
Viewpoint
Primary Basis
for Motivation
Good vs.
Evil
Rational vs.
Irrational
Free vs.
Determined
Psychoanalytic Unconscious
frequently rules
the conscious
(especially in
survival modes)
Evil or
dangerous
(if person
is
threatened)
Most often
irrational, but with
rational potential
Mostly
determined, but
some free will
is
possible
Behavioristic Extrinsic factors
most important
Neutral
(good or
evil)
Either, depending
upon learning and
rewards/punishments
Determined by
environment
Humanistic Intrinsic factors
can be more
important than
extrinsic factors
Basically
good
(unless
threatened)
Rational, unless
unhealthy
Free, but
depends upon
subjectivity and
perception
Cognitive Intrinsic and
extrinsic
factors are both
important
Neutral
(good or
evil)
Highly dependent
upon efficient
rational thinking
Free, but
depends upon
perception


You might recall some of these beliefs from a previous course in psychology. Please feel
free to ask questions related to these beliefs as we progress through that class at points that seem
most relevant. If readers can keep these distinctions in mind, we are now prepared to launch into
a more detailed description of each of the four viewpoints. Please recall that we are striving to
accentuate differences rather than similarities between viewpoints here. The topic of similarities
between viewpoints will be addressed later in the paper.
First Force: The Behavioristic Viewpoint
The behavioristic viewpoint relies upon the regimented devotion to a strict scientific
(experimental) approach to studying behavior and focuses upon environmental (external) forces
which influence behavior. The extreme adoption of such a view could conjure up views of
people as robots controlled by their masters (programmers) who modify the environment in order
to shape behavior in desired ways. On the other hand, it is difficult to suggest that each of us are
not in powerful ways influenced by the physical setting, context of people (friends, family, and
co-workers), and rewards/punishments that are offered to us. Although it is hard to dispel such
environmental influences as inconsequential, it is relevant to ask exactly “who” controls the
environment. In essence, this view provides a highly scientific technology for understanding and
changing behavior without dealing with mental constructs or value issues regarding whether such
modification of behavior is appropriate or moral.
Thoresen (1973) suggested that behaviorists could be characterized by:
 Reliance on objectivity and operational definitions.
 Focus on the “here and now” environment and its influence on the individual.
 Rejection of trait-state labels (e.g., introvert/extrovert)—a person can be best understood
by what he/she does in particular situations.
Understanding Psychology Page 19
 The use of the scientific method which stresses careful, systematic observation and
control of behavior.
Behavioristic View
Prominent Theorists/Researchers:
John B. Watson, Edward Thorndike, Ivan Pavlov, and B.F. Skinner
Underlying Philosophy: Science (rigid application of the scientific method)
Key Words and Ideas: Stimulus and response (S—R), environment is most important,
reductionistic thinking (searching for the smallest elements of behavior), behavior modification,
shaping of behavior, operant conditioning, reward and punishment, extinction of behaviors,
token economics, positive and negative reinforcement, classical conditioning, measureable
characteristics, animals often used in research (but basic laws apply to humans as well),
behavioral engineering, human beings are creatures of habit, unconditioned (unlearned)
responses, conditioned (learned) responses, spontaneous recovery, Skinner box, objectivity is
highly valued, mechanical mirror model, successive approximations, discrimination and
generalization, extrinsic motivation, rigid adherence to the scientific method, contingencies,
instrumental learning, recoding data, making graphs to chart behavior change, determining
baselines, reliance upon statistical evidence, aversive therapy, observable characteristics more
important than mental reports, observational learning, human beings are passive and molded by
external stimuli, overt (outward/measureable) characteristics, Premack Principle, schedules of
reinforcement, Law of Effect, A-B-C (Antecedents-Behavior-Consequences)
Second Force: The Psychoanalytic View
The psychoanalytic view, as originally formulated by Sigmund Freud, provided a
dynamic view of human behavior that was powerfully influenced by constitutional (innate
biological) factors such as sexual and aggressive drives, psychic conflict between the demands of
these drives and social expectations, and unconscious versus conscious processes. Although
psychoanalysts can agree or disagree and emphasize some facets over others, most accept these
basic premises regarding human behavior. Freud can be credited with forcing everyone to
consider where they stand on the influence of such factors as biological drives and the
Understanding Psychology Page 20
unconscious. For example, Freud’s notion of defense mechanisms continues to be a powerful
reminder that observed behavior may not always be rooted in what it first seems.
Unfortunately, it is often difficult to empirically test hypotheses generated from
psychoanalytic theories. Imagine that you wish to discover the “true” motivation for a particular
action through an interview or survey question. This theoretical model forces us to consider the
possibility that the respondent may not consciously be aware of such motivations and be unable
to share this information. If the person is really aware of such “true” motivations, will he/she
choose to share them with a researcher if divulging such information could be embarrassing? It
deserves to be noted that even empirical support exists for the existence of some defense
mechanisms (see Baumeister, Dale, & Sommer, 1998).
Many neo-Freudians (those who have adopted some and modified other of Freud’s basic
premises) have been called ego psychologists because they have chosen to emphasize the ego
functions (logical and rational problem solving mechanisms of the personality) that mediate
conflicts between the drives of the “id” and the societal constraints of the “superego.” This view
