PERBEDAAN TINGKAT PENGETAHUAN TENTANG FAKTOR PREDISPOSISI GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN PSIKOEDUKASI PADA REMAJA DI DESA NGUTER

PERBEDAAN TINGKAT PENGETAHUAN TENTANG FAKTOR PREDISPOSISI GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN PSIKOEDUKASI PADA REMAJA DI DESA NGUTER

NASKAH PUBLIKASI Diajukan sebagai salah satu syarat untuk meraih gelar Sarjana Keperawatan

Disusun Oleh : M FAJAR SODIQ J 210112004

FAKULTAS ILMU KESEHATAN UNIVERSITAS MUHAMMADIYAH SURAKARTA 2015

Differences Level of Knowledge About Predisposing Factors Mental Disorders Between Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M. Fajar Sodiq)

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RESEARCH

DIFFERENCES LEVEL OF KNOWLEDGE ABOUT PREDISPOSING FACTORS MENTAL DISORDERS BETWEEN BEFORE AND AFTER PROVIDED PSYCHOEDUCATION IN TEENEGER GROUP IN THE NGUTER VILLAGE By: M Fajar Sodiq One of important factor to prevent increasing of mental illness is how to manage them. Teenager is part of crusial thing that role in preventing of mental illness. So they need to have knowledge about prevention of mental illness. This study purpose to analyze the influence of psychoeducation toward the level of knowledge on teenager. The design of study of quantitative with pre experimental methods. Sample in the research is number 30 teenagers, tehnique sampling in this research is purposive sampling. The collect of data used quetionary level of knowledge and the data analyze utilized Wilcoxon Rank Test. The result of the research show that there were different the level knowledge between before and after study with the significance value 0,0001.

Keywords: psycheducation, mental disorders predisposing factor. .


INTRODUCTION The phenomenon of mental disorder at this time has increased very significantly, and every year in various parts of the world increases the number of people with mental disorders. Based on data from the World Health Organization (WHO) in Joseph (2013), there are approximately 450 million people worldwide who experience mental illness. WHO said at least one of the four people in the world experiencing mental health problems, and mental health disorders problems that exist around the world has become a very serious problem for us examine. The high number of inhabitants and the many problems of both social and economic, some communities had to struggle to overcome the pressures of life and be able to adapt to environmental changes. In fact, with so many other problems arise; causing not a few people we finally have a degree of frustration, depression and high stress to cause mental health problems. Indonesia is not a taboo anymore know someone who is mentally ill. Mental disorders experienced by humans various causes, one of which is a psychosis, ie the types of diseases that interfere with brain function. Various psychoses include: psychosis relatively short, due to cannabis psychosis, organic psychosis, psychotic delusions, skizofreniform psychosis, schizophrenia, skizofreniform disorder, bipolar affective disorder, psychotic post partum (Majid, 2004). A mental disorder that is a syndrome or pattern of behavior that is associated with clinically significant distress or suffering and causing disruption on one or more

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functions of human life. (Keliat, 2011) Not only had the health profile of Indonesia in 2014 revealed that mental illness is a health problem in the community. It can be seen from the data base of health (Riskesdas), Bella (2014) The Department of Health in 2014 said there were 1 million patients with severe mental disorders and 19 million patients with mild mental disorder in Indonesia. Central Java is included in the 5 provinces with the highest prevalence figures in Indonesia with prevalence figures reaching 2.3 %. Central Java Province itself is included in the 5 provinces with the highest prevalence figures in Indonesia with prevalence figures reaching 2.3 % (Riskesdas, 2013). In Central Java alone there are 3 people per thousand residents who are mentally handicapped and 50 % is a result of job loss. Thus 32.95204 million residents of Central Java, there are around 98 856 people suffering from mental disorders. In line with the health paradigm that proclaimed health department memekankan more proactive efforts to prevent than to wait in hospitals, mental health orientation is now more on prevention (preventive) and (promotive). Based on preliminary studies in the area Sukoharjo are still many people who experience mental illness at approximately 2778 cases of people with mental disorders, or about 0.6 % of the total population of productive age amounted to 507 517 inhabitants (DKK Kabupaten Sukoharjo, 2013). Based on data from the mental hospital Surakarta number of people with mental disorders is hospitalized from regions Sukoharjo many as 331 people, while the outpatient


amounted (Rekam Medik RSJD Surakarta, 2013). Research concluded by Aji (2013) Nguter in the district showed that in 2013 obtained the data 152 mental patients and 43 patients deprived who shackled (Dinkes, 2013). At Nguter village found 22 peoples was who experience mental ills Hartanto (2014) mentions that in the treatment of patients with mental disorders are rare families that bring patients to the health service. Treatment of mental disorders requires different components. One is the family support. But what happened today is a lot of family members who experience mental illness precisely in exile by the family or society. Though this will make pasiean increasingly severe stress and can worsen the disease. Mental disorders can happen to anyone, one of them in adolescents. Adolescence is known as a critical period in the development of personality, as a period of "storm and stress ". In this period the individual faced with rapid growth, changes bodily and sexual maturation, At the same time social status is also subject to change, when first he was very dependent on parents or others, now he must learn to stand alone and responsible brings its own problems of marriage, employment, and general social status. Greater freedom brings greater responsibility anyway (Yosep, 2013). Factor that led to the occurrence of mental disorders is a lack of knowledge about family pretisipasi and predisposing factors. Given psychoeducation researchers hope to provide education to the youth in the village Nguter so that when they get a stressor from outside they could make copping mechanisms themselves so that they

