Effect of CERDIK-Based Health Promotion on Healthy Lifestyle Behavior among Patients with Coronary Heart Disease: A Quasi-Experimental Study / Pengaruh Promosi Kesehatan Berbasis CERDIK terhadap Perubahan Perilaku Hidup Sehat Pasien Penyakit Jantung Koroner: Studi Kuasi-Eksperimental

Background: Coronary heart disease (CHD) remains a major cause of morbidity and mortality, and sustained lifestyle modification is essential for secondary prevention. The Indonesian Ministry of Health promotes CERDIK, a six-component healthy-lifestyle strategy comprising regular health checks, avoidance of cigarette smoke, regular physical activity, a healthy balanced diet, adequate rest, and stress management. Evidence regarding structured CERDIK education among patients with established CHD in hospital outpatient settings remains limited. Objective: This study evaluated the effect of CERDIK-based health promotion on knowledge, attitudes, and healthy lifestyle practices among patients with CHD. Methods: A quasi-experimental two-group pretest-posttest study was conducted in the cardiac outpatient clinic of Murni Teguh Hospital, Medan. Forty patients were recruited by purposive sampling and allocated to an intervention group (n=20) and a control group (n=20). The intervention group received structured CERDIK-based health education for four weeks, whereas the control group received routine education. Outcomes were measured before and after the intervention using questionnaires assessing knowledge, attitudes, and practices. Change scores were compared between groups using the Mann-Whitney U test. Results: After the intervention, 85% of participants in the intervention group had good knowledge, 85% had positive attitudes, and 45% had good practices; the corresponding proportions in the control group were 0%, 0%, and 10%, respectively. Mean change scores were substantially greater in the intervention group than in the control group for knowledge (25.75 vs 2.95), attitudes (27.30 vs 1.85), and practices (23.35 vs 1.85). Between-group differences were statistically significant for all outcomes (all p<0.001). Conclusion: Structured CERDIK-based health promotion significantly improved short-term knowledge, attitudes, and healthy lifestyle practices among patients with CHD. The intervention may be incorporated into outpatient secondary-prevention education, although larger randomized studies with longer follow-up are needed to assess sustained behavioral effects.

Latar belakang: Penyakit jantung koroner (PJK) tetap menjadi penyebab penting morbiditas dan mortalitas, sedangkan modifikasi gaya hidup yang berkelanjutan merupakan bagian utama pencegahan sekunder. Kementerian Kesehatan Republik Indonesia mempromosikan CERDIK sebagai strategi perilaku hidup sehat yang mencakup cek kesehatan secara berkala, enyahkan asap rokok, rajin aktivitas fisik, diet sehat dengan gizi seimbang, istirahat cukup, dan kelola stres. Bukti mengenai efektivitas edukasi CERDIK yang terstruktur pada pasien PJK di pelayanan rawat jalan rumah sakit masih terbatas. Tujuan: Penelitian ini menganalisis pengaruh promosi kesehatan berbasis CERDIK terhadap pengetahuan, sikap, dan tindakan perilaku hidup sehat pada pasien PJK. Metode: Penelitian kuasi-eksperimental dengan desain two-group pretest-posttest dilakukan di Poliklinik Jantung Rumah Sakit Murni Teguh Medan. Sebanyak 40 pasien direkrut dengan purposive sampling dan dibagi menjadi kelompok intervensi (n=20) dan kelompok kontrol (n=20). Kelompok intervensi memperoleh edukasi kesehatan berbasis CERDIK secara terstruktur selama empat minggu, sedangkan kelompok kontrol memperoleh edukasi rutin. Pengetahuan, sikap, dan tindakan diukur sebelum dan sesudah intervensi menggunakan kuesioner, kemudian skor perubahan antar kelompok dibandingkan dengan uji Mann-Whitney U. Hasil: Setelah intervensi, 85% responden kelompok intervensi memiliki pengetahuan baik, 85% memiliki sikap positif, dan 45% memiliki tindakan baik; pada kelompok kontrol proporsinya masing-masing 0%, 0%, dan 10%. Rerata perubahan skor pada kelompok intervensi lebih tinggi dibandingkan kelompok kontrol untuk pengetahuan (25,75 vs 2,95), sikap (27,30 vs 1,85), dan tindakan (23,35 vs 1,85). Seluruh perbedaan antar kelompok bermakna secara statistik (semua p<0,001). Kesimpulan: Promosi kesehatan berbasis CERDIK yang terstruktur secara signifikan meningkatkan pengetahuan, sikap, dan tindakan perilaku hidup sehat jangka pendek pada pasien PJK. Intervensi ini berpotensi diintegrasikan dalam edukasi pencegahan sekunder di layanan rawat jalan, namun penelitian acak dengan sampel lebih besar dan tindak lanjut lebih panjang diperlukan untuk menilai keberlanjutan perubahan perilaku.