Analisis Faktor Yang Mempengaruhi Keluarga Penderita Gangguan Jiwa Berat Memilih Pengobatan Tradisional Di Wilayah Kerja Puskesmas Bantur Kab. Malang

Aminah, Tien and Dr. dr. Retty Ratnawati,, M.Sc. and Ns. Tina Handayani Nasution,, S.Kep.,M.Kep (2018) Analisis Faktor Yang Mempengaruhi Keluarga Penderita Gangguan Jiwa Berat Memilih Pengobatan Tradisional Di Wilayah Kerja Puskesmas Bantur Kab. Malang. Magister thesis, Universitas Brawijaya.

Abstract

Gangguan jiwa merupakan suatu sindrom pola perilaku atau psikologik seseorang yang bermakna secara klinis dimana gejala klinis tersebut menimbulkan penderitaan (distress) berupa rasa nyeri, rasa tidak nyaman, rasa tidak tenteram, terganggu, serta disfungsi organ tubuh dan disabilitas dalam aktivitas kehidupan sehari- hari. Gangguan jiwa tidak menyebabkan kematian secara langsung, namun beratnya gangguan jiwa ini dapat menyebabkan ketidakmampuan serta invaliditas baik secara individu maupun kelompok sehingga akan menghambat pembangunan suatu negara, apalagi sebagian besar penderita tergolong dalam usia yang masih produktif. Saat ini masih banyak kasus gangguan jiwa yang terlambat mendapatkan penanganan petugas kesehatan, karena biasanya keluarga atau masyarakat mencari pengobatan alternatif dulu sebelum datang ke pelayanan kesehatan. Banyak faktor yang mempengaruhi diri seseorang dalam memilih fasilitas pelayanan kesehatan, baik itu pelayanan kesehatan konvensional maupun pelayanan kesehatan tradisional. Tujuan dari penelitian ini adalah untuk menganalisis faktor-faktor yang mempengaruhi keluarga penderita gangguan jiwa berat memilih pengobatan tradisional. Desain penelitian ini adalah observasional analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh keluarga yang memiliki anggota keluarga menderita gangguan jiwa berat di wilayah kerja Puskesmas Bantur Kabupaten Malang Propinsi Jawa Timur sejumlah 132 orang. Sampel diambil dengan teknik proportional cluster random sampling dengan jumlah responden sebanyak 100 orang. Variabel independent yang diteliti adalah health beliefs, sumber daya keluarga, sumber daya social, kebutuhan keluarga, dan evaluasi pencapaian kebutuhan keluarga. Sedangkan variabel dependent-nya adalah pemilihan pengobatan tradisional. Instrumen pengumpulan data menggunakan kuesioner yang terdiri dari 6 bagian. Bagian A: kuesioner untuk mengukur health beliefs merupakan hasil modifikasi dari Health Beliefs Toolkit yang dibuat oleh Maritza Concha, Maria Elena Villar, dan Lauren Azevedo dari Covian Consulting, University of South Florida pada tahun 2014. Bagian B: kuesioner untuk mengukur variabel sumber daya keluarga mengadopsi dari SCREEM Family Resources Survey (SCREEM-RES) yang dikembangkan oleh M. Medina, Jr. M.D dan The Section of Supportive Hospice and Palliative Medicine University of the Philippines tahun 2011. Bagian C: kuesioner untuk mengukur variabel sumber daya social/masyarakat mengadopsi dari Social Determinants of Health (SDH) Needs Assessment Survey dari Colorado Community Health Work tahun 2014. Bagian D: kuesioner untuk mengukur variabel kebutuhan keluarga mengadopsi dari Social Determinants of Health (SDH) Needs Assessment Survey dari Colorado Community Health Work tahun 2014. Bagian E: kuesioner untuk mengukur variabel evaluasi kebutuhan yang ditelah dicapai keluarga merupakan modifikasi dari Social Determinants of Health (SDH) Needs Assessment Survey dari Colorado Community Health Work tahun 2014. Dan bagian F: kuesioner untuk mengukur pemilihan pengobatan tradisional mengadopsi dari The International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). Data dianalisis secara univariat, bivariate, dan multivariate. Analisis data univariat menggunakan persentase, analisis bivariat menggunakan uji Chi square, dan analisis