is not entirely pessimistic regarding the human potential for mental health, since even Freud held
a somewhat limited hope that clients could make the unconscious become conscious and deal
more logically and rationally with their “hidden” problems in life.
PSYCHOANALYTIC VIEW
Prominent theorists/Researchers: Sigmund Freud, Erik Erikson
Underlying Philosophy: Hedonism (seeking pleasure and avoiding pain)
Key words and Ideas: id, ego, and superego elements of the human personality; ego-defense
mechanisms; projection; regression; libido; ego ideal; reaction formation; displacement;
sublimation; repression; suppression; passive aggressive behavior; Freud’s 5 psychosexual
stages: oral, anal, phallic, latency, and genital; fixation; unconscious/conscious motivation;
preconscious state; adult behavior is largely dependent upon early childhood experiences;
identification (unconscious modeling); psychoanalyst (therapist, usually an M.D. who employs
Understanding Psychology Page 21
psychoanalytic techniques); catharsis; dreams and dream interpretation; hypnosis; manifest and
latent dream content; symbolic meanings; Oedipus and Electra complexes; slips of the tongue;
free association; phobias; subliminal techniques; transference; Erikson’s 8 psychosocial stages
(trust vs. mistrust, autonomy vs. shame and doubt, initiative vs. guilt, industry vs. inferiority,
identity vs. identity confusion or diffusion, intimacy vs. isolation, generativity vs. stagnation,
integrity vs. despair); foreclosure; moratorium; negative identity
Third Force: The Humanistic View:
The humanistic view in psychology tends to emphasize the processes and outcomes of
mental health and healthy human relationships, which promote growth and development. Many
of the people who are heavily invested in this view are clinicians (therapists, counselors, social
workers, etc.). The view also promotes the exploration of the objective and subjective world
while relying upon quantitative as well as qualitative measurement as tools to better understand
the “whole” person. A hopeful posture regarding the possibility of human beings changing is
inherent to the nature of working with clients in a clinical setting. Such people have also focused
upon mental health (self-actualization) rather than only upon the mental illness model through
creating an atmosphere where freedom with responsibility for actions and empathic
understanding are at the core of behavioral change. An existential philosophical viewpoint is
often adopted by proponents of this view.
Thoresen (1973) suggested that the goals of humanistic psychology include:
 Increasing the conscious range of a person’s behavior—helping people identify what
his/her behavior is and how it affects self and others.
 The need for the compassionate person who can relate and communicate effectively with
others.
 Self-determination and responsibility—helping people accept responsibility for their own
behavior.
Understanding Psychology Page 22
 The need for educational experiences that engage the total person—the cognitive, social,
spiritual, and emotional being.
As you might guess, many of those in the helping professions (teachers, nurses, counselors,
therapists, etc.) have adopted ideas from this viewpoint in order to carry out their work.
Characteristics such as empathy, congruence, and trust (unconditional positive regard) that
make an excellent therapist have been applied to other helping professions. The topics of
values clarification, promoting self-esteem, and moral development are of great interest to
those who adopt this psychological viewpoint.
THE HUMANISTIC VIEW
Prominent Theorists/Researchers: Carl Rogers, Abraham Maslow, Rollo May
Underlying Philosophy: Existentialism (ideas such as free will, responsibility, choices,
being and becoming, personal meaning, human potential, significance of the individual)
Key words and Ideas: self-actualization; self-concept; 5 levels of Maslow’s Hierarchy of
Needs: physiological, safety and security, belongingness, self-esteem, and self-actualization;
feelings and emotions; attitudes; values; individual personal growth; holistic or wholistic
approach to studying human behavior; not likely to use animals in research; intrinsic motivation
slightly emphasized over extrinsic motivation; the total person; facilitator of learning; empathic
understanding; unconditional positive regard; self-directed rather than other–directed is the goal;
encounter groups; individual human uniqueness is prized; sensitivity groups; philosophy of
existentialism forms a foundation here; faith in human potential for change, improvement, and
achievement; self-appraisal; self-disclosure; phenomenology; introspection; human experience is
complex and multidimensional; active learning rather than passive learning is valued; Third
Force psychology; subjectivity is valued; objectivity is also valued, but total objectivity is
impossible to ever achieve; free will is tempered with individual responsibility for actions;
Rogerian approaches: non-directive therapy, client-centered therapy, and person-centered
therapy; focus upon the present (here-and-now) and future, rather than the past; Gestalt
psychology (whole is more or greater than the sum of its parts); assertiveness is advocated in
contrast to aggressiveness; focus upon being and becoming human; values clarification; study of
human possibilities; focus upon the process without losing sight of the end-product focus; focus
upon the unique individual; the source motivation and understanding lies within the individual
Fourth Force: The Cognitive View:
Understanding Psychology Page 23
The cognitive viewpoint in psychology is a re-emergent view that has strong historical
roots in other viewpoints. In some respects, this view has incorporated several key elements of
the humanistic, behavioristic, and even the psychoanalytic viewpoints. Some examples include
the focus upon intrinsic and extrinsic motivation, S—R (behavioristic) psychology morphs to
become S—O—R (cognitive) psychology, and flexibility in research methodology as
demonstrated by quantitative and qualitative research designs. One of the obvious strengths of
the cognitive view point is that it has been successfully able to integrate important ideas from
other views.
