KECENDERUNGAN GANGGUAN PERILAKU PADA ANAK DENGAN SINDROM NEFROTIK

DIARUM PUSPASARI, DR. Indria Laksmi Gamayanti, MSi, Psi

2015 | Tesis | S2 KEDOKTERAN KLINIK/MS-PPDS

memiliki kekambuhan tinggi sehingga rentan gangguan perilaku. Beberapa ditemukan saat terapi inisial dosis tinggi steroid sehingga jika tidak terdeteksi dini akan memberikan dampak serius. Tujuan: Menilai perbedaan prevalensi gangguan perilaku pada anak dengan SN dibandingkan anak dengan penyakit kronis lainnya, baik yang mendapatkan terapi steroid maupun tidak. Metode: Penelitian potong lintang yang melibatkan 33 anak penderita SN, 33 anak penyakit kronis dengan terapi steroid (KrS) dan 33 anak penyakit kronis tanpa terapi steroid (KrNS) usia 3 – 16 tahun di RSUP Dr Sardjito, Yogyakarta. Deteksi gangguan perilaku diukur menggunakan instrumen Strength and Difficulties Questionnair (SDQ). Hasil: Prevalensi gangguan perilaku dan peer problem lebih banyak pada SN (36,4% dan 27,3%) dibandingkan pada KrS (9,1% dan 9,1%) dan KrNS(3% dan 3%). Dosis kumulatif steroid tinggi (OR 11,64; IK 95% 2,33-58,06; p=0,003), frekuensi mondok lebih 2 kali (OR 10,08; IK 95% 1,7-59,65; p=0,01) dan usia muda (OR 22,87; IK 95% 1,9-274,71; p= 0,01) merupakan faktor risiko terjadi gangguan perilaku. Faktor risiko peer problems adalah menderita SN (OR 12; IK 95% 1,42-101,2; p=0,02) dan frekuensi mondok lebih dari 2 kali (OR 4,9; IK 95% 1,31-18,24; p=0,01). Kesimpulan: Prevalensi gangguan perilaku dan peer problem ditemukan lebih banyak pada SN dibanding penyakit kronis lain, tetapi gangguan tersebut lebih dipengaruhi oleh dosis kumulatif steroid tinggi, frekuensi mondok lebih dari 2 kali dan usia muda dibandingkan dengan penyakitnya.

Background: Nephrotic syndrome (NS) is a chronic disease that has high relaps rate and may cause behavioral problems. Some even found at initial therapy with high dose steroid, therefore early detection is important to prevent serious impact. Objective: To determine the prevalence of behavioral problems in children with NS compare to children with other chronic disease, both those received steroid therapy and not. Methods: A cross-sectional study involving 33 children with NS, 33 children with chronic disease with steroid therapy (CrDS), and 33 children with chronic disease without steroid therapy (CrDNS) aged 3-16 years in Dr Sardjito hospital Yogyakarta. The behavioral problems were measured using Strength and Difficulties Questionnaire (SDQ) instruments. Results: The prevalence of behavioral problems and peer problems in NS (36.4% and 27.3%) was found higher than those with CrS (9.1% and 9.1%) and CrNS (3% and 3%). High cumulative dose of steroid (OR 11.64; 95% CI 2.33 to 58.06; p = 0.003), frequency of hospitalization for more than 2 periods (OR 10.08; 95% CI 1.7 to 59.65; p = 0.01) and younger age (OR 22.87; 95% CI 1.9 to 274.71; p = 0.01) found as risk factors for behavioral problems. Risk factors of peer problems include suffering NS disease (OR 12; 95% CI 1.42 to 101.2; p = 0.02) and the frequency of hospitalization more than 2 times (OR 4.9; 95% CI 1.31 to 18, 24; p = 0.01) Conclusion: The prevalence of behavioral problems and peer problems are more common in children with NS compare to other chronic disease. However, such disorder is more influenced by the high cumulative dose of steroid, frequency of hospitalization more than 2 periods, and younger age, compare to the disease itself.

Kata Kunci : sindrom nefrotik, gangguan perilaku, SDQ