multivariate menggunakan uji regresi logistik berganda. Penelitian ini dilakukan pada tanggal 11 - 14 Juli 2018 di wilayah kerja Puskesmas Bantur Kabupaten Malang Propinsi Jawa Timur, yang terdiri dari 5 desa yaitu: desa Bantur, Bandungrejo, Wonorejo, Sumberbening, dan Srigonco. Hasil penelitian diketahui bahwa karakteristik keluarga penderita gangguan jiwa berat selaku responden rata-rata berumur 47,4 tahun, bersuku Jawa 94%, beragama x Islam 87%, berjenis kelamin perempuan 67%, status menikah 74%, pendidikan tamatan SD 47%, pekerjaan petani 54%, penghasilan dibawah UMR 100%, hubungan dengan penderita sebagai ibu kandung 29%, rata-rata jarak rumah ke puskesmas 9 km dengan transportasi 92% milik sendiri, rata-rata jarak rumah ke pelayanan pengobatan tradisional 9,2 km dengan transportasi milik sendiri 48% dan sewa 47%. Karakteristik penderita gangguan jiwa berat di wilayah kerja Puskesmas Bantur Kabupaten Malang Propinsi Jawa Timur rata-rata berumur 40 tahun, bersuku Jawa 94%, beragama Islam 87%, berjenis kelamin perempuan 57%, status belum menikah 46%, pendidikan tamatan SD 48%, pekerjaan serabutan 46%, penghasilan dibawah UMR 100%, dan lama menderita gangguan jiwa berat rata-rata 6 tahun. Dari 100 orang responden yang diteliti, sebanyak 73 orang (73%) memiliki keyakinan kesehatan negatif dan 27 orang (27%) memiliki keyakinan kesehatan positif. Sumber daya keluarga reponden sebanyak 29 orang (29%) tidak memadai dan 71 orang (71%) memadai. Sumber daya sosial/masyarakat responden sebanyak 31 orang (31%) tidak memadai dan 69 orang (69%) memadai. Kebutuhan yang dirasakan oleh keluarga sebanyak 30 orang (30%) kebutuhan tinggi dan 70 orang (70%) kebutuhan rendah. Dari hasil evaluasi pencapaian kebutuhan keluarga, sebanyak 30 orang (30%) terpenuhi tinggi dan 70 orang (70%) terpenuhi rendah. Hal ini menggambarkan bahwa kehidupan responden sangat sederhana dan tidak memiliki keinginan yang tinggi akan kebutuhan hidupnya, dan mereka merasa sudah cukup dengan pemenuhan kebutuhan selama ini. Dari 100 orang responden, sebanyak 51 orang (51%) memilih pengobatan tradisional dan 49 orang (49%) tidak memilih pengobatan tradisional. Gambaran pemilihan pengobatan tradisional, dari 51 orang responden yang memilih pengobatan tradisional, sebanyak 38 orang (75%) memilih kyai/tokoh agama sebagai jenis pengobat tradisional untuk mengobati anggota keluarganya yang menderita gangguan jiwa berat, 20 orang (40%) memilih dukun, dan yang paling sedikit dipilih adalah akupunkturist yaitu hanya 5 orang (9%). Sedangkan dari segi produk pengobatan tradisional yang dipilih paling banyak oleh responden adalah jamu-jamuan yaitu sebanyak 22 orang (44%) disusul produk herbal sebanyak 21 orang (42%). Dari segi praktek pengobatan tradisional, sebanyak 33 orang (77%) responden memilih mempraktekkan doa-doa, disusul mantra/jampi-jampi sebanyak 23 orang (45%), dan yang paling sedikit adalah meditasi 6 orang (11%). Hasil uji chi square didapatkan nilai variabel health beliefs (p value 0.005), sumber daya keluarga (p value 0.022), sumber daya sosial (p value 0.025), kebutuhan keluarga (p value 0.013), dan evaluasi pencapaian kebutuhan (p value 0.013). Hasil uji regresi logistic berganda diketahui bahwa p value variabel health beliefs adalah 0.007 dengan OR 0.258. Kesimpulan dari penelitian ini adalah ada pengaruh variabel keyakinan kesehatan (health beliefs), variabel sumber daya keluarga,variabel sumber daya social/masyarakat, variabel kebutuhan keluarga, dan variabel evaluasi pencapaian kebutuhan keluarga terhadap pemilihan pengobatan tradisional oleh keluarga penderita gangguan jiwa berat. Variabel yang paling dominan berpengaruh terhadap pemilihan pengobatan tradisional adalah variabel keyakinan kesehatan (health beliefs) dengan kekuatan korelasi kuat