The advent and rapid growth of the computer as a developmental force in society has also
contributed to this viewpoint that promotes the study of the mind, imagination, thinking (moral,
critical, expert decision making, etc.), problem solving, memory, attention, perception, and
language. Informal introspection, case studies, and other forms of qualitative research have been
employed by proponents of this view to develop hypotheses that can eventually be confirmed
and expanded by more objective methods. Advancements in measurement, technology, and
brain research hold the keys to producing workable theories and interventions.
Students sometimes look forward to taking a course labeled “cognitive psychology.”
This is certainly to be encouraged if the topics mentioned here are found to be appealing or
useful. However, cognitive psychology is more than just a class; it is a powerful movement
within the field of psychology. Cognitive science has had a major influence in recent years upon
nearly every specialization or sub-field of psychology such as motivation, learning theory,
therapy, human development, personality, social psychology, biopsychology, etc.
The cognitive view has emerged as the most prominent view in the field today and it is
the current wave of popularity that many theorists and researchers are riding. Many departments
Understanding Psychology Page 24
of psychology across the country pride themselves in having well-known researchers and
theoreticians working on the cutting-edge of cognitive science. It would appear that many
psychologists believe that the next major advancements to the field will come from this
viewpoint.
While it is often very exciting and rewarding to be a proponent of the most popular
viewpoint in psychology, a word of caution is in order. The wise cognitive psychologists today
are well aware of how other viewpoints have helped to shape the current field of psychology and
they should honor these origins. Students also need to be familiar with the inherent strengths and
weaknesses of joining any psychological bandwagon.
THE COGNITIVE VIEW
Prominent Theorists and Researchers: J. P. Guilford, Jean Piaget, Lawrence Kohlberg,
Jerome Bruner, Howard Gardner, Albert Bandura, Jerome Kagan, Albert Ellis, Robert Sternberg,
Martin Seligman, Bernard Weiner, David Ausubel, Donald Meichenbaum, Mary Budd Rowe
Underlying Philosophy: Interactionism (the person mediates the environmental influence)
Key Words and Ideas: human intellectual events; conscious control of behavior;
perception; thought processes; problem solving; decision making in particular contexts; language
development (since we think in a particular language); information processing theory [sensory
storage, short-term memory (STM), and long-term memory (LTM)]; 7±2; eidetic (photographic)
memory; encoding; decoding; mnemonic devices; attention; interference theory; rote rehearsal
(repetition); elaborative rehearsal (connecting unknown to known information); retrograde
amnesia; semantic and episodic memory; chunking techniques; Guilford’s Structure of the
Intellect Model (contents, products, and operations); convergent and divergent thinking;
Kohlberg’s Moral Development(pre-conventional, conventional, and post-conventional); use of
moral dilemmas; universal ethical principle stage; focus upon the rationale (reason) for a moral
decision rather than only the actual behavior; Piaget’s Cognitive Developmental Theory
(sensorimotor stage, preoperational stage, concrete operational stage, and formal operational
stage); schema or schemata; assimilation and accommodation; organization and adaptation;
interactionism (human beings interact with the environment—both the person and the
environment become important here); cognitive disequilibrium; Gardner’s multiple intelligence
theory (8 types); Sternberg’s Triarchic Theory of Intelligence; Ellis: Rationale-Emotive Therapy
(RET) and Rational-Emotive-Behavior Therapy (REBT); constructivism; metacognition;
metamemory; Seligman: learned helplessness and learned hopefulness; S—O—R (Stimulus—
Organism—Response) theory; Weiner: attribution theory; Kagan: impulsivity and reflectivity;
Understanding Psychology Page 25
Bloom: Taxonomy of the Cognitive Domain (knowledge, comprehension, application, analysis,
synthesis, and evaluation); discovery learning, intuition; structure of knowledge; inductive and
deductive reasoning; Ausubel: advance organizers; Bandura: self efficacy, modeling, social
learning theory; teaching for transfer; heuristic devices; conceptual change; proactive rather than
reactive; wait-time; cognitive behavior modification; Piaget’s Two Stage Theory of Moral
Development: 1. Moral realism (morality of constraint) and 2. Morality of Cooperation; self talk;
task analysis
Use of the Four-Point of View Model
As a final note on how you might use this paper, think of using your accumulated
knowledge in the field of psychology to broaden and deepen your knowledge base. Cognitive
psychology would suggest that employing this knowledge base should help you learn new
information when you connect what you are learning to what you have already learned. If you
succeed here, you will be using cognitive psychology in order to learn cognitive psychology.
What a fitting use of such knowledge! We have sound empirical evidence that this is exactly
what successful students do in order to reach high levels of achievement.
Imagine that you have just been given an example of human behavior to analyze,
understand, and make suggestions regarding how you might modify such behavior. What if you
had four pair of lenses each ground and tinted somewhat differently in order to enhance
particular aspects of what you are viewing? You could take each pair of lenses marked with a
different point of view in psychology to examine the behavior. Just imagine how this would
improve your understanding of human behavior.
The four pair of lenses would help you to see different characteristics of the behavior. If
one pair of glasses failed to provide you with insights or answers to questions that you have
generated regarding human behavior, you simply remove that pair and pick up another. If you
can accomplish this intellectual challenge of seeing behavior through different lenses, you will
be well on your way to employing an eclectic (multi-viewpoint) approach to understanding
