PENGARUH IMPLEMENTASI PROGRAM PRO-SELF TERHADAP KECEMASAN DAN DEPRESI PASIEN KEMOTERAPI

Abstract

ABSTRAK
Latar belakang: Kemoterapi menimbulkan efek samping fi siologis dan psikologis. Gejala psikologis yang dapat
terjadi berupa kecemasan dan depresi. Masalah psikososial dapat diatasi dengan memfasilitasi peningkatan
koping pasien melalui pemberian informasi dan peningkatan sistem dukungan. Program PRO–SELF yang
didesain untuk pasien kanker dewasa meliputi informasi, keterampilan, dan dukungan supaya penderita
kanker dapat terlibat mandiri secara efektif dan konsisten dalam mengelola efek samping kemoterapi sehingga
keparahan gejala yang berhubungan dengan penyakitnya atau penanganan penyakitnya dapat diminimalkan.
Tujuan: mengetahui pengaruh implementasi Program PRO-SELF terhadap kecemasan dan depresi pada
pasien kemoterapi. Metode: penelitian quasi eksperimen dengan pre-test-post-test one group design yang
melibatkan 40 responden selama 3 bulan dengan kriteria inklusi semua pasien kemoterapi, berusia kurang
dari 65 tahun, nilai skala Eastern Cooperative Oncology Group (ECOG) 0–2. Data dikumpulkan pada bulan
Juli–September 2013 di Ruang Penyakit Dalam IRNA 1 RSUP Dr. Sardjito. Kriteria eksklusinya pasien kanker
yang memiliki riwayat gangguan psikiatri. Responden diberikan pre-test, kemudian diberikan intervensi oleh
peneliti berupa pemberian program PRO-SELF yang terdiri atas pemberian informasi, keterampilan tentang
kemoterapi dan pengurangan efek samping kemoterapi, serta pemberian dukungan melalui telepon saat
pasien di rumah. Setelah intervensi, responden diberikan post-test dengan jarak waktu 3 minggu dari pretest. Pengukuran kecemasan dan depresi menggunakan kuesioner hospital anxiety depression scale (HADS).
Analisis data dilakukan dengan analisis Wilcoxon Test dengan tingkat kepercayaan 95%. Hasil: Terdapat
perbedaan bermakna tingkat kecemasan pada responden (p=0,001) dari pre-test ke post-test. Tingkat depresi
tidak bermakna dari pre-test ke post-test (p=0,258). Kesimpulan: Implementasi program PRO-SELF secara
efektif dapat mengurangi kecemasan pasien kemoterapi, tetapi tidak dapat secara efektif mengurangi depresi.
Kata Kunci: kemoterapi, kecemasan, depresi, program PRO-SELF.
ABSTRACT
Background: Chemotherapy causes physiological and psychological side effects. Psychological symptoms
that can occur are anxiety and depression. Psychosocial problems can be overcame by improved patient coping
through the provision of information and improved support system. PRO-SELF program that was designed
increase self-care skills for adult patients undergoing cancer therapy includes information, skills, and support so
cancer patients can be engaged effectively and consistently independent in managing side effect chemotherapy,
so the severity of symptoms due to disease or treatment disease can be minimized. Objectives: To identify the
effect of implementation PRO-SELF program to anxiety and depression in chemotherapy patients. Methods:
This study used pre-experimental, one-group pre-test-post-test design involving 40 respondents for 3 month,
inclusion criteria in this study are all chemotherapy patients, aged less than 65 years, screening patients with
Eastern Cooperative Oncology Group (ECOG 0–2) scale. Data were collected within July–September 2013 in
Internal Injuries IRNA 1 Room RSUP Dr. Sardjito Yogyakarta. Exclusion criteria is cancer patients who have
history of psychiatric disorder. Respondents were given a pre-test, then were given intervention by nursing
student with provision of information, skills in reducing chemotherapy side effects, and provide support with
telephone when patients are at home. Respondent were given post-test after intervention 3 weeks after pretest. Measurement of anxiety and depression using hospital anxiety depression scale (HADS) questionnaires
and analyzed with Wilcoxon test with 95% level of signifi cancy. Results: Decrease respondents anxiety from
pre-test to post-test with signifi cancy 0.001, there is signifi cant difference. Depression respondents changed
from pre-test to post-test with signifi cancy 0.258, that is non-signifi cant difference. Discussion: PRO-SELF
program effectively reduce anxiety because information, skills, support can reduce anxiety. Conclusions:
Implementation of the PRO-SELF program effectively reduce patient anxiety chemotherapy. Yet it can not
reduce depression effectively.
Keywords: chemotherapy, anxiety, depression, PRO-SELF program.