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are not at risk of mental disorders, and for adolescents who have family members with mental illness they can understand the situation her and could provide the appropriate treatment. This study discussed the differences in the level of adolescent knowledge about mental disorders predisposing factor between before and after psychoeducation at -risk groups in the Nguter. THEORETICAL BASIS The Concept of Mental Disorder Mental disorders are maladaptive response of the internal and external environment, evidenced through the thoughts, feelings and behaviors that are not in accordance with local norms or local culture and disrupt the function of social, occupational or physical (Townsend, 2008). Farida (2010) claim that the disorder occurs in people with mental disorders, namely : Impaired sensation, perceptual disorders, attention disorders, memory disorders, disorders of the association, impaired judgment, impaired thinking, impaired consciousness, orientation disorder, impaired volition, emotional disorders and affective, and impaired. Yosep (2007) signs and symptoms in patients with mental disorders, namely : Impaired cognition, attention disorders, memory disorders, disorders of the association, impaired judgment, impaired thinking, impaired consciousness, volition disorders, emotional disorders and affective, psychomotor. Stuart dan Laraia (2001) in his book said predisposing factor is the factors associated with risk factors for mental disorders.


Stuart & Sandine (2001) said predisposing factor in one's patient is the patient’s role as perpetrators, victims, and witnesses, these factors consist of: a) Physical Persecution: Persecution own physical could come later if the patient was on the perpetrators, victims and witnesses of the persecution that occurred. b) Sexual Persecution : Persecution of sexual usually often we know as rape, patients themselves can be derived from rape victims, perpetrators c) Rejection: Rejection here can be interpreted as an exile or ignored someone in a society so that it can to make someone’s stress. d) Violence in the family : Violence in the family can occur not only her husband's violence against his wife, but also the parents who do the wrong upbringing of the child, when the child was a child when the parents commit violence that memory can be stored until he was an adult and until she had children of her own. e) The crimes: Patients with mental disorders can occur due to criminal acts which he found; here the patient can be abusers, victims of violence and witnesses of violence itself. Erik Erikson who is also a predisposing factor of mental disorder is when the person's growth and development within its phases. The phases are: a) 0 - 18 months at trust versus Mistrust phase b) 18 months until 3 years autonomy versus shame and doubt phase. c) 3 years until 5 years inisiatif versus guilty feeling.

d) e) f) g) h)

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6 years - 10 years, Industry versus inferiority phase. 10 years - 20 years, Identity versus Identity confusion. 20 years - 30 years, intimacy versus Isolation phase. 40 years - 50 years, Generativity versus Stagnation phase. 60 years and olders, integrity versus depair.

The factor of mental disorder’s are (Yosep, 2013) : a) Heredity b) Constitution factors c) Congenital defects. d) Incorrect psychological development. e) Self deprivation f) Who pathogenic family pattern g) Adolescence h) The wrong factor of sociological development. i) Genetics. j) Neurobiologikal k) Biochemestry body l) Neurobehavioral m) Stress n) Drug abuse o) Psikodinamic Knowledge Knowledge gained from the results of curiosity, all of this happens someone did sensing of objects that happen. Out of curiosity then one can take a decision faced (Achmadi, 2013). Knowledge generally comes from experience myself for example a child put his hand into the fire stove heat will occur on the knowledge gained in pain he will not repeat (Irianto, 2014). Achmadi (2013) argued classified into 6 levels of knowledge, namely : 1) Know 2) Comprehension 3) Application

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4) Analysis 5) Synthesis 6) Evaluation Sulihah (2002) knowlegde is affected by the: 1) Level of education. Educations are an attempt to give the knowledge to change attitudes for the better. 2) Information More someone who gets it will be clearer information he received knowledge. 3) Culture The behavior of the public in making a habit that has an attitude and confidence. 4) Experience Events that have happened in the past that can increase a person's. 5) Social economic A person's level of income that can meet the needs. Psycho education Psychoeducation is a form of education or training of a person with a psychiatric disorder that is aimed at treatment and rehabilitation process. The goal of psychoeducation is to develop and increase patient acceptance of a disease or disorder that he experienced, increase patient participation in treatment, and the development of coping mechanism when patients face problems related to the disease (Goldman, 1998 quoted from Bordbar & Faridhosseini, 2010). The purpose of psychoeducation alone is to enhance the adaptive function of the family and meningakatkan katrampilan positive coping mechanisms. It is basically used to help nurses identify problems in the family (Stuart & Sundeen, 2005)

Framework Psycho education

Pre test knowledge

1. 2. 3. 4. 5.

Post test knowledge

Confounding factors: The level of education Information Culture Experience Social economic

Picture 1. Framework Hypothesis Ha : There are differences in the level of knowledge about mental disorders predisposing factor between before and after psychoeducation in adolescents in the village Nguter.