Understanding Psychology Page 26
human behavior. This will also maximize your chances of applying what you have learned about
psychology.
The author of this paper conducts pedagogical research on his own teaching so that he as
the course instructor, students, and other instructors might learn not only what works, but why
something works as a teaching or learning tool. As an example of such research with the same
Four-Point of View Model, readers are offered empirical evidence that the classroom use of this
model as an instructional tool was statistically significantly correlated to overall class exam
performance (see Herman, 2001).
Summary
You have a major challenge in studying the field of psychology. Sometimes
psychologists use several different terms to describe basically the same process, principle, or
event, so you will need to rapidly learn many new terms and distinguish them from other ideas.
Try to learn the names of the originators of the major theories rather than just the ideas
themselves. This should help you quickly find original source material because it offers more
hooks on which to hang information in your mind. You should also strive to understand the
philosophical foundations behind each theory. When learning about a new theory, try to think
about the implications and interventions of each theory.
As you learn these new terms and ideas, try to relate them to what you already know and
what you have experienced in life. It is always possible to over-analyze your own behavior and
conclude that you and/or others are neurotic or in possession of some form of mental illness.
Remember to leave the diagnosis to the professionally licensed therapists. The point here is that
some self-exploration in a psychology is obviously very useful, normal, and motivational.
Understanding Psychology Page 27
You will note that I have opted to encourage you to initially focus upon the distinctive
nature of these four points of view in order to build a solid knowledge base in psychology. I
have found that this is a good first step. Students sometimes find that after organizing their
thinking about psychology as described in this paper, they also begin to see some similarities or
interconnections between viewpoints. This should be your long-term goal, but don’t rush into
this phase too soon. A mastery of the basic distinctions should naturally lead you eventually to
discover similarities as well. I offer you best wishes in your quest to master the field of
psychology and hope that such an endeavor proves to be well worth the time and energy you
choose to invest.
Understanding Psychology Page 28
References
Baumeister, R. F., Dale, K, & Sommer, K. L. (1998). Freudian defense mechanisms and
empirical findings in modern social psychology: Reaction formation, projection,
displacement, undoing, isolation, sublimation, and denial. Journal of Personality, 66 (6),
1081-1124.
Benjamin, L. T., Jr. (2007). A brief history of modern psychology. Malden, MA: Blackwell.
Biehler, R. F., & Snowman, J. (1990). Psychology applied to teaching (6th ed.). Boston:
Houghton Mifflin.
Bruner, J. S. (1960). The process of education. New York: Vintage Books.
Evans, R. B. (1999). A century of psychology: A once fledgling field comes of age.
A.P.A. Monitor, December, 14.
Gazzaniga, M. S., Heatherton, T. F., & Halpern, D. F. (2010). Psychological Science (3rd ed.).
New York: W. W. Norton.
Herman, W. E. (2001). Student organization of psychological content as a predictor of college
classroom success. Paper presented at the Eighth Annual American Psychological
Society Institute on the Teaching of Psychology, Toronto, Ontario, Canada. (ERIC
Document Reproduction Service No. ED454761)
Hilgard, E. R. (1953). Introduction to psychology. New York: Harcourt Brace.
Hilgard, E. R. (1977). Psychology’s influence on educational practices: A puzzling history.
Education, 97 (3), 203-219.
Hilgard, E. R., Atkinson, R. C., & Atkinson, R. L. Introduction to psychology (6th ed.). New
York: Harcourt, Brace, Jovanovich.
Hitt, W. D. (1969). Two models of man. American Psychologist, 24, 651-658.
Understanding Psychology Page 29
Keller, F.S. (1937). The definition of psychology. New York: Appleton-Century-Crofts.
Neisser, U. (1967). Cognitive psychology. New York: Appleton-Century-Crofts.
Nye, R. D. (2000). Three psychologies: Perspectives from Freud, Skinner, and Rogers (6th ed.).
Belmont, CA: Wadsworth.
Roediger, H. L., III, Capaldi, E. D., Paris, S. G., Polivy, J., and Herman, C. P. (1996).
Psychology (4th ed.). St. Paul, MN: West.
Smith, E. E., Nolen-Hoeksema, S., Fredrickson, B., & Hilgard, E. R. (2003). Atkinson and
Hilgard’s introduction to psychology (14th ed.). Belmont, CA: Wadsworth.
Sternberg, R. J. (2004). Psychology (4th ed.). Belmont, CA: Wadsworth.
Thoresen, C.W. (1973). Behavioral humanism. National Society for the Study of Education
Yearbook, 72 part 1, 385-421.
Zimbardo, P. G., Johnson, R. L., & McCann, V. (2009). Psychology: Core concepts (6th ed.).
Boston, MA: Pearson.
Understanding Psychology Page 30
Author Notes
In a very real sense, I have written this paper for two distinctive audiences: 1) my
students and 2) other teachers/researchers/scholars who desire to improve the teaching of
psychology. The reader will immediately notice that I have tried to write this paper in a tone that
is directed to a student audience while maintaining the importance of grand ideas and factual
details. This paper serves as an example of how academic scholars frequently write for various
audiences for distinctive purposes. It is believed that every course instructor has the
responsibility to inform students regarding how the academic content under consideration is
structured, since this will improve teaching and learning. This paper is dedicated to all of those
teachers of psychology and other disciplines who strive to improve learning outcomes.
The author also wishes to acknowledge a break with APA Style guidelines in placing the
two tables into the text in this paper instead of placing such tables at the end of the paper. This
diversion from standard practice was done in order to offer readers a format more conducive to
learning and avoidance of frequently flipping to the end of the manuscript for the tables.

