PENGARUH PURSED-LIPS BREATHING TERHADAP SIMTOM DEPRESI PADA PENDERITA PENYAKIT PARU OBSTRUKTIF KRONIK STABIL

DIAH MARINDA, dr. H. Agus Siswanto, SpPD, KPsi.; dr. Noor Asyiqah Sofia, M.Sc, SpPD, KPsi.

2017 | Tesis-Spesialis | SP Ilmu Penyakit Dalam

Latar belakang. PPOK menyebabkan kondisi hipoksia kronis yang memberikan dampak psikologis, yaitu depresi. Pursed-lips breathing (PLB) merupakan salah satu bagian dari rehabilitasi pulmoner yang dapat memperlancar oksigenasi di seluruh tubuh. Penelitian mengenai rehabilitasi pulmoner terhadap perbaikan simtom depresi ataupun kualitas hidup telah dilakukan di beberapa negara, namun khusus mengenai PLB terhadap simtom depresi belum pernah diteliti. Tujuan Penelitian. Tujuan utama penelitian ini adalah untuk menganalisis pengaruh rehabilitasi pulmoner dengan menggunakan teknik pursed-lips breathing (PLB) terhadap perbaikan simtom depresi pada pasien PPOK stabil. Metode. Penelitian ini menggunakan desain randomized controlled trial, open label pada pasien PPOK rawat jalan yang dinilai simtom depresi saat awal dengan kuesioner Beck Depression Inventory (BDI) kemudian dilakukan randomisasi. Subyek dibagi menjadi 2 kelompok, yaitu kelompok perlakuan yang mendapat latihan teknik PLB dan kelompok kontrol. Terapi standar tetap dilanjutkan. Setelah 4 minggu dilakukan evaluasi ulang skor BDI. Hasil Penelitian. Sebanyak 55 subyek penelitian yang dianalisis pada akhir penelitian, terdiri dari 29 orang kelompok PLB dan 26 orang kelompok kontrol. Rerata umur kelompok PLB 64,31+-6,61 tahun dan kelompok plasebo 65,65+-8,53 tahun. Terjadi penurunan skor BD+-6,39 (p=0.001) dibandingkan kelompok kontrol sebesar 2,19+-5,97 (p=0.53). Namun tidak didapatkan perbedaan rerata delta BDI pada kedua kelompok (p = 0,136) Kesimpulan. Meskipun tidak terdapat perbedaan simtom depresi yang bermakna secara statistik pada kedua kelompok, namun perbaikan simtom depresi lebih banyak terjadi pada kelompok PLB. Dapat dipertimbangkan latihan pursed-lips breathing sebagai terapi tambahan pada pasien PPOK stabil yang sudah mendapat terapi medikamentosa standar.

Background: COPD can be caused a condition called chronic hypoxia that can lead to one of psychological problem, depression. Pursed-lips breathing (PLB) is one of pulmonary rehabilitation that can help the oxygenation flow in the body. Nowadayas, there are several studies about the effect of pulmonary rehabilitation on the quality of life or the improvement of the symptoms of depression, but there are no studies about the effect of PLB on the symptoms of depression. Objective : The aim of this study was to analyze the effect of pulmonary rehabilitation with pursed-lips breathing technique on the improvement of the symptoms of depression in patients with stable COPD. Method : Method used in this research was randomized controlled trial design. We conducted open label in COPD outpatient with early symptom of depression by scorring them with Beck Depression Inventory (BDI) questionnaire and then we randomized the result. The subjects was divided into two groups, the study group who went through PLB training and the control group. Standard therapy were maintained. After four weeks, the BDI score was being evaluate. Results : Out of total 55 subjects, 29 subjects were in the PLB group and 26 subjects were in the control group. The average age of subjects in the PLB group was 64,31 +- 6,61 years old and in the placebo group was 65,65 +- 8,53 years old. There was a bigger decrease of BDI score in the PLB group 4,72+-6,39 (p=0.001) compare to the control group 2,19+-5,97 (p=0.53). But, there was no difference of the mean of delta between these two groups (p = 0,136). Conclusion : Despite no significant difference in the symptoms of depression between two groups statistically, the improvement of the symptoms of depression were much more to be found in the PLB group. As a result, pursed-lips breathing exercise may be considered as an adjunctive therapy for stable COPD patient that already receiving standard medical treatment

Kata Kunci : PPOK stabil, pursed-lips breathing, depresi, Beck Depression Inventory, hipoksia, stable COPD, pursed-lips breathing, depression, Beck Depression Inventory, hypoxia