VALIDITAS KLINIK GENERAL HEALTH QUESTIONNAIRE-12 SEBAGAI INSTRUMEN SKRINING GANGGUAN PENYESUAIAN

INDIRA PRIMASARI, Rahmat Hidayat, S.Psi, M.Sc, Ph.D

2013 | Tesis | S2 Magister Profesi Psikologi

Gangguan Penyesuaian (GP) banyak dijumpai pada pasien yang datang di layanan kesehatan primer, terutama Pusat Kesehatan Masyarakat (Puskesmas). Penelitian ini bertujuan untuk melakukan adaptasi dan menguji validitas klinik GHQ-12, melalui Structured Clinical Interview for DSM IV Disorder-Axis I (SCID-I), sebagai standar baku emas, sehingga dapat digunakan sebagai instrumen skrining GP pada pasien Puskesmas. Penelitian ini melibatkan 243 sampel pasien di 25 Puskesmas di Kabupaten Sleman, Yogyakarta Properti psikometri GHQ-12 dianalisis menggunakan Alpha Cronbach, Principal Component Analysis, dan Korelasi Pearson. Validitas klinik GHQ-12 dianalisis dengan Receiver Operating Curve (ROC) dan Likelihood Ratio (LR). Hasil analisis menunjukkan prevalensi GP di Puskesmas sejumlah 17.3%. Analisis reliabilitas menunjukkan hasil yang memuaskan (rxx’= 0.863, 0.841, 0.832). Hasil analisis faktor dengan menggunakan metode Principal Component Analysis (PCA) menemukan 3 faktor pembentuk konstrak, yaitu distres psikologis, kesuksesan koping, dan full of enjoyment. Hasil analisis korelasional Pearson menunjukkan bahwa skor GHQ-12 berkorelasi dan signifikan dengan SCID-I (r=0.397, r=370, r=0.402, p<0.001). Analisis ROC dan LR menghasilkan nilai sensitivitas sebesar 0,81, spesivitas 0.62, LR+ 2.12, dan LR- 0.31, dengan titik potong optimum ≥11 (Likert), sensitivitas 0.81, spesivitas 0.57, LR+ 1.90, dan LR- 0.34, dengan titik potong optimum ≥2 (Bimodal), serta spesivitas 0.81, spesivitas 0,55, LR+ 1.80, dan LR- 0.35 dengan titik potong ≥4 (CGHQ). Dapat disimpulkan bahwa GHQ-12 valid, reliabel dan akurat sebagai instrumen skrining GP.

Adjustment Disorder (AD) is a common mental health problem in primary health center. This study aimed to adapt and examine the clinical validity of GHQ-12 as Adjustment Disorder screening instrument in Puskesmas. Structured Clinical Interview Diagnosis (SCID) based on Diagnostic and Statistical Manual of Mental Disorder (DSM) IV was used as a gold standard to which questionnaire was compared. The subjects were 250 adult outpatients from twenty five community health center (Puskesmas) in Sleman, Yogyakarta. Alpha Cronbach, Principal Component Analysis, dan Pearson Corelation were conducted to assess the psychometric properties. Receiver Operating Curve (ROC) dan Likelihood Ratio (LR) were conducted to assess the clinical validity. The prevalence of AD was 17.3%. A cronbach’s Alpha of .863 (likert’s scoring method), .841 (bimodal’s scoring method), .832 (CGHQ’s scoring method), a Pearson’s correlations of .397 (bimodal’s), .370 (likert’s), .402 (CGHQ’s), p<0.001). and a 3-factor structure, which are psychological distres, successful coping, and full of enjoyment were obtained, Sensitivity and specivity for GHQ-12 were .81 and .62 (for the optimum cut-off point ≥11 in Likert’s scoring method), .81 and .57 (for the optimum cut-off point ≥2 in bimodal’s scoring method), .81 and .55 (for the optimum cut-off point ≥4 in CGHQ’s scoring method). Positive Likelihood Ratio and negative Likelihood Ratio for GHQ-12 were 2.12 and 0.31 (Likert’s scoring method), 1.90 and 0.34 (Bimodal’s scoring method), and 1.80 and 0.35 (CGHQ’s scoring method). The GHQ-12 is valid, reliable, and accurate in Puskesmas population, and can be employed as a screening instrumen in this population.

Kata Kunci : GHQ-12, SCID, Gangguan Penyesuaian, Puskesmas, Validitas klinik