HUBUNGAN PENYAKIT DENGAN FAKTOR PERILAKU DAN SOSIAL-BUDAYA STUDI KASUS HIV/AIDS DI PAPUA DAN DIFTERI DI SUMENEP

BAB I
PENDAHULUAN

Timbulnya suatu penyakit dalam masyarakat tidak serta merta karena penyakit tersebut muncul begitu saja. Apalagi bila sebelumnya penyakit tersebut tidak pernah ditemukan pada masyarakat pendahulunya. Tentu ada faktor penyebab munculnya penyakit tersebut selain faktor lingkungan yang mendukung penyebaran penyakit tersebut.
Diantara penyebab-penyebab timbulnya suatu penyakit selain faktor lingkungan adalah faktor perilaku dan sosial-budaya masyarakat. Faktor-faktor tersebut sangat berpengaruh dalam penyebaran penyakit karena ada sebagian penyakit yang timbul karena pola perilaku masyarakat yang dipengaruhi oleh kondisi sosial dan budayanya.
Begitu pula dengan penyebaran penyakit HIV/AIDS di Papua dan penyakit difteri di Sumenep yang semakin meluas dikarenakan ada faktor budaya dan adat-istiadat disamping karena faktor individual masyarakatnya.
Oleh karena itu, dengan mempelajari perilaku masyarakat beserta adat-istiadatnya diharapkan dapat dijadikan pedoman dalam pengambilan kebijakan kesehatan untuk mencegah penyebaran lebih lanjut dan melakukan pengobatan bagi masyarakat yang telah terjangkit.

BAB II
PERMASALAHAN



A. HIV/AIDS di Papua
I. Latar Belakang
Beberapa studi menunjukkan bahwa tingkat epidemi HIV-AIDS di Papua jauh lebih tinggi dibandingkan wilayah Indonesia lainnya dan salah satu yang tertinggi di Asia Tenggara. Hal tersebut tidak terlepas dari lokasi yang terpencil, sulitnya mendapatkan akses pelayanan dan informasi kesehatan, perilaku masyarakat, dan adat serta budayanya.
Penyebaran HIV/AIDS di Papua tidak terlepas dari perilaku masyarakatnya yang sering melakukan hubungan homoseksual dan heteroseksual. Dimana, perilaku seksual seperti itu merupakan salah satu penyebab terbesar terjadinya penyebaran penyakit tersebut. Perilaku menyimpang tersebut sebagian besar dilakukan dalam praktek ritual, adat istiadat, perayaan festival-festival, dan pesta seks antri yang sudah menjadi suatu kebudayaan bagi masyarakat Papua.
Hubungan homoseksual yang sering dilakukan oleh masyarakat Papua tidak hanya dilakukan oleh kaum lelakinya saja tetapi juga oleh kaum wanitanya. Mereka melakukannya atas dasar adat-istiadat yang berlaku dan merupakan suatu praktek ritual terhadap nenek moyang.
Selain itu, perilaku masyarakatnya yang sering mendatangi pekerja seks komersil (PSK) juga turut berpengaruh terhadap tingginya kasus HIV/AIDS di Papua. Mereka sering mendatangi para PSK yang menjajakan diri di pinggir-pinggir jalan dan tempat-tempat hiburan lainnya.
Dari hasil Studi Kualitatif Perilaku Seks di Papua (Uncen, 2002) mengindikasikan banyak masyarakat Papua yang mempunyai banyak pasangan dan sebagaian besar memulai hubungan seks pada umur yang muda. Sementara hasil survei perilaku pada pegawai negeri di Jayapura pada tahun 2003 menunjukkan bahwa sekitar 32 persen pegawai negeri lelaki di Jayapura membeli seks.

