Perbedaan Status Nutrisi Antara Penderita Gagal Jantung Kronik Dengan Simtom Depresi Dan Tanpa Simtom Depresi

MIRA ASTUTI, dr. Agus Siswanto, SpPD-KPsi; dr. Hariadi Hariawan, SpPD, SpJP (K)

2015 | Tesis-Spesialis | SP Ilmu Penyakit Dalam

Latar Belakang. Pasien penyakit jantung kronik sangat sering mengalami depresi dan hal ini berkaitan dengan kualitas hidup yang buruk serta perawatan rumah sakit berulang. Prevalensi malnutrisi pada pasien gagal jantung kronik dari beberapa penelitian didapatkan sangat tinggi. Kondisi gagal jantung disertai dengan komorbid depresi diduga akan semakin menurunkan status nutrisi sesorang. Tujuan Penelitian. Untuk mengetahui apakah terdapat perbedaan status nutrisi pada penderita gagal jantung kronis dengan simtom depresi dan tanpa simtom depresi. Metode Penelitian. Penelitian ini adalah studi potong-lintang. Populasi terjangkau adalah pasien gagal jantung kronik yang berobat di poliklinik Jantung RSUP Dr. Sardjito Yogyakarta yang memenuhi kriteria inklusi dan eksklusi. Penilaian simtom depresi dengan kuesioner Patient Health Questionnaire 9 (PHQ-9) dan penilaian status nutrisi dengan kuesioner Mini Nutritional Assassment (MNA). Perbedaan rerata status nutrisi (MNA) antara kelompok depresi dan tanpa depresi diperoleh dengan uji t tidak berpasangan jika sebaran data terdistribusi normal dan menggunakan uji Mann-Whitney apabila tidak terdistribusi normal. Interval kepercayaan 95% dan nilai p <0.05 adalah bermakna secara statistik. Hasil Penelitian. Rerata skor MNA antara kelompok simtom depresi (21,09+-3,71) dan tanpa depresi (22,89+-2,94) dengan perbedaan rerata (1,8; IK95%:0,01-3,60). Skor MNA mempunyai distribusi normal (uji KolmogorovSmirnov, p=0,200), didapatkan hasil terdapat perbedaan bermakna rerata skor MNA antara kedua kelompok p=0,049 (p<0,05)

Background. Patients with chronic heart disease are very often depressed and this is related to poor quality of life and recurrent hospitalization. The prevalence of malnutrition in patients with chronic heart failure of some of the research is very high. Heart failure condition is accompanied by comorbid depression will further lower nutritional status. Objective. To determine whether there are differences of nutritional status between chronic heart failure patients with symptoms of depression and without symptoms of depression. Methods. The research design is a cross-sectional study. Subjects were outpatients at cardiology clinic at Dr. Sardjito Hospital, that fulfilled inclusion and exclusion criteria. Symptoms of depression were assessed by Patient Health Questionnaire 9 (PHQ-9) and the nutritional status were assessed by Mini Nutritional Assessments (MNA). The mean differences of nutritional status (MNA) between symptoms depression group and without depression group obtained by unpaired t test if data distribution were normally distributed and using the Mann-Whitney test were not normally distributed. The level of significance was set at p<0.05 with confidence interval 95%. Result. The mean MNA scores between groups of depressive symptoms (21.09 +- 3.71) and without depression (22.89 +- 2.94) with a mean difference (1.8; IK95%: 0.01 to 3.60). The MNA scores have a normal distribution (Kolmogorov-Smirnov test, p = 0.200). The result showed there were significant mean differences in MNA scores between the two groups p = 0.049 (p <0.05) Conclusions. Chronic heart failure patients with symptoms of depression had a lower nutritional status than chronic heart failure patients without symptoms of depression were statistically significant

Kata Kunci : gagal jantung kronis, status nutrisi, depresi, chronic heart failure, nutritional status, depression