PENGARUH TERAPI MENULIS EKSPRESIF TERHADAP DEPRESI PADA REMAJA DENGAN TALASEMIA BETA MAYOR DI RSUD TIDAR MAGELANG

NILAM PURWANINGRUM, Sri Hartini, S.Kep.,Ns.,M.Kes.,PhD.; Anik Rustiyaningsih, S.Kep.,Ns.,M. Kep., Ns.Sp.Kep.An

2018 | Tesis | MAGISTER KEPERAWATAN

Latar Belakang: Remaja dengan talasemia beta mayor merupakan kelompok yang rentan mengalami depresi. Terapi non farmakologi yang pernah diberikan pada penderita talasemia beta mayor terkait depresi adalah cognitive-behavioural family therapy (CBFT), paket pelatihan fisik dan telenursing, namun terapi ini membutuhkan terapis dan waktu yang lama. Salah satu terapi non farmakologi yang dapat dilakukan dengan waktu yang relatif singkat, tidak membutuhkan banyak biaya, dapat dilakukan oleh semua orang serta terbukti dapat membantu menangani depresi adalah terapi menulis ekspresif. Terapi ini belum pernah diberikan kepada remaja dengan talasemia beta mayor. Tujuan : mengetahui gambaran depresi dan mengetahui pengaruh terapi menulis ekspresif terhadap depresi pada remaja dengan talasemia beta mayor di RSUD Tidar Magelang Metode : Penelitian kuantitatif dengan desain penelitian pre experimental-one group pretest posttest design. Penelitian dilakukan di Ruang Dahlia 2, Bangsal An RSUD Tidar Magelang. Pengambilan data dilakukan pada bulan Mei-Juni 2018. Pemilihan responden menggunakan consecutive sampling pada 39 remaja yang terdiagnosa talasemia beta mayor berusia 10-18 tahun. Terapi menulis ekspresif diberikan sebanyak 3 sesi dengan durasi per sesinya adalah 20 menit dengan jeda persesi 10 menit dan dilakukan selama transfusi darah. Depresi diukur menggunakan Children Depression Inventory berbahasa Indonesia. Pengaruh terapi menulis ekspresif dianalisis menggunakan uji Wilcoxon Signed Rank. Hasil: Terdapat perbedaan yang signifikan pada skor depresi sebelum dan sesudah terapi menulis ekspresif dilakukan dengan nilai signifikansi p = 0,000 (p<0,05) dan besar efek terapi (ES= 0,83). Kesimpulan: Terapi menulis ekspresif berpengaruh terhadap depresi remaja dengan talasemia beta mayor di RSUD Tidar Magelang.

Background: Adolescents with beta thalassemia major are vulnerable to get depression. Non-pharmacological therapies that had been used to handle depression in beta thalassemia major were cognitive-behavioural family therapy (CBFT), exercise training program and telenursing but those therapies needed therapist and took a long duration. One of non-pharmacological therapies that can be done in a short duration, does not require much cost and can be done by everyone is expressive writing. This therapy has never been given to adolescents with beta thalassemia major. Objective: to describing the depression and to know the effect of expressive writing therapy on the depression in adolescents with beta thalassemia major in RSUD Tidar Magelang. Methods: quantitative research with pre experimental-one group pretest posttest design. The data was collected in May-June 2018 in Dahlia 2, RSUD Tidar Magelang. Consecutive sampling was used to select 39 adolescents aged 10-18 years old diagnosed with beta thalassemia major. Expressive writing therapy had been given in 3 sessions which took 20 minutes for each session with 10 minutes pause. The therapy was carried out during the blood transfusion. The depression was measured by using Indonesian version obeta thalassemia major, depression, expressive writing therapyf Children Depression Inventory questionnaire. The effect of expressive writing therapy was analyzed by using the Wilcoxon Signed Rank test. Results: there were differences on the score of depression before and after expressive writing therapy with the point of significance at p = 0,000 (p < 0,05) and the effect size at 0,83. Conclusion: Expressive writing therapy has an effect on the depression in adolescents with major beta thalassemia in RSUD Tidar Magelang

Kata Kunci : depresi, talasemia beta mayor, terapi menulis ekspresif, beta thalassemia major, depression, expressive writing therapy