II. Teori Dasar Penyebab dan Penyebaran Penyakit
HIV (Human Immunodeficiency Virus) adalah virus yang dapat merusak sistem kekebalan tubuh manusia. HIV adalah sejenis retrovirus, yaitu virus yang mengunakan sel tubuhnya sendiri untuk memproduksi kembali dirinya. Asal dari HIV tidak jelas, penemuan kasus awal adalah dari sampel darah yang dikumpulkan tahun 1959 dari seorang laki–laki dari Kinshasa di Republik Demokrat Congo dan tidak diketahui bagaimana ia terinfeksi.
HIV dapat ditularkan dari orang ke orang melalui kontak seksual, penggunaan jarum dan syringes yang terkontaminasi, transfusi darah atau komponen-komponennya yang terinfeksi; transplantasi dari organ dan jaringan yang terinfeksi HIV. Sementara virus kadang-kadang ditemukan di air liur, air mata, urin dan sekret bronkial, penularan sesudah kontak dengan sekret ini belum pernah dilaporan. Risiko dari penularan HIV melalui hubungan seks lebih rendah dibandingkan dengan Penyakit Menular Seksual lainnya. Namun adanya penyakit yang ditularkan melalui hubungan seksual terutama penyakit seksual dengan luka seperti chancroid, besar kemungkinan dapat menjadi pencetus penularan HIV. Determinan utama dari penularan melalui hubungan seksual adalah pola dan prevalensi dari orang orang dengan “sexual risk behavior” seperti melakukan hubungan seks yang tidak terlindung dengan banyak pasangan seks. Tidak ada bukti epidemiologis atau laboratorium yang menyatakan bahwa gigitan serangga bisa menularkan infeksi HIV, risiko penularan melalui seks oral tidak mudah diteliti, tapi diasumsikan sangat rendah.
AIDS adalah sindroma penyakit yang pertama kali dikenal pada tahun 1981. Sindroma ini menggambarkan tahap klinis akhir dari infeksi HIV. Beberapa minggu hingga beberapa bulan sesudah terinfeksi, sebagian orang akan mengalami penyakit “self-limited mononucleosis-like” akut yang akan berlangsung selama 1 atau 2 minggu. Orang yang terinfeksi mungkin tidak menunjukkan tanda atau gejala selama beberapa bulan atau tahun sebelum manifestasi klinis lain muncul. Berat ringannya infeksi ”opportunistic” atau munculnya kanker setelah terinfeksi HIV, secara umum terkait langsung dengan derajat kerusakan sistem kekebalan yang diakibatkannya. Definisi AIDS yang dikembangkan oleh CDC Atlanta tahun 1982 memasukkan lebih dari selusin infeksi “opportunistics” dan beberapa jenis kanker sebagai indikator spesifik akibat dari menurunnya kekebalan tubuh.

B. KLB Penyakit Difteri di Sumenep
I. Latar Belakang
Berdasarkan hasil laporan Dinas Kesehatan Kabupaten Sumenep, terjadi KLB (Kejadian Luar Biasa) penyakit difteri. Namun demikian dinas kesehatan setempat mengalami kesulitan untuk mendeteksi dan memberikan pengobatan kepada masyarakat yang mengidap difteri di kabupaten tersebut.
Dari hasil penelitian terhadap pasien, diketahui bahwa difteri diakibatkan oleh bakteri mematikan yang menyerang anak-anak, karena rata-rata bayi yang tidak diimunisasi lengkap. Tanda-tandanya yakni tubuh demam dan terjadi suhu yang panas pada tubuhnya. Lambat laun, tiba-tiba pasien mengalami penyumbatan dan pembengkakan saluran pernafasan atas dan menyerang jantung.
Untuk mengantisipasi penyebaran penyakit tersebut, Dinas Kesehatan setempat telah melakukan sweeping untuk memberikan pengobatan melalui vaksinasi, namun penderita cenderung menutup diri. Selain itu masyarakat juga menganggap remeh penyakit tersebut. Padahal penyakit difteri sangat berbahaya, selain termasuk penyakit yang menular, juga merupakan penyakit yang mematikan.
Menurut salah satu anggota dinas kesehatan setempat, jumlah penderita penyakit defteri akan terus bertambah, jika masyarakat sulit untuk mendapatkan pengobatan vaksinasi. Oleh karena itu sebagai langkah awal, dinas kesehatan melakukan pendataan kepada masyarakat yang menderita penyakit tersebut dengan melibatkan pihak Puskesmas di masing-masing Kecamatan.

II. Teori Dasar Penyebab dan Penyebaran Penyakit
Difteria adalah suatu penyakit bakteri akut terutama menyerang tonsil, faring, laring, hidung, adakalanya menyerang selaput lendir atau kulit serta kadang-kadang konjungtiva atau vagina. Timbulnya lesi yang khas disebabkan oleh cytotoxin spesifik yang dilepas oleh bakteri. Lesi nampak sebagai suatu membran asimetrik keabu-abuan yang dikelilingi dengan daerah inflamasi. Tenggorokan terasa sakit, sekalipun pada difteria faucial atau pada difteria faringotonsiler, diikuti dengan kelenjar limfe yang membesar dan melunak. Pada kasus-kasus yang sedang dan berat ditandai dengan pembengkakan dan oedema di leher dengan pembentukan membran pada trachea secara ekstensif dan dapat terjadi obstruksi jalan napas.
Difteri disebakan oleh bakteri Corynebacterium diphtheria dari biotipe gravis, mitis atau intermedius. Bakteri ini membuat toksin bila bakteri terinfeksi oleh coryne bacteriophage yang mengandung diphtheria toxin gene tox. Strain nontoksikogenik jarang menimbulkan lesi lokal, namun strain ini dikaitkan dengan kejadian endokarditis infektif.
Kematian yang terjadi pada penderita umumnya disebabkan oleh kekuatan dari exotoxin. Exotoxin ditransportasikan melalui aliran darah ke jaringan lain, dimana dia menggunakan efeknya pada metabolisme seluler. Toxin terlihat terikat pada membran sel melalui porsitoxin yang disebut "B" fragment, dan membantu dalam transportasi porsitoxin lainnya, "A" fragment ke dalam cytoplasma. Dalam beberapa jam saja setelah terpapar dengan toxin difteri, sintesa protein berhenti dan sel segera mati.
Organ penting yang terlibat adalah otot jantung dan jaringan saraf. Pada miokardium, toxin menyebabkan pembengkakan dan kerusakan mitochondria, dengan fatty degeneration, oedem dan interstitial fibrosis. Setelah terjadi kerusakan jaringan miokardium, peradangan setempat akan terjadi, diikuti dengan perivascular dibalut dengan lekosit (cuffing). Sedangkan kerusakan oleh toxin pada myelin sheath dari saraf perifer terjadi pada keduanya, yaitu saraf sensork dan saraf motorik.
Difteri terjadi setelah periode masa inkubasi yang pendek yaitu 2-4 hari, dengan jarak antara 1-5 hari. Gambaran klinik tergantung pada lokasi anatomi yang dikenai. Beberapa tipe difteri berdasarkan lokasi anatomi adalah :
• Nasaldiphtheria
• Tonsillar (faucial) diphtheria
• Pharyngeal diphtheria
• Laryngeal atau laryngotracheal diphtheria dan
• Nonrespiratory diphtheria.
Cara penularannya adalah melalui kontak dengan penderita atau carrier, jarang sekali penularan melalui peralatan yang tercemar oleh discharge dari lesi penderita difteri. Susu yang tidak dipasteurisasi dapat berperan sebagai media penularan.



