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BOBOT PENGARUH PEMBERIAN EXPRESSIVE WRITING THERAPY TERHADAP PENURUNAN SKOR BODY IMAGE DISTRESS PADA PASIEN KANKER PAYUDARA PASCA MASTEKTOMI DI RSUD RAA SOEWONDO PATI

Nabila Syifa Marta Widanti, dr. Silas Henry Ismanto, Sp.KJ(K); dr. Andrian Fajar Kusumadewi, M.Sc, Sp.KJ

2023 | Tesis-Spesialis | SP PSIKIATRI

Latar belakang: Kanker payudara adalah kanker yang paling sering didiagnosis di seluruh dunia, termasuk di Indonesia. Operasi mastektomi atau pengangkatan payudara merupakan tatalaksana kanker payudara yang dapat menyebabkan Body Image Distress (BID). Pasien kanker payudara pasca mastektomi yang mengalami BID berisiko mengalami depresi yang dapat menjadi pemicu terjadinya bunuh diri. Expressive Writing Therapy merupakan intervensi yang telah terbukti menurunkan skor BID pada pasien kanker payudara.

Tujuan penelitian: Menganalisis bobot pengaruh pemberian Expressive Writing Therapy terhadap penurunan skor Body Image Distress pada pasien kanker payudara pasca mastektomi di RSUD RAA Soewondo Pati.

Metode: Merupakan penelitian eksperimental dengan rancangan two group pretest posttest with control group.  Subjek penelitian adalah pasien kanker payudara pasca mastektomi di poli bedah onkologi RSUD RAA Soewondo Pati. Skor BID diukur dengan menggunakan instrumen Body Image Scale (BIS). Analisis data menggunakan Uji Mann Whitney dan Uji Regresi Linier. Semua data dianalisis menggunakan SPSS versi 25.

Hasil: Responden penelitian sebanyak 46 subjek (23 subjek kelompok intervensi dan 23 subjek kelompok kontrol). Dari uji Mann Whitney, didapatkan perbedaan yang bermakna pada selisih penurunan skor BID antara kelompok intervensi dan kelompok kontrol (p=0,00). Pada analisis multivariat didapatkan hasil berupa intervensi Expressive Writing Therapy memiliki bobot pengaruh yang paling signifikan secara statistik terhadap penurunan skor BID (p=0,00). 

Kesimpulan: Pemberian Expressive Writing Therapy mempunyai bobot pengaruh yang bermakna sebesar 41,6% terhadap penurunan skor BID pada pasien kanker payudara pasca mastektomi di RSUD RAA Soewondo Pati.

Kata kunci: Body Image Distress, Expressive Writing Therapy, Kanker Payudara, Mastektomi

Background: Female breast cancer has become the most commonly diagnosed cancer type in the world. Mastectomy as a surgical treatment for breast cancer may negatively affect a woman’s body image. Post mastectomy breast cancer patients which leads to Body Image Distress (BID) and depression were identified as risk factors of suicide mortality. Expressive Writing Therapy is a psychological intervention that aims to reduce BID scores in breast cancer patients. This study aimed to analyze the effect of Expressive Writing Therapy on reducing BID scores in post mastectomy breast cancer patients at RAA Soewondo Hospital Pati.

Methods: An experimental study with a two group pretest posttest design with a control group was undertaken at the oncology surgery clinic at RAA Soewondo Hospital Pati from February to March 2023. There were 46 study subjects who met the inclusion criteria (23 patients on Structured Expressive Writing Therapy as the intervention group and 23 patients on Unstructured Expressive Writing Therapy as the control group). The BID score was assessed with the Body Image Scale (BIS) questionnaire. Bivariate analysis to determine the effectiveness of the two treatments was analyzed using Mann Whitney Test and Linear Regression Test. Data analyzed with SPPS version 25.

Results: In this study, there was a significant difference in BID score reduction among the intervention group and the control group (p=0,00). In addition, the Structured Expressive Writing Therapy intervention had the most statistically significant effect on the BID score reduction (p=0,00).

Conclusion: Expressive Writing Therapy has a significant effect of 41,6% on reducing the BID score in post mastectomy breast cancer patients at RAA Soewondo Hospital Pati.

Keywords: Breast Cancer, Body Image Distress, Expressive Writing Therapy, Mastectomy

Kata Kunci : Breast Cancer, Body Image Distress, Expressive Writing Therapy, Mastectomy

  1. SPESIALIS-2023-450547-abstract.pdf  
  2. SPESIALIS-2023-450547-bibliography.pdf  
  3. SPESIALIS-2023-450547-tableofcontent.pdf  
  4. SPESIALIS-2023-450547-title.pdf