English Abstract

Mental disorder is a syndrome of behavior patterrns or psychological person with clinical judgement, where the clinical symptoms cause distress such as pain, discomfort, discomfort, discomfort and organ dysfunction and disability in daily life activities for self- care and survival. Mental disorders do not caused death, but the severity of mental disorder can cause the inability and invalidity both in individually and in groups so it will inhibit the development of a country, and commonly the most of the mental disorder occure in productive age. Currently there are still many cases of mental disorder who late to get the handling of health workers, because the family or community try to found alternative treatment before come to health care services. Many factors were influence a person in choosing health care facilities, both conventional health services and traditional health services. The purpose of this study to analyzed the factors that influenced the families who live with severe mental disorders patient to take traditional treatment. The design of this study was observational analytic with use cross sectional approach. Population of this research was all family who living with severe mental disorder and registered in Bantur’s Primary Health Care Services (PHC), Malang District of East Java Province-Indonesia with the number 132 people. Moreover, 100 samples were taken by proportional cluster random sampling technique. Independent variables were health beliefs, family resources, social resources, family needs, and needs evaluation. While the dependent variable is the selection of traditional treatment. The data were collected by using questionnaires. The questionnaire to assess dependent variables are consist six parts, it are: Part A: questionnaire to assess health beliefs was modification from Health Beliefs Toolkit by Maritza Concha, Maria Elena Villar, and Lauren Azevedo at Covian Consulting, University of South Florida, 2014. Part B: questionnaire to assess family resources was adopted from SCREEM Family Resources Survey (SCREEM-RES) by M. Medina, Jr. M.D dan The Section of Supportive Hospice and Palliative Medicine University of the Philippine, 2011. Part C: questionnaire to assess social resources was adopted from Social Determinants of Health (SDH) Needs Assessment Survey at Colorado Community Health Work, 2014. Part D: questionnaire to assess family needs was adopted from Social Determinants of Health (SDH) Needs Assessment Survey at Colorado Community Health Work, 2014. Part E: questionnaire to assess the evaluation of family needs achievement was adopted from Social Determinants of Health (SDH) Needs Assessment Survey at Colorado Community Health Work, 2014 and part F: questionnaire to assess the decision on taking traditional treatment was adopted from The International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). The univariate data were analyzed by using percentage, bivariate data were analyzed by using Chi-Square test and multivariate data were analyzed by using multiple logistic regression. This research was done at Bantur’s Primary Health Care Services, Malang District, East Java Province-Indonesia are consist five villages, it are: Bantur, Bandungrejo, Wonorejo, Sumberbening, and Srigonco, July 11-14, 2018. The result of this research, it can be known the characteristics of the family who living with severe mental disorders as respondents were found the mean of age was 47.4 years old, 94% were Javanese, 87% were Muslim, 67% were female, 74% were married, 47% were hold elementary school, 54% were farmer as their profession, 100% were got under UMR as their salarry, only 29% of the participant mentined that they were have relation with patient as the mother, an average distance of their house to Primary Health Care Services was around 9 km and 92% of them to reach Primary Health Care Services by using their own transportation. However, an average distance of their home to xii traditional treatment service was 9,2 km with and 48% of them reach it by their own transportation and 47% by rent the transportation. Characteristics of patients who have severe mental disorder in work area of Bantur’s Primary Health Care Services in Malang District, East Java Province-Indonesia was in average 40 years old, 94% was Javanese, 87% was Islamic as their religion, 57% were female, 46% were unmarried, 48% were hold elementary school, and 46% were odd jobs, 100% of them were got income under the minimum, and in an average 6 years old suffering severe mental disorders. The result of this research, from 100 respondents (family) of severe mental disorder, as many as 73 people (73%) have negative health beliefs and always looking for traditional medicine. Family resource variable found that 29 people (29%) were inadequate and 71 people (71%) said that family resources were adequate. Need family variable found mostly (70%) had low of family needs and only 30 respondents (30%) said that they had high family needs. This was describe that the lives of respondents were very simple and did not have a high desire for the needs of life, and they feelt enough to their live. For social resources, as much as 69% of respondents said that got adequate social resources or supportive environments. The result of this research, from 51 respondents who had selected traditional medicine, as many as 38 people (75%) selected kyai (religious leaders) as a kind of treatments to taking care of family members who have severe mental disorder, 20 people (40%) selected shamans, and only 5 people (9%) selected acupuncturist. In terms of traditional medicines products, as many as 22 people (44%) selected herb, and 21 people (42%) selected herbal products. In terms of traditional medicine practice, 33 people (77%) selected practice prayers, followed by spells of 23 people (45%), and only 6 people (11%) selected meditation as their traditional medicine practice Chi square test results showed that variable of health beliefs (p value 0.005), family resources (p value 0.022), social resources (p value 0.025), family needs (p value 0.013), and evaluation of achievement needs (p-value 0.013) to the selection of traditional treatment among families who living with severe mental disorders. Multiple logistic regression test showed that the most dominant variable was health beliefs with p value 0.007 with OR 0.258. Based on the result of this research, it can be concluded that there are influence of health beliefs, family resources, social / community resources, family needs, and evaluation of the achievement of family needs on the selection of traditional treatment among family who living with serious mental disorder and the most dominant factor is health beliefs

Other obstract

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Item Type:	Thesis (Magister)
Identification Number:	TES/362.2/FK/a/2018/041809788
Subjects:	300 Social sciences > 362 Social problems of and services to groups of people > 362.2 People with mental illness and disabilities
Divisions:	S2/S3 > Magister Keperawatan, Fakultas Kedokteran
Depositing User:	Nur Cholis
Date Deposited:	12 Aug 2022 08:08
Last Modified:	12 Aug 2022 08:08
URI:	http://repository.ub.ac.id/id/eprint/193199

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