Abstract
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DAFTAR ISI HALAMAN JUDUL........................................................................................................ i HALAMAN PENGESAHAN......................................................................................... ii HALAMAN PERSEMBAHAN................................................................................... iii HALAMAN PERSEMBAHAN...................................................................................... iv KATA PENGANTAR..................................................................................................... v DAFTAR ISI................................................................................................................. vi DAFTAR TABEL........................................................................................................... vii DAFTAR GAMBAR....................................................................................................... viii DAFTAR BAGAN........................................................................................................ ix DAFTAR SINGKATAN……………………………………..…………………… x DAFTAR LAMPIRAN................................................................................................. xi INTISARI...................................................................................................................... xii ABSTRACT................................................................................................................. xiii BAB I. PENDAHULUAN A. Latar Belakang..................................................................................................... 1 B. Rumusan Masalah................................................................................................ 7 C. Tujuan Penelitian.............................................................................................. 8 D. Manfaat Penelitian............................................................................................ 8 E. Penelitian Terkait..................................................................................................... 9 BAB II. TINJAUAN PUSTAKA A. Landasan Teori.................................................................................................. 12 1. Penyakit Jantung Koroner............................................................................... 12 2. Kateterisasi Jantung ........................................................................................... 16 3. Percutaneous Transluminal Coronary Angioplast (PTCA)................................ 24 4. Kecemasan....................................................................................................... 27 5. Psikoedukasi..................................................................................................... 46 v 6. Guided Imagery.................................................................................................. 49 B. Kerangka Teori................................................................................................... 59 C. Kerangka Konsep ............................................................................................... 60 D. Hipotesis.............................................................................................................. 61 BAB III. METODE PENELITIAN A. Desain Penelitian.................................................................................................. 63 B. Populasi dan Sampel............................................................................................ 64 C. Lokasi dan Waktu Penelitian .............................................................................. 66 D. Definisi Operasional............................................................................................. 66 E. Instrumen Penelitian............................................................................................ 68 F. Pengumpulan Data............................................................................................... 69 G. Uji Validitas dan Realibilitas............................................................................... 73 H. Tehnik Analisa Data............................................................................................ 73 I. 74 Etika Penelitian..................................................................................................... BAB IV. HASIL PENELITIAN DAN PEMBAHASAN....................................................... 75 A. Hasil Penelitian................................................................................................. 75 B. 85 Pembahasan ................................................................................................... BAB. V SIMPULAN DAN SARAN...................................................................................... 95 A S impulan............................................................................................................ 95 B Saran................................................................................................................ 96 DAFTAR PUSTAKA............................................................................................................ 96 LAMPIRAN..................................................................................................................... 101 vi DAFTAR TABEL Tabel 3.2 Definisi Operasional................................................................................. Tabel 4.1 Perbandingan tingkat Kecemasan Pasien Prekateterisasi Jantung Sebelum dan Halaman 66 80 Sesudah Diberikan Guided Imagery Tabel 4.2 Perbandingan tingkat Kecemasan Pasien Prekateterisasi Jantung Sebelum dan 81 Sesudah Psikoedukasi Tabel 4.3 Perbandingan tingkat Kecemasan Pasien Prekateterisasi Jantung Sebelum dan 82 Sesudah Protap ruangan. Tabel 4.4 Perbandingan Tingkat Kecemasan Pasien Prekateterisasi Jantung dan Sesudah Diberikan Terapi Psikoedukasi, Guided Imagery dan Protap ruangan. vii 84 DAFTAR GAMBAR Gambar 2.1 Potongan Arteri Koroner........................................................................ Halaman 13 Gambar 2.2 Percutaneous transluminal coronary angioplasty...................................... 16 Gambar 2.3 Insertion of a coronary artery stent.......................................................... 17 Gambar 2.4 Akses masuk kateter jantung.................................................................. 18 Gambar 2.5 Rentang Respon Cemas.......................................................................... 37 Grafik 4.1 Distribusi Responden Berdasarkan Jenis Kelamin dan Kecemasan 76 Grafik 4.2 Distribusi Responden Berdasarkan Umur dan Kecemasan 77 Grafik 4.3 Distribusi Responden Berdasarkan Pendidikan dan kecemasan 77 Grafik 4.4 Distribusi Responden Berdasarkan Intervensi……………………………. 