PERAN PSIKOLOG DALAM IMPLEMENTASI PROGRAM PROMOTIF KESEHATAN JIWA DI PUSKESMAS KABUPATEN SLEMAN

RINA TRI AGUSTINI, Diana Setiyawati, S.Psi., MHSc., Ph.D.; Dr. Retna Siwi Padmawati, MA.

2019 | Tesis | MAGISTER ILMU KESEHATAN MASYARAKAT

Latar Belakang: Prevalensi gangguan jiwa di Daerah Istimewa Yogyakarta tinggi. Gangguan jiwa berat tertinggi pada 2013 dan kedua tertinggi pada 2018. WHO dan Wonca menginisiasi integrasi kesehatan jiwa pada layanan kesehatan primer untuk menurunkan angka kasus kesehatan jiwa, mengurangi treatment gap, serta meningkatkan akses terhadap layanan kesehatan jiwa. Peran psikolog dalam implementasi program promotif kesehatan jiwa di puskesmas Kabupaten Sleman, perlu dievaluasi. Tujuan: Menganalisis peran psikolog dalam implementasi program promotif kesehatan jiwa di puskesmas Kabupaten Sleman. Metode: Riset implementasi dengan metode kualitatif dan desain studi kasus yang dilakukan di puskesmas Kabupaten Sleman pada bulan Februari - April 2019. Pemilihan subjek puskesmas menggunakan extreme case, sedangkan pemilihan informan dengan purposive sampling. Informan berasal dari pembuat kebijakan, pelaksana program, dan penerima program. Tema penelitian terdiri dari peran psikolog, coherence, cognitive participation, collective participation, reflexive monitoring, faktor pendukung dan penghambat peran psikolog dalam implementasi program promotif kesehatan jiwa di puskesmas. Data dikumpulkan melalui wawancara mendalam, focuss group discussion, dan studi dokumen. Keabsahan data memperhatikan kredibilitas, reliabilitas, konformitas, generalitas, dan otentitas data. Analisis data menggunakan thematic analysis. Hasil: Coherence meliputi pemahaman tentang peran psikolog yaitu edukasi, kunjungan masyarakat, koordinasi, dan layanan kesehatan jiwa, serta adanya perbedaan dan urgensi yang dirasakan dengan keberadaan psikolog; cognitive participation meliputi keterlibatan internal dan eksternal puskesmas dalam program; collective action meliputi kerja sama lintas profesi dan lintas sektor berdasarkan aturan dan perencanaan terkait; reflexive monitoring meliputi penilaian terhadap internal maupun eksternal psikolog, serta saran dan kebermanfaatan terkait dengan peran psikolog dalam program; faktor pendukung dan penghambat peran psikolog baik dari internal maupun eksternal puskesmas. Kesimpulan: Psikolog telah berperan dalam implementasi program promotif kesehatan jiwa bekerja sama dengan pihak internal dan eksternal puskesmas yang terlibat, disertai dengan faktor yang mendukung maupun menghambat. Dirasa perlu untuk menambah kuantitas dan meningkatkan kualitas psikolog puskesmas.

Background: The prevalence of mental disorders in Daerah Istimewa Yogyakarta was the highest in 2013 and the second highest in 2018. WHO and Wonca was inisiated the integration of mental health in primary health care to decrease mental health problem rate, to decrease the treatment gap, and to increase mental health access. The role of psychologists in the implementation of mental health promotive programs in PHC of Sleman District need to evaluate. Objective: Analyzing the role of psychologists in the implementation of mental health promotive programs in PHC of Sleman District. Methods: Implementation research with qualitative methods and case study design conducted in PHC of Sleman District during February - April 2019. The selection of PHC subjects used the extreme case, while the selection of informants with purposive sampling. Informants come from policy makers, program implementers, and program recipients. Theme of the study consist of the psychologists role, coherence, cognitive participation, collective action, reflexive monitoring, supporting and obstacles factors relate to the psychologists role in the implementation of mental health promotive programs in PHC. Data was collected through in-depth interviews, focuss group discussion, and document studies. The validity of the data considers to the credibility, reliability, conformity, generality and authenticity of the data. Data analysis using thematic analysis. Results: Coherence included an understanding of the role of psychologists like education, community visits, coordination, and services in mental health, and differences and urgencies of the presence of psychologists; cognitive participation includes involvement of internal and external of PHC in the program; collective action includes cross-profession and cross-sector cooperation based on related rules and plans; reflexive monitoring includes assessment of internal as well as external of psychologists, and also advices and usefulness related to role of psychologists in the program; supporting and inhibiting factors of role of psychologists are from internal and external PHC. Conclusion: Psychologists have been role in the implementation of mental health promotve program in collaboration with internal and external of participants involved, accompanied by both of support and inhibit factors. It is necessary to add quantity and to improve the quality of psychologists in PHC.

Kata Kunci : implementasi, kesehatan jiwa, Normalization Process Theory, peran psikolog, program, promotif, puskesmas, implementation, mental health, normalization process theory, psychologists role, programme, promotive, public health center