Validasi Klinik Recent Life Changes Questionnaire sebagai Instrumen Deteksi Dini Gangguan Penyesuaian

CITRA SARASWATI, Rahmat Hidayat, M.Sc., Ph.D

2015 | Tesis | S2 Psikologi Profesi

Berbagai literatur menyebutkan kaitan antara stres dengan gangguan fisik dan mental emosional. Perubahan hidup telah dikenal sebagai salah satu stresor yang berkontribusi terhadap kemunculan gangguan mental emosional, salah satunya adalah Gangguan Penyesuaian (GP). Penelitian ini dilakukan untuk memeriksa daya prediksi instrumen skrining Recent Life Changes Questionnaire (RLCQ) terhadap GP pada pasien Puskesmas, dengan Structured Clinical Interview for DSM-IV Disorder-Axis I (SCID-I) sebagai standar baku emas. Sejumlah 144 pasien Puskesmas di Kota Yogyakarta dan Kabupaten Sleman dilibatkan dalam penelitian ini. Hasil: prevalensi GP yang didapatkan sebesar 3,52%. Daya diskriminasi RLCQ terhadap GP secara statistik tidak signifikan. Subskala kesehatan menjadi satu-satunya subskala RLCQ yang terbukti mampu membedakan subjek terdiagnosis dan tidak terdiagnosis GP berdasarkan analisis diskriminan. Subskala kesehatan juga memiliki nilai AUC sebesar 76,1% (p<0,05), sensitivitas 80%, spesifisitas 56,9%, NDP 6,12%, NDN 98,8%, LR+ 1,86, dan LR- 0,35. Dapat disimpulkan bahwa RLCQ tidak mampu melakukan deteksi dini terhadap GP, namun eksplorasi terhadap subskala RLCQ mendapati bahwa kesehatan memiliki daya diskriminasi terhadap GP.

Various literature mentioned the link between stress and physical and mental emotional disorders. Life changes has been recognized as one of the stressors that contribute to the emergence of emotional mental disorders. This study examined predictive power of Recent Life Changes Questionnaire (RLCQ) as early detection instrument of Adjustment Disorders (AD) in primary health center (Puskesmas) patient, with the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) as the gold standard. A number of 144 patients at the Puskesmas of Yogyakarta City and Sleman District involved in this study. Result: the prevalence of AD was 3.52%. RLCQ did not meet the discriminative and predictive power to AD. Health was the only subscala of RLCQ that proved able to differentiate subjects were diagnosed and undiagnosed AD based on discriminant analysis. Health subscale also showed AUC values 76.1% (p<0,05), sensitivity 80%, specificity 56.9%, PPV 6.12%, NPV 98.8%, LR + 1.86, and LR- 0, 35. It can be concluded that RLCQ was not able to perform early detection of AD, but exploration of the subscales of RLCQ found that health has a discriminative power to AD.

Kata Kunci : life change, stress, adjustment disorder, Recent Life Changes Questionnaire, predictive power