78 Grafik 4.5 Distribusi Respoden Berdasarkan Kecemasan Sebelum Diberikan Terapi 79 Psikoedukasi,Guided Imagery dan Protap Ruangan Grafik 4.6Distribusi Responden Sesudah diberikan Terapi Psikoedukasi,Guided 79 Imagery dan Protap Ruangan Grafik 4.10 Distribusi Penurunan Tingkat Kecemasan Pasien Prekateterisasi Jantung dan Sesudah Diberikan Terapi Psikoedukasi, Guided Imagery dan Protap ruangan. viii 83 DAFTAR BAGAN Halaman Bagan 2. 6 Kerangka Teori.......................................................................................... 59 Bagan 2. 7 Kerangka Konsep...................................................................................... 60 Bagan 2. 8 Alur Penelitian ........................................................................................ 72 ix DAFTAR LAMPIRAN Lampiran 1surat Permohonan Persetujuan Menjadi Responden........................................ 101 Lampiran 2 Surat Permohonan Menjadi Responden ........................................................ 102 Lampiran 3 Lembar Penilaian Tingkat Kecemasan............................................................. 103 Lampiran 4 Prosedur Pelaksanaan Psikoedukasi.............................................................. 107 Lampiran 5Prosedur Guided Imagery................................................................................ 111 Lampiran 6 Surat Persetujuan Menjadi Assisten Penelitian.......................................... 113 Lampira 7 Liflet Psikoedukasi..................................................................................... 114 Lampiran 8 Rekapitulasi Data....................................................................................... 115 Lampiran 9 Olah Data SPSS.............................................................................................. 116 Lampiran 10 Surat Keterangan Kelayakan Etika Penelitia................................................. 122 Lampiran 11 Ethics Committee Approval.......................................................................... 123 Lampiran 12 SPO Pendidikan Kesehatan Pasien dan Keluarga........................................ 124 Lampiran 13 Pemberian Pendidikan Kesehatan Pasien/Keluarga Iinter Disipli........... 125 Lampiran 14 Daftar riwayat hidup................................................................................. 126 x DAFTAR SINGKATAN WHO : World Health Organization NCDS : non comunicable disease RISKESDAS : riset kesehatan dasar EKG : elektrokardiografi HARS : Hamilton Anxety Rating Scale CAD : artery coronay disease ACS : Acut Coronary Sindroma CO : karbonmonoksida LDL : Low-density lipoprotein PTCA : Percutaneous Transluminal Coronary Angioplasty GABA : gamma amino butyric acid xi VAS : visual analog scale ASA : acetylsalicylic acid AGI : academi of guided imagery NIC : Nursing Intervention and clasification JCI : Join Commision International INTISARI Latar belakang :Tindakan kateterisasi jantung dapat menimbulkan kecemasan, kecemasan dapat diturunkan menggunakan psikoedukasi maupun guided imagery. Psikoedukasi adalah sebuah terapi modalitas yang disampaikan oleh professional,mengintegrasikan dan mensinergikan antara psikoterapi dan edukasi³¹. guided imagery, yaitu proses yang menggunakan kekuatan pikiran mengarahkan tubuh untuk menyembuhkan diri memelihara kesehatan/ relaksasi melalui komunikasi dalam tubuh melibatkan semua indera. Tujuan : Menganalisis efektivitas terapi psikoedukasi dan guided imagery terhadap kecemasan pasien pre kateterisasi jantung di RSUP Dr. Sardjito Yogyakarta. Metode: Desain penelitian true experiment menggunakan pre and post test with control group design. Jumlah sampel 35 responden. Penilaian kecemasan dengan Hamilton Anxiety Scale (HARS) analisa data yang digunakan adalah uji statistik Wilcoxon, kruskal Wallis dan mann-whitney. Hasil: hasil uji statistic Wilcoxon P<0.05 menunjukkan bahwa psikoedukasi, guided imagery dan protap ruangan (edukasi) sama-sama bisa menurun kecemasan pasien pre kateterisasi, kemudian dari 3 variabel penelitian dilakukan uji Kruskal-Wallis Tes hasil P>0.05 (0,278) dan lanjutkan uji mann-whitney tes untuk melihat perbandingan penurunan dua variabel dengan P>0.05 sehingga tidak ada perbedaan penurunan kecemasan pada 3 intervensi, akan tetapi dari data distribusi didapatkan bahwa guided imagery dapat menurunkan lebih baik yaitu 3 tingkat dibawahnya. Kesimpulan: Terjadi penurunan tingkat kecemasan sebelum dan sesudah diberikan psikoedukasi, guided imagery dan protap ruangan, dengan P< 0,05. Tidak ada perbedaan penurunan kecemasan setelah terapi psikoedukasi, guided imagery dan protap ruangan (edukasi) P> 0,05, akan tetapi guided imagery lebih baik dari keduanya, dapat menurunkan 3 tingkat kecemasan dibawahnya. Kata Kunci: guided imagery dan psikoedukasi, kecemasan, prekateterisasi jantung. xii ABSTRACT Background : Cardiac catheterization actions can cause anxiety, anxiety can be derived using psychoeducation and guided imagery.Psychoeducation is a therapeutic modality that is delivered by professional , integrate and synergize between psychotherapy and education³¹. guided imagery , which is a process that uses the power of the mind directs the body to heal itself maintain health / body relaxation through communication involves all the senses . Objective : To analyze the effectiveness of psychoeducation therapy and guided imagery on anxiety pre cardiac catheterization patients in Dr . Sardjito . Methods : The study design using a true experiment with pre and post test control group design . Total sample of 35 respondents . The Hamilton Anxiety Rating Scale anxiety ( HARS ) data analysis is a statistical test used Wilcoxon , Kruskal-Wallis and Mann-Whitney . Results: The results of the statistical Wilcoxon test P> 0.05 indicates that psychoeducation , guided imagery and standard operating procedure ( education ) are equally able to decrease patient anxiety pre catheterization , then from 3 variable research conducted Kruskal - Wallis test results P > 0:05 ( 0.278 ) and mann-Whitney test continue to see a comparison test of two variables decrease with P > 0:05 so there is no difference in the 3 intervention decreased anxiety , but the distribution of the data showed that guided imagery can lower the better that is 3 levels below . Conclusion : There was a decrease in anxiety levels before and after psychoeducation , guided imagery and standard operating Procedure , with P < 0.05 . There was no difference decreased anxiety after psychoeducation therapy , guided imagery and standard operating procedure ( education ) P > 0.05 , but guided imagery is better than both , can reduce anxiety levels below 3 . Keywords : guided imagery and psychoeducation , anxiety , heart prekateterisasi . xiii