Properti Psikometri Health Utility Index 3 sebagai Instrumen Pengukur Utilitas pada Pasien Hemodialisis

ANNISA DWI NUGRAHENI, Prof. Dr. apt. Tri Murti Andayani, Sp.FRS.

2022 | Skripsi | S1 FARMASI

Penyakit ginjal kronis dengan hemodialisis memiliki beban ekonomi yang besar, sehingga mendorong untuk dilakukan kajian cost utility analysis (CUA). Parameter luaran CUA adalah utilitas. Instrumen untuk mengukur nilai utilitas harus memenuhi syarat properti psikometri, yaitu valid dan reliabel. Penelitian ini bertujuan untuk mengetahui properti psikometri kuesioner HUI3 pada pasien hemodialisis di RSA UGM Yogyakarta dan RSUP dr. Sardjito. Penelitian ini menggunakan data sekunder yang diperoleh dari Andayani et al. pada tahun 2019. Data yang digunakan berupa data karakteristik responden, kuesioner HUI3, dan kuesioner EQ-5D-5L. Berdasarkan hasil pengisian kuesioner HUI3 dan EQ-5D-5L dilakukan analisis properti psikometri berupa known-group validity, convergent validity, internal-construct validity, internal-consistency reliability, dan ceiling effect. Known-group validity dianalisis menggunakan Mann Whitney dan Kruskal Wallis. Convergent validity dan internal-construct validity dianalisis menggunakan Spearman's rank correlation. Internal-consistency reliability dianalisis menggunakan Cronbach's Alpha coefficient, sedangkan ceiling effect dianalisis dengan melihat proporsi responden dengan status kesehatan sempurna. Penelitian terhadap 103 pasien hemodialisis di RSA UGM Yogyakarta dan RSUP dr. Sardjito menghasilkan rata-rata nilai utilitas sebesar 0,655 + 0,040 dengan nilai standar deviasi sebesar 0,328. Analisis known-group validity dapat menunjukkan perbedaan nilai utilitas berdasarkan karakteristik pasien. Convergent validity menunjukkan bahwa kedua kuesioner memiliki korelasi yang baik hingga sangat baik (r = 0,534-0,923). Internal-construct validity menunjukkan domain kemampuan berjalan dan kecekatan dalam kuesioner HUI3 memiliki korelasi yang baik (r = 0,683). Internal-consistency reliability menunjukkan nilai Cronbach's Alpha yang dapat diterima (0,665). Nilai ceiling effect yang didapat 8,7% (<15%). Kuesioner HUI3 memiliki properti psikometri yang baik dalam mengukur nilai utilitas pada pasien hemodialisis.

Chronic kidney disease with hemodialysis has large economic burden, which encourages cost-utility analysis (CUA). The output of CUA is utilities. Instruments to measure utility values must fulfill the requirements of psychometric properties, which are valid and reliable. This study aims to determine the psychometric properties of the HUI3 questionnaire in hemodialysis patients in RSA UGM Yogyakarta and RSUP dr. Sardjito. This study uses secondary data obtained from Andayani et al. in 2019. The data included patient characteristics, HUI3 questionnaires, and EQ-5D-5L questionnaires. Based on the results of filling out the HUI3 and EQ-5D-5L questionnaires, psychometric property analysis was analyzed using known-group validity, convergent validity, internal-construct validity, internal-consistency reliability, and ceiling effect. Known-group validity was analyzed using Mann Whitney and Kruskal Wallis. Convergent validity and internal-construct validity were analyzed using Spearman's rank correlation. Internal-consistency reliability was analyzed using Cronbach's Alpha coefficient, while the ceiling effect was analyzed by calculate the proportion of respondents with perfect health status. A study of 103 hemodialysis patients in RSA UGM Yogyakarta and RSUP dr. Sardjito showed the average utility value was 0.655 + 0,040 with standard deviation 0.040. Known-group validity can differentiate utility values based on the patient's characteristics. Convergent validity shows a moderate to strong correlation (r = 0.534-0.923). Internal-construct validity shows a good correlation between ambulation and dexterity in the HUI3 questionnaire (r = 0.683). Internal-consistency reliability indicates an acceptable value of Cronbach's Alpha (0.665). Ceiling effect scores in this study were 8.7% (<15%). The HUI3 questionnaire had good psychometric properties in measuring utility values in hemodialysis patients.

Kata Kunci : HUI3, properti psikometri, utilitas, hemodialisis