Relationship Between Nurse Therapeutic Communication with Patient Satisfaction in Outpatient Installation of Special Eye Hospital

Therapeutic Communication is communication that is consciously planned and aims to heal the patient. Therapeutic communication is carried out by nurses and plays an important role in helping patients recover. Therapeutic communication is needed in dealing with patients, if it is not implemented properly it will disrupt the relationship which has an impact on patient dissatisfaction. Objective of the research to determine the relationship between nurse therapeutic communication and patient satisfaction in the Outpatient Installation of the Medan Baru Special Eye Hospital. Method: The research method used is quantitative with a cross sectional approach. The research location is at the Medan Baru Special Eye Hospital. The study population was all outpatient BPJS patients at the Medan Baru Special Eye Hospital and a sample of 95 people. Sampling was done by accidental sampling. The results shows that the orientation stage variable has a p-value of 0.000 <0.05, the work stage has a p-value of 0.000 <0.05 and the termination stage has a p-value of 0.002 <0.05. Conclusion there is a relationship between orientation stage, work stage and termination stage variables with BPJS patient satisfaction with p sig <0.05. It is recommended that nurses improve therapeutic communication to patients so that they can improve the quality of health services.


Introduction
Hospital according to WHO (World Health Organization) is an integral part of a social and health organization with the function of providing comprehensive (comprehensive) services, disease healing (curative) and disease prevention (preventive) to the community. The hospital is also a training center for health workers and a medical research center (Keeton et al., 2012;Casey et al., 2011).
Based on the Law of the Republic of Indonesia Number 44 of 2009 that Hospital is a health service institution that provides complete individual health services that provide inpatient, outpatient and emergency services. As well as being able to improve services that are of a higher quality and are affordable to the community in order to realize the highest degree of health (Law of the Republic of Indonesia Number 44 of 2009 concerning Hospitals, 2009).
The services provided by the Hospital are services in the field of nursing. Nurses are one of the most important human resources in hospitals because apart from being dominant in number, they are also a profession that provides 24-hour service to patients. Nurses are like the spearhead of the patient's recovery while in the hospital, providing good service by means of good communication so that patients feel satisfying service. Nursing is the activity of providing Understanding the patient's needs and desires is the most important thing that is considered by the Hospital. Patient satisfaction is the first indicator in the hospital and as a measure of service quality and is one of the goals to be achieved by a hospital. Nursing services are basically aimed at providing satisfaction to patients (Yanti, 2013). The concept of service quality related to patient satisfaction is determined by five elements commonly known as service quality "SERVQUAL" namely Reliability, Responsiveness, Assurance, Empathy, Tangible (Direct Evidence) (Muhammad Imron Rosyidi, 2020).
Therapeutic Communication is communication that is consciously planned and aims to heal the patient. Therapeutic communication is carried out by nurses and plays an important role in helping patients recover. Therapeutic communication is needed in dealing with patients, if it is not implemented properly it will disrupt the relationship which results in patient dissatisfaction (Lalongkoe, 2014).
Nurses also have to think about how to maintain the quality of nursing services by minimizing negative impacts when in contact with patients. Therapeutic communication has an important role in the task of nursing services. The stages in therapeutic communication may get interference or noise which can cause patient dissatisfaction. Nurses must be able to suppress the emergence of problems in the communication process and communication techniques (Yuni Susiana Nur, 2021).
The Medan Baru Special Eye Hospital is one of the health services belonging to the social organization of the city of Medan which is classified as a class C hospital. The vision is to become a center for superior eye health services, quality and affordable to all levels of society so that optimal vision is achieved, and in realizing this vision the new field eye hospital has a mission which includes providing excellent eye health services with professional health workers supported by modern facilities and equipment, providing eye health services to all people regardless of socioeconomic status, ethnicity and religion, Organizing cooperation in eye health services with other agencies or institutions to complement each other, creating quality, competent and ethical hospital human resources as well as professional management in their field, realizing the development and improvement of the quality of health services through education and training facilities for health workers, so as to realize the vision and mission It is necessary to create a relationship between health workers and patients to recognize the patient's needs and determine a plan of action and cooperation in meeting these needs. As for what nurses do in maintaining good cooperation with patients in helping to meet patient health needs, as well as in order to help overcome patient problems is to communicate. By communicating, the nurse can listen to the patient's feelings or complaints and explain nursing action procedures.