BAB III
PEMBAHASAN


I. HIV/AIDS di Papua
Meluasnya kasus HIV/AIDS di Papua sebagian besar disebabkan oleh perilaku seksual masyarakatnya yang sering melakukan seks bebas dan berganti-ganti pasangan seks. Perilaku tersebut tidak hanya berkaitan dengan perilaku individu masing-masing tetapi juga berkaitan dengan adat-istiadat dan budaya yang telah lama berkembang.
Berdasarkan survey yang dilakukan pada tahun 2006, sebagian besar masyarakat Papua telah mengetahui bahwa salah satu penyebab penularan HIV adalah hubungan seksual dengan berganti-ganti pasangan. Ada 46,4 persen penduduk yang tahu bahwa dengan berganti-ganti pasangan akan mudah tertular HIV.
Namun permasalahannya adalah meskipun sebagian besar masyarakatnya telah mengetahui hal tersebut, mereka tetap melakukannya. Bahkan sebagian besar pelakunya adalah para remaja baik di daerah terpencil maupun perkotaan. Mereka berdalih bahwa hal tersebut merupakan sesuatu yang wajar dan telah menjadi budaya sejak lama. Padahal sebagaimana telah dijelaskan pada bab sebelumnya bahwa penyebab terbesar terjadinya penyebaran HIV/AIDS adalah melalui kontak seksual baik melalui anal maupun oral.
Menurut H.L. Bloom, salah satu faktor penentu status kesehatan seseorang selain tersedianya pelayanan kesehatan dan keturunan (genetika) adalah faktor perilaku individu maupun masyarakat dan faktor lingkungan termasuk didalamnya lingkungan fisik (alam) maupun lingkungan social (adat-istiadat, budaya, kebiasaan, dan sebagainya).
Dari kasus HIV/AIDS yang terjadi di Papua terdapat kecenderungan bahwa faktor perilaku dan social-budaya merupakan faktor utama terjadinya penyebaran penyakit tersebut. Namun demikian, perilaku seks bebas tersebut tidak serta merta berdiri sendiri tanpa adanya factor lain yang mendukung pola perilaku tersebut. Bila dipelajari lebih lanjut pola perilaku seks bebas tersebut diawali dengan adanya budaya dan adat-istiadat yang mendorong terjadinya pola perilaku seperti itu.
Budaya seks bebas yang dilakukan setiap diadakannya pesta adat membentuk pola perilaku seks bebas sebagai suatu hal yang wajar di dalam masyarakat Papua. Sudah merupakan hal yang lazim bagi mereka untuk melakukan seks bebas, bahkan ada suatu budaya dimana setiap perempuan Papua yang akan menikah harus berhubungan seks terlebih dahulu dengan 10 orang laki-laki yang berasal dari keluarga mempelai laki-lakinya dengan tujuan untuk meningkatkan kesuburan. Padahal perilaku seks dengan berganti-ganti pasangan seperti itu dan tanpa menggunakan kondom dapat meningkatkan resiko penyebaran HIV/AIDS dibandingkan dengan melakukan seks dengan pasangan tetap.
Virus tersebut akan masuk ke dalam tubuh melalui cairan yang dihasilkan oleh alat kelamin dan masuk melalui luka yang terjadi saat melakukan hubungan seks tanpa pengaman baik yang dilakukan bersama pasangan tetap maupun dengan berganti-ganti pasangan. Kemudian virus tersebut akan merusak sistem kekebalan tubuh penderitanya dengan masa inkubasi selama selama 1-3 bulan. Virus tersebut akan menular ke orang lain ketika berhubungan seks tanpa pengaman dengan si penderita. Lalu virus tersebut akan semakin berkembang menjadi AIDS setelah 10 tahun dan akan menyebabkan kematian bagi penderitanya.
Demikianlah faktor-faktor dan penyebab tingginya penyebaran HIV/AIDS di Papua. Penting diketahui bahwa munculnya suatu perilaku tidak selalu karena terbentuk begitu saja, lebih dari itu ada faktor lain berupa kebudayaan, lingkungan sosial, dan lingkungan fisik yang dapat menjadi faktor pendukung maupun pencetus munculnya suatu perilaku.

