Analisis Dukungan Sosial Pada Orang Dengan Gangguan Jiwa Berat Rujuk Balik di Puskesmas Gembong Kabupaten Pati

Kristina, Dr. Supriyati, S.Sos., M.Kes / Diana Setiyawati, S.Psi, MHSc., Ph.D

2024 | Tesis | S2 Ilmu Kesehatan Masyarakat

Latar Belakang: Berdasarkan data Disability Adjusted Life Years (DALY), bahwa 60% jumlah penyakit di dunia adalah penyakit tidak menular. Selama 29 tahun terakhir, gangguan jiwa merupakan urutan kedua penyakit dengan beban penyakit terbanyak di dunia. Penanganan ODGJ selain membutuhkan penanganan medis juga membutuhkan dukungan sosial yang dapat mendukung proses pemulihan dan mengurangi kekambuhan pada ODGJ berat rujuk balik.
Tujuan Penelitian: Untuk menganalisis dukungan sosial yang diterima ODGJ berat rujuk balik di Puskesmas Gembong Kabupaten Pati.
Metode: Penelitian ini merupakan penelitian kualitatif fenomenologi yang dilakukan di wilayah Puskesmas Gembong Pati. Informan utama dalam penelitian ini adalah 10 ODGJ yang sudah pulih dan dapat beraktivitas dengan baik. Perekrutan informan dilakukan critical case sampling sesuai kriteria inklusi yang telah ditetapkan. Dikuatkan dengan surat persetujuan dari Puskesmas, informed concent dari ODGJ dan persetujuan dari pihak keluarga. Cara pengumpulan data melalui wawancara mendalam dan observasi. Instrumen penelitian menggunakan tools wawancara mendalam dan observasi.  Analisis data dengan melakukan transkrip wawancara, pengkodingan data, kategorisasi data, tema. Keabsahan data menggunakan triangulasi sumber, triangulasi media, member checking dan peer debriefing.
Hasil: Bentuk dukungan sosial pada ODGJ berat rujuk balik berupa dukungan emosional, dukungan instrumental, dukungan informasi, dukungan apresiasi dan komunikasi para pihak. Dukungan emosional antara lain menyiapkan keluarga dan masyarakat saat ODGJ kembali ke rumah, membangun komunikasi yang baik, memberikan perhatian, berbagi peran dan memantau perkembangan ODGJ. Dukungan instrumental berupa materi dengan pemberian uang untuk kebutuhan ODGJ, modal usaha, asuransi kesehatan, pemeriksaan kesehatan dan obat, pengobatan alternatif dan jaringan kerja. Dukungan informasi yaitu dengan pemberian informasi dan saran tentang patuh minum obat, patuh kontrol, beraktivitas, berinteraksi, dan berperilaku hidup sehat. Dukungan apresiasi dengan memberikan penghargaan kepada ODGJ. Koordinasi para pihak dilakukan oleh kepala dusun dengan Puskesmas dan Kecamatan, namun belum menjadi suatu sistem. Dukungan kepada ODGJ paling banyak diberikan oleh keluarga. Dukungan sosial ini ditanggapi baik oleh ODGJ.
Kesimpulan: Dukungan sosial memberikan dampak baik kepada ODGJ berat rujuk balik antara lain: ODGJ mampu berinteraksi, melakukan aktivitas harian, aktivitas usaha yang menghasilkan, mau membantu, berkontribusi, bekerja sama dan berbagi peran dengan orang lain, membangun jaringan kerja, mengelola keuangan dengan baik, patuh berobat dan patuh minum obat.

Background: Based on Disability Adjusted Life Years (DALY) data, 60% of diseases in the world are non-communicable diseases. Over the past 29 years, mental disorders have been the second disease with the highest burden of disease in the world. Handling mental illness, apart from requiring medical treatment, also requires social support that can support the recovery process and reduce relapses in severe mental illness.

Objective: To analyze of the social support received by people with mental illness who are hard to reconcile at the Gembong Community Health Center, Pati.

Method: This research is a qualitative phenomenological research conducted in the Gembong Pati Community Health Center area. The main informants in this research were 10 mental illness who had recovered and were able to carry out their activities well. Recruitment of informants was carried out by sampling critical cases according to predetermined inclusion criteria. Strengthened by a letter of approval from the Community Health Center, informed consent from mental illness and approval from the family. Data collection method is through in-depth interviews and observation. The research instrument uses in-depth interviews and observation.  Data analysis by transcribing interviews, coding data, categorizing data, themes. Data validity uses source triangulation, media triangulation, member checking and peer debriefing.

Results: The form of social support for mental illness is heavy on back-and-forth in the form of emotional support, instrumental support, information support, appreciation support and communication between the parties. Emotional support includes preparing the family and community when mental illness return home, building good communication, providing attention, sharing roles and monitoring the progress of mental illness. Instrumental support takes the form of material by providing money for people with mental illness needs, business capital, health insurance, health checks and medicines, alternative medicine and work networks. Information support is by providing information and advice about medication compliance, control compliance, activities, interactions and healthy living behavior. Support awards by giving awards to mental illness. Coordination of the parties is carried out by the hamlet head with the Community Health Center and District, but it has not yet become a system. Most support for mental illness is provided by the family. ODGJ responded well to this social support.
 
Conclusion: Social support has a good impact on mental illness who are hard to reconcile, including: mental illness are able to interact, carry out daily activities, business activities that produce results, are willing to help, contribute, work together and share roles with others, build networking, manage finances well, comply with treatment and comply with taking medication.

Kata Kunci : Orang Dengan Gangguan Jiwa berat, rujuk balik, dukungan sosial, people with serious mental disorders, re-admitted, social support