Formulir Etik Penelitian Kesehatan (2)

Please download to get full document.

View again

of 6
0 views
PDF
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Document Description
WERF
Document Share
Document Transcript
  FORMULIR ETIK PENELITIAN KESEHATAN 1. Peneliti :……………………………………………Dibawah bimbingan komisi pembimbing :1. …………………………………… (NIK. ……………………….)2. …………………………………… (NIK. ……………………….) 2. Judul Penelitian :……………………………………………………………………………………....................................................................................................................................................... !ub ek :…………………………………………………………………………………………#. Pe$ki$aan waktu Penelitian :…………………………………………………………………………………………...%. &ingkasan usulan penelitian ang men'akup obekti tuuan penelitian* manaat$ele+ansi da$i hasil penelitian dan alas an moti+asi untuk melakukan penelitian. 1.Tujuan Penelitian :A.Tujuan Umum ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… B.Tujuan Khusus 1. ……………………………………………………………………………………………………………………………………………………2. ……………………………………………………………………………………………………………………………………………………... …………………………………………………………………………………………………………………………………………………….. 2.Manfaat Penelitian : A.Manfaat Teoritis ………………………………………………………………………………………………………………………………………………………………………………… B.Manfaat Praktis 1. ,anaat -agi P$oesi Kepe$awatan ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….....  2. ,anaat -agi Peneliti…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………. ,anaat -agi Institusi............................................................................................................................................................................................................................................................................................................................................................................................................................................................................#. ,anaat -agi ,as a$akat…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………. 3.Motivasi …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….………………………………… . ,asalah etik (n atakan pendapat anda tentang masalah etik ang mungkin dihadapi)…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………/. -ila penelitian ini menggunakan sub ek manusia* apakah pe$'obaan pada hewan sudah dilakukan 0 -ila belum* sebutkan alasan untuk pemulai penelitian ini pada manusia…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………. P$osedu$ penelitian ang dilakukan :  1. ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………2. ………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….#. ………………………………………………………………………………………………………………………………………………………………………….%. ………………………………………………………………………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………………………………………………./. …………………………………………………………………………………….. ………………………………………………………………………………………………………………………………………………………………………….. -aha a potensial ang langsung atau tidak langsung* sege$a atau kemudian dan 'a$a3'a$a untuk men'egah atau mengatasi keadian (te$masuk $asa n e$i dan keluhan lain) …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………14. Pengalaman te$dahulu (sendi$i atau o$ang lain) dan tindakan ang hendak dite$apkan…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………11. -ila penelitian ini menggunakan o$ang sakit dan dapat membe$i manaat untuk sub ek ang be$sangkutan* u$aikan manaat itu 0  ……………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………12. -agaimana memilih pasien5suka$elawan sehat 0…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………1. -ila penelitian ini menggunakan sub ek manusia* elaskan hubungan anta$a peneliti dengan sub ek ang diteliti :………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………… 1#. -ila penelitian ini menggunakan o$ang sehat* elaskan 'a$a peme$iksaankesehatann a……………………………………………………………………………………………………………………………………………………………………………………1%. Jelaskan 'a$a pen'atatan selama penelitian* eek samping dan komplikasi bila ada :……………………………………………………………………………………………………………………………………………………………………………………1. -ila penelitian ini menggunakan sub ek manusia* elaskan bagaimana 'a$amembe$itahu dan mengaak sub ek (lampi$kan 'ontoh su$at pe$setuuan sub ek)-ila pembe$itahuan dan kesediaan sub ek be$siat lisan atau bila ka$ena sesuatu halsub ek tidak dapat atau tidak pe$lu dimintakan pe$setuuan* be$ilah alasan ang kuatuntuk itu.
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks