VALIDITAS KLINIK RECENT LIFE CHANGES QUESTIONNAIRE (RLCQ) SEBAGAI INSTRUMEN DETEKSI DINI GANGGUAN SOMATOFORM

MARIA RATIH MAHARANI, Rahmat Hidayat, M.Sc., Ph.D

2015 | Tesis | S2 Psikologi Profesi

Treatment Gap antara prevalensi gangguan mental dengan jumlah kasus yang tertangani di Layanan Kesehatan Primer salah satunya terjadi akibat kegagalan identifikasi keluhan fisik sebagai gejala gangguan mental pada saat pemeriksaan medis. Jika tidak dicermati, Gangguan Somatoform dapat muncul dalam gejala-gejala yang serupa dengan gejala penyakit fisik sedangkan instrumen deteksi dini terhadap gangguan somatoform belum pernah ada dan digunakan di seting layanan kesehatan. Penelitian ini bertujuan melakukan kajian untuk mengadaptasi dan memvalidasi Recent Life Changes Questionnaire (RLCQ) sebagai instrumen deteksi dini gangguan somatoform (somatisasi, nyeri, somatoform YTT) di Puskesmas. Analisis statistik dengan analisis diskriminan, Receiver Operating Characteristic (ROC), dan Likelihood Ratio (LR) diberlakukan untuk menguji daya prediksi hasil pengukuran RLCQ terhadap diagnosis gangguan somatoform yang ditegakkan melalui Structured Clinical Interview for DSM-IV Disorder Axis I (SCID-I) sebagai standard baku emas. Hasilnya, kategori �Pekerjaan� dalam RLCQ pada titik potong �65,5 memiliki sensitivitas 100% dan spesifisitas 74,6% mendeteksi gangguan nyeri, dengan LR+ 3,94 dan LR- 0.00. Nilai AUC sebesar 84,3%. Artinya, RLCQ kategori �Pekerjan� valid digunakan sebagai instrumen deteksi dini gangguan nyeri.

Gap between the prevalence of mental disorders by the number of cases handled in the Primary Health Services (PHS) or treatment gap, can be explained from the failure of identification of physical complaints as symptoms of a mental disorder at the time of the medical examination. If not observed, Somatoform disorders could arise in which the symptoms were similar to symptoms of physical illness while the instrument early detection of somatoform disorders has never been used in health care settings. This study aimed to conduct a study to adapt and validate the Recent Life Changes Questionnaire (RLCQ) as an instrument for the early detection of somatoform disorders in PHS. Statistical analysis of Discriminant Analysis, Receiver Operating Characteristic testing (ROC), and Likelihood Ratio (LR) were applied to test the predictive power of the measurement results RLCQ diagnosis of somatoform disorders. The diagnosis was enforced through the Structured Clinical Interview for DSM-IV Axis I Disorder (SCID-I) as the gold standards. The result show that optimum cut off higher than 65,5 on Workplace Problem RLCQ had a sensitivity of 100% and a specificity of 74,6% to detect Pain Disorders. LR+ 3,94 and LR- 0,00. AUC value was 84,3%. It is indicated that category Workplace problem can be use as early detection instrumen to predict Pain Disorder. Keywords: Treatment Gap, Somatoform Disorder, Stressful Life Event, Recent Life Changes Questionnaire (RLCQ), Workplace problem

Kata Kunci : Treatment Gap, Gangguan somatoform, Stressful Life Event, Recent Life Changes Questionnaire (RLCQ), Masalah pekerjaan.