PENGARUH LATIHAN PASRAH DIRI TERHADAP PERBAIKAN GEJALA DEPRESI PADA PENDERITA PENYAKIT PARU OBSTRUKSI KRONIK

VISENSIUS KURNIEL NAZARA, dr. Agus Siswanto, SpPD-KPsi,

2012 | Tesis | S2 Ilmu Penyakit Dalam

Latar belakang. Penyakit paru obstruksi kronik (PPOK) dikategorikan dalam penyakit kronik yang bisa memberi dampak psikologis, baik depresi maupun ansietas. Keadaan ini akan mengakibatkan toleransi olahraga yang lebih rendah, ketidakpatuhan terhadap pengobatan dan peningkatan disabilitas. Latihan pasrah diri (LPD) adalah suatu metode yang memadukan antara relaksasi dan dzikir (relaxation and repetitive prayer), timbulnya respons relaksasi diharapkan mampu memperbaiki gejala depresi. Intervensi yang mengurangi gejala depresi berpotensi mempengaruhi hasil PPOK Tujuan. Untuk mengetahui berapa besar pengaruh penurunan skor Beck Depression Inventory (BDI) setelah mendapatkan latihan pasrah diri pada penderita PPOK dibandingkan kontrol. . Metode. Penelitian dilakukan dengan metode kuasi eksperimental pada penderita PPOK yang menjalani terapi rutin di Poliklinik Paru RSUP DR. Sardjito Yogyakarta dan BP4 Yogyakarta. Subyek penelitian diminta untuk mengisi kuesioner Beck Depression Inventory (BDI) dan dilatih untuk latihan pasrah diri oleh seorang ahli Psikosomatik. Subyek yang bersedia dan mampu melakukan LPD dengan baik dimasukkan dalam kelompok perlakuan. Dan subyek yang tidak bersedia dan tidak mampu melakukan LPD dimasukkan dalam kelompok kontrol. Latihan pasrah diri dilakukan 2 kali sehari selama 21 hari berturut-turut. Data kategorikal disajikan dalam bentuk persentase dan data numerik disajikan dalam bentuk standar deviasi. Variabel dengan distribusi normal diuji dengan uji t. Perbedaan dianggap bermakna bila p < 0,05 dengan interval kepercayaan 95%. Hasil. Terdapat 26 subyek penelitian yang memenuhi kriteria dengan masing-masing kelompok perlakuan dan kelompok kontrol terdapat 13 subyek penelitian. Analisis awal terhadap data dasar subyek penelitian tidak ada perbedaan antara kelompok perlakuan dan kelompok kontrol. Secara keseluruhan kepatuhan subyek penelitian untuk melakukan LPD cukup tinggi lebih dari 80%. Selama periode penelitian, pada kelompok perlakuan terjadi adverse effects pada 2 subyek penelitian (15,4% dari 13 subyek). Rerata skor BDI pada kelompok perlakuan dari 17,0±12,02 menjadi 13,69±10,86, terjadi remisi gejala depresi (remisi, skor BDI ≤ 3,3) dibandingkan kelompok kontrol dan secara statistik bermakna (p value = 0,012, 95%CI : -0,69-(- 4,53)). Simpulan. Terdapat perbaikan gejala depresi yang ditunjukkan dengan penurunan skor Beck Depression Inventory (BDI) setelah mendapatkan latihan pasrah diri pada penderita PPOK dibandingkan kontrol.

Background. Chronic obstructive pulmonary disease (COPD) is categorized as a chronic disease which can give a psychological impact, both depression and anxiety. This condition will result in a lower exercise tolerance, non-adherence to treatment and increased disability. Latihan pasrah diri (LPD) is a method that combines relaxation and dzikir (relaxation and repetitive prayer), where the onset of the relaxation response is expected to improve the depressive symptoms. Interventions that reduce depressive symptoms could potentially affect the outcome of COPD. Purpose. To investigate the decrement in Beck Depression Inventory score (BDI) following a self-surrender exercise in patients with COPD compared to controls. Method. The research was carried out by a quasi-experimental methods in patients with COPD who underwent a routine therapy in Pulmonary Clinic of Dr. Sardjito Central Hospital Yogyakarta and BP4 Yogyakarta. The study subjects were asked to fill out questionnaires Beck Depression Inventory (BDI) and trained to exercise selfsurrender by a phsycosomatic expert. Subjects who are willing and able to perform LPD well were included in the treatment group. And subjects who are unwilling and unable to perform the LPD were included in the control group. Latihan Pasrah Diri (LPD) exercises were performed 2 times a day for 21 consecutive days. Categorical data are presented as percentages and numerical data presented in the form of standard deviation. Variables with normal distribution were tested by t test. Differences are considered significant when p <0.05 with 95% confidence interval. Results. There were 26 study subjects who met the criteria with each treatment group and there were 13 study subjects in the control group. Preliminary analysis of the data base research subjects showed no differences between treatment groups and control groups. Overall, the study subject’s rate of compliance to perform LPD is sufficiently high, i.e. more than 80%. During the study period, adverse effects among the treatment group occurred in 2 subjects (15.4% of 13 subjects). The mean BDI scores in the treated group ranged from 17.0 ± 12.02 to 13.69 ± 10.86, remission of depressive symptoms occurred (remission, BDI score ≤ 3.3) compared to the control group and was statistically significant (p value = 0.012, 95% CI: -0,69-(-4,53)). Conclusion. There were improvement in symptoms of depression as indicated by the decrease in the score of Beck Depression Inventory (BDI) following a self-surrender exercise in patients with COPD compared to controls.

Kata Kunci : Latihan Pasrah Diri, PPOK, gejala depresi