Methods
The research design is a part of the research that contains descriptions of the research flow which describes the mindset of researchers in conducting research which is commonly called the research paradigm (Muhammad, 2012). The type of research used is quantitative with a cross sectional approach (Prof. Dr. Sugiyono, 2018 The population in this study were all research subjects, namely all BPJS Outpatient patients at the Medan Baru Special Eye Hospital, totaling 2008 patients. And a sample of 95 people. Sampling was carried out by accidental sampling (sampling), namely taking cases or respondents who happened to be in the inpatient department of the Eye Special Hospital.
Data collection techniques consist of primary data obtained from observation, interviews and giving questionnaires to patients. Secondary data collection was obtained from inpatient BPJS patient visit data. Tertiary data obtained from journals and books. Data processing techniques include collecting, checking, coding, entering and data processing (Muhammad, 2013).
The collected data were analyzed using the SPSS (Statistical Product and Service Solution) program. The data analysis used in this study was univariate analysis and bivariate analysis using the chi-square test (Muhammad, 2015).

Relationship of Orientation Stage Variables with Patient Satisfaction in the Outpatient Installation of the Medan Baru Special Eye Hospital
Based on the results of the study using the chi square test, there was a significant relationship between the orientation stage variable and patient satisfaction at the Furthermore, it is also in line with research conducted by Mahendro Prasetyo Kusumo "The Influence of Nurse Therapeutic Communication on Patient Satisfaction at Outpatient Hospital Jogja in 2020" shows that a significance value of 0.016 <0.05 indicates that the orientation stage variable has an influence on patient satisfaction.
The orientation stage is the initial stage that begins when the nurse meets the patient. The orientation phase begins with the nurse greeting and introducing herself to the patient. By This research is in line with research conducted by Rachmat Ramli "The Relationship between Therapeutic Communication Implementation and Patient Satisfaction in Obtaining Nursing Services at Bhayangkara Hospital Makassar in 2021". The results of the study showed a sig p 0.023 <0.05 indicating that the working stage variable had a relationship with patient satisfaction.
Furthermore, it is also in line with research conducted by Mahendro Prasetyo Kusumo "The Influence of Nurse Therapeutic Communication on Patient Satisfaction at Outpatient Hospital Jogja in 2020" shows that a significance value of 0.010 <0.05 indicates that the working stage variable has an influence on patient satisfaction.
The work stage is the next stage after the orientation stage and is also the core stage in therapeutic communication. Apart from being a communicator, nurses must also be able to become communicants for patients by listening actively, enthusiastically and with full attention when patients express complaints that they feel and also nurses are able to deal with complaints from patients. At this stage of work, the nurse gives enthusiasm to recover, motivates patients that their complaints can be overcome and gives attention through touch during communication. That way the patient feels very cared for so as to bring patient satisfaction. The effect of work stage on patient satisfaction is the result of services in the field of nursing.

Relationship of Termination Stage Variables with Patient Satisfaction in the Outpatient Installation of the Medan Baru Special Eye Hospital
Based on the results of the study using the chi-square test, there was a significant relationship between the termination stage variable and patient satisfaction at the Temporary termination is the stage where the nurse will meet again with the patient at a predetermined time. While the final termination is the stage where the nurse has completed the nursing process as a whole. It is during this termination stage that nurses and patients jointly re-evaluate the nursing service process that has been carried out. The nurse is expected to be able to achieve the goals of the interaction that has been carried out by asking the patient's feelings after the nursing action is carried out and making a contract for the next meeting.

Conclusion
There is a relationship between the orientation stage variable 0.000 (p <0.05) and patient satisfaction at the Outpatient Installation of the Medan Baru Special Eye Hospital. There is a relationship between the working stage variable 0.000 (p<0.05) and patient satisfaction at the Outpatient Installation of the Medan Baru Special Eye Hospital. There is a relationship between the termination stage variable 0.002 (p <0.05) and patient satisfaction at the Outpatient Installation of Medan Baru Special Eye Hospital

Suggestion
It is expected that nurses will maintain and improve the therapeutic communication orientation stage such as starting by introducing themselves and always greeting patients when entering and leaving the room. This will bring patient satisfaction. It is expected that nurses will maintain and improve the working stage of therapeutic communication. By providing motivation, enthusiasm and attention to patients so that they are satisfied and feel very cared for by nurses. It is expected that nurses will improve the termination stage of therapeutic communication. By providing an evaluation related to nursing services that have been given to patients and providing health education before the patient goes home. It is expected that nurses can further improve and improve therapeutic communication so that the relationship between nurses and patients can be well established so as to provide patient satisfaction.