PENGARUH COGNITIVE BEHAVIOUR THERAPY TERHADAP DERAJAT DEPRESI DAN AKTIVITAS PERAWATAN DIRI PADA PASIEN DIABETES MELLITUS (DM) TIPE 2

EFFECT OF COGNITIVE BEHAVIOUR THERAPY ON DEGREES OF DEPRESSION AND SELF- CARE ACTIVITIES OF TYPE 2 DIABETES PATIENT

  • Rohmaningtyas Hidayah Setyaningrum SMF Psikiatri Fakultas Kedokteran Universitas Sebelas Maret/RS dr Moewardi Surakarta
  • Aris Sudiyanto SMF Psikiatri Fakultas Kedokteran Universitas Sebelas Maret/RS dr Moewardi Surakarta
  • Nanang Wiyono Sub Bagian Neurobiologi, Bagian Anatomi Fakultas Kedokteran Universitas Sebelas Maret
  • Muhammad Fanani SMF Psikiatri Fakultas Kedokteran Universitas Sebelas Maret/RS dr Moewardi Surakarta

Abstract

Pemberian psikoterapi telah terbukti berhasil untuk pasien depresi yang menderita penyakit medis kronik. Psikoterapi kognitif perilaku didasarkan atas konsep bahwa perubahan dalam struktur kognitif akan mengubah kondisi emosi serta perilaku pasien. Sehingga diharapkan dengan membaiknya depresi maka akan memperbaiki perilaku pasien dalam hal ini aktivitas perawatan diri diabetesnya. Penelitian ini untuk mengetahui keefektifan Cognitive Behaviour Therapy (CBT) dalam menurunkan derajat depresi dan meningkatkan aktivitas perawatan diri pada pasien Diabetes Mellitus tipe-2 di Rumah Sakit Dr. Moewardi Surakarta. Penelitian ini menggunakan metode eksperimental dengan rancangan randomized controlled trial pre and post design. Jumlah subjek 34 pasien, dibagi dua kelompok yaitu perlakuan dan kontrol. Subjek adalah pasien 34 pasien Diabetes Mellitus tipe-2 di Poli Penyakit Dalam Rumah Sakit Dr. Moewardi Surakarta dengan kadar GDP ≥ 100 mg/dL, GD2PP ≥ 140 mg/dL, umur 18 – 60 tahun, pendidikan minimal SMP, skor BDI ≥ 10, dan kriteria eksklusi apabila mengalami komplikasi dan atau menderita penyakit fisik medis yang berat, gangguan mental berat (psikotik), retardasi mental, atau demensia, gangguan berat dalam berkomunikasi (kesulitan bahasa, tuli), gangguan kognitif yang berat atau ketidakmampuan intelektual, yang ditunjukkan dari penilaian MMSE < 25, dan skor L-MMPI ≤ 1. Depresi dievaluasi menggunakan Beck Depression Inventory, aktivitas perawatan diri diabetes menggunakan The Summary of Diabetes Self-Care Activities. Uji statistik menggunakan uji t tidak berpasangan dan uji Mann Whitney, dipakai untuk signifikansi perbedaan variabel dengan tingkat kemaknaan 5%. Subjek yang mendapat CBT secara signifikan (p<0,05) didapatkan penurunan skor depresi (5,76 ± 3,58) dibandingkan kelompok yang tidak mendapat CBT (2,76 ± 1,56) sedangkan subjek yang mendapat CBT secara sangat signifikan (p<0,01) mengalami peningkatan aktivitas perawatan diri diabetes (15,35±7,78) dibandingkan kelompok yang tidak mendapat CBT (3,00±2,78), sehingga disimpulkan CBT efektif menurunkan derajat depresi dan meningkatkan aktivitas perawatan diri pada pasien diabetes mellitus tipe-2.


 


Cognitive behavior therapy had sucesfully referred as an effective method for reducing depression, particularly in individual with a chronic disease. Cognitive behavior psychotherapy is based on the concept that changes in cognitive structure will change patient's emotional state and behavior. The decreasing depression in patient with diabetes will improve diabetes self-care activities. The aim was to determine the effectiveness of Cognitive Behavior Therapy (CBT) adjuvant therapy in decreasing and improving the degree of diabetes self-care activities of patients with type-2 Diabetes Mellitus in Dr. Moewardi Hospital Surakarta. This study was an experimental design of randomized controlled trial with pre and post-test design. In total, 34 patients were enrolled in the mg/dl, Blood sugar level test post pandrial 140 mg/dL aged between 18-60 years old with junior high school as minimum education, BDI score > 10, the exclusion criteria is when experiencing complication with or suffering from physical illness, psychotic, mental retardation or dementia , severe interference in communication ( language difficulties and deafness), severe cognitive impairment, intellectual impairment, MMSE score < 25, L MMPI score < 1, The total 34 subjects devided into two groups, treatment and control. Statistical test using unpaired T-test and Mann Whitney, with level of 5%. Depression was evaluated by using the Beck Depression Inventory and diabetes self-care activities using the Summary of Diabetes Self-Care Activities. Subjects who received CBT significantly decrease (p <0,05) scores of depression compared with that of the group without CBT and increase in diabetes self-care activities (p<0,01). It is concluded that CBT is effective to decrease degree of depression and improve diabetes self-care activities of patients with type 2 diabetes mellitus.

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Published
2018-10-17
How to Cite
SETYANINGRUM, Rohmaningtyas Hidayah et al. PENGARUH COGNITIVE BEHAVIOUR THERAPY TERHADAP DERAJAT DEPRESI DAN AKTIVITAS PERAWATAN DIRI PADA PASIEN DIABETES MELLITUS (DM) TIPE 2. Mandala Of Health, [S.l.], v. 11, n. 1, p. 31-43, oct. 2018. ISSN 2615-6954. Available at: <https://jos.unsoed.ac.id/index.php/mandala/article/view/569>. Date accessed: 20 june 2024. doi: https://doi.org/10.20884/1.mandala.2018.11.1.569.