II. Difteri di Sumenep
Terjadinya Kejadian Luar Biasa (KLB) penyakit difteri di Kabupaten Sumenep tidak muncul begitu saja. Selain karena adanya faktor lingkungan yang berpengaruh terhadap penyebaran penyakit, terdapat faktor lain yaitu faktor perilaku individu dan sosial-budaya masyarakat setempat.
Masyarakat di Kabupaten Sumenep kurang sadar terhadap pentingnya imunisasi bagi bayi. Sehingga banyak masyarakatnya yang tidak mengimunisasi bayi secara lengkap padahal imunisasi yang lengkap sangat penting bagi bayi untuk memberikan kekebalan terhadap suatu penyakit. Dengan kurangnya daya imun tubuh bayi, semakin cepat dan mudah ia terserang penyakit. Sehingga sebagaimana diketahui sebagian besar penderita penyakit difteri di daerah tersebut adalah anak-anak dan balita.
Perilaku anak-anak dan masyarakat di daerah tersebut yang kurang menjaga kebersihan diri mereka dan kurang menjaga kesehatan juga turut andil dalam penyebaran penyakit difteri. Mereka jarang mencuci tangan sebelum makan, tidak menjaga kebersihan rumah dan lingkungan dan sebaginya. Tangan yang kotor merupakan sarana yang baik bagi penyebaran suatu penyakit, apalagi bila masyarakat tidak mencuci tangan setelah terjadi kontak dengan seseorang tanpa mengetahui bahwa orang tersebut terjangkit difteri.
Kebiasaan tidak menggunakan masker saat sakit dan tetap melakukan aktifitas setelah mendapat gejala awal penyakit turut memperparah keadaan kesehatan mereka bahkan menularkannya pada yang lain. Padahal penyakit difteri merupakan penyakit yang meyerang system pernapasan. Itulah sebabnya mengapa perilaku tersebut dapat menjadi salah satu penyebab meluasnya penyakit tersebut.
Selain itu kebiasaan masyarakat yang mendahulukan tabib untuk mengobati penyakit sehingga terlambat melakukan tindakan medis dan keadaan sosial yang dipengaruhi faktor ekonomi menjadikan masyarakat desa takut untuk berobat ke dokter sehingga membuat penyebaran penyakit difteri semakin meluas. Tentu saja hal tersebut dapat terjadi karena difteri merupakan penyakit yang disebabkan oleh bakteri Corynebacterium diphteria yang menyerang saluran pernapasan sehingga menyebabkan obstruksi jalan napas dan membuat penderitanya sulit bernapas bahkan meninggal. Penangan penyakit ini tidak bisa dilakukan secara sembarangan karena tidak semua orang tahu bagaimana cara penangannya. Kepercayaan untuk berobat kepada tabib atau dukun yang sudah menjadi suatu kepercayaan bagi masyarakat hanya akan memperparah kondisi si penderita karena tabib atau dukun tidak memiliki keahlian untuk menyembuhkan penyakit-penyakit infeksi. Oleh karena itu penangan kasus difteri harus dilakukan oleh orang yang tepat dan dengan cara yang tepat yaitu dalam hal ini adalah tenaga medis.


BAB IV
PENUTUP



I. KESIMPULAN
Penyebab timbulnya suatu penyakit selain karena faktor lingkungan adalah karena faktor perilaku dan sosial-budaya masyarakat. Faktor-faktor tersebut sangat berpengaruh dalam penyebaran penyakit karena ada sebagian penyakit yang timbul karena pola perilaku masyarakat yang dipengaruhi oleh kondisi sosial dan budayanya.
Meluasnya kasus HIV/AIDS di Papua sebagian besar disebabkan oleh perilaku seksual masyarakatnya yang sering melakukan seks bebas dan berganti-ganti pasangan seks. Perilaku tersebut tidak hanya berkaitan dengan perilaku individu masing-masing tetapi juga berkaitan dengan adat-istiadat dan budaya yang telah lama berkembang.
Terjadinya Kejadian Luar Biasa (KLB) penyakit difteri di Kabupaten Sumenep tidak muncul begitu saja. Selain karena adanya faktor lingkungan yang berpengaruh terhadap penyebaran penyakit, terdapat faktor lain yaitu faktor perilaku individu dan sosial-budaya masyarakat setempat.
Munculnya suatu perilaku tidak selalu karena terbentuk begitu saja, lebih dari itu ada faktor lain berupa kebudayaan, lingkungan sosial, dan lingkungan fisik yang dapat menjadi faktor pendukung maupun pencetus munculnya suatu perilaku.

II. DAFTAR PUSTAKA
Irmanigrum, Yeane et al. 2007. Situasi Perilaku Berisiko dan Prevalensi HIV di Tanah Papua 2006. Jakarta : Departemen Kesehatan dan Biro Pusat Statistik.
Swann, Ken. 2004. Media dan HIV/AIDS. Family Health International East Timor.
Chin, James. 2000. Manual Pemberantasan Penyakit Menular Edisi ke-17. American Public Health Association.
P.L, Chairuddin. 2009. Diphteria (Difteri). Medan : Universitas Sumatera Utara
Savari, Harisandi. 2010. Tiga Balita Meninggal, Difteri Serang 7 Kecamatan di Sumenep. http://m.beritajatim.com, diunduh pada tanggal 22 November 2010