Methodology Research Research Design In this study, using a quantitative design with preexperimental research methods, research design pretest - posttest design group. Studies that provide treatment without the use of a control group to give a pretest before treatment and ends with the provision of post test after being given treatment (Sugiono, 2014). Population and sample The population in this study is a teenager who lives in the village Nguter as many as 988 peoples. The sample was 30 adolescents with determination techniques cluster random sampling.


The Research Instruments This study uses a measuring instrument in the form of a questionnaire.

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RESULT AND DISCUSSION

Wilcoxon Rank Test results obtained knowledge Zobs value of 4.791 and a significance value of 0.000. Because probability value < 0.05 (0.000 < 0.05), then the test is concluded there are differences in pre-test and post test knowledge. The average value of knowledge is a pre-test and post-test 12.867 for 14.767. Based on the average value of the knowledge it appears that the value of post test knowledge higher than the value of pre-test knowledge.

Univariate Analysis

Discussion

Distribution of Pre Test Knowledge Table 1. Distribution Frequency of Pre Test Knowledge

The level of knowledge about the predisposing factors of mental disorder before psychoeducation

The Data Analysis Analysis of the data in this study is bivariate. To be able to test and analyze the data used technique Wilcoxon Signed Rank Test.

No 1 2 3

Knowledge Bad Moderate God Total

F 6 21 3 30

% 20% 70% 10% 100%

Distribution of Pre Test Knowledge Tabel 2. Distribution of Pre Test Knowledge No 1 2 3

Knowledge Bad Moderate God Total

F 4 8 18 30

% 13% 27% 60% 100%

Knowledge of the Effectiveness of Psychoeducation Against Predisposition Factors Mental Disorders in Teens in the village of Sukoharjo Nguter Table 3. Uji Wilcoxon Rank Test of Knowledge The result Knowledg e Mean Pre test Post test

z-hit

p-v

Con clus sion

12,867 4,791 0,000 Sign 14,767

Distribution of adolescents knowledge about the predisposing factors of mental disorder before being given psychoeducation mostly being that 21 respondents (70 %) and 10 % of respondents berpengetahhuan well. Based on the knowledge of the data, it was concluded that the level of knowledge about mental disorders predisposing fatkor most respondents before the study was moderate with an average of 12.867. The level of knowledge that was the one caused by the level of education is good enough most of the high school educated. Respondents who are well educated have the ability to examine or analyze a question and find a solution answers. In this study, the question of knowledge using the model of multiple choice, so that respondents can make comparisons of the answer choices and determine the answers they think are reasonable and the best, so although previously they do not know about that question, but the


answer choices lead respondents could choose the best answer. Knowledge of the predisposing factors of mental disorders are adolescent understanding of the predisposing factors of mental disorder, or information obtained from a source of the experience they gain in their environment. When adolescents have people around them are mentally ill, there will be discussions in the community about the person, well why he had a mental disorder, how it happened, what the cause and so forth. When adolescents obtain such information, then teens will analyze it and making it into knowledge of psychiatric disorders. Relationship information and experiences on knowledge as expressed by Sulihah (2002) which suggests that one of the factors that influence knowledge is experience. Experience that teens about mental disorders around teenagers become resources for teen’s knowledge about mental disorders predisposing factors. Research Vivin (2011) concluded that there is a relationship utilization of various media with adolescent reproductive health knowledge level of class XI SMA Darul ' Ulum 3 Jombang. Research also shows that there are 10 % of respondents who have knowledge of the predisposing factors of mental disorders is lacking. This condition is caused there are 10 respondents (33 %) junior high school education. The education level of the respondents that cause their ability to understand information about predisposing factors both from lessons at school as well as from the mass media is lower than the respondents had high school, so that their level of knowledge is low.

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Research shows teens knowledge about the distribution of predisposing factors are mostly moderate. These results support the research Nopyawati (2013) which revealed that knowledge of communities in the PHC Colomadu Karanganyar Work on mental disorders is largely sufficient. This study states that the factors that shape public knowledge about mental disorders, among others, the level of public education, and information that affect the public opinion.

Increasing the effectiveness of psychoeducation for Knowledge Research in a comparative study comparing adolescent’s knowledge about mental disorders predisposing factors before and after getting psychoeducation about the predisposing factors of mental disorder. Testing is done by comparing the scores of knowledge before and after psychoeducation. Comparative analysis techniques used in this study were paired samples t -test if the data were normally distributed or Wilcoxon rank test if the data is not normally distributed. Testing data normality using the Kolmogorov Smirnov test at a significance level of 5 %. Furthermore normality test results show that knowledge of both the research data before psychoeducation and data after psychoeducation is not normal because it has a p-value less than 0.05. Based on the results of the data normality test, the comparison test techniques used in this study is the Wilcoxon rank test.


Wilcoxon rank test results concluded that there psychoeducation effectiveness of the increased knowledge about mental disorders predisposing to an increased level of adolescent knowledge Nguter In the village of Sukoharjo (p - value = 0.000). The average value of knowledge is a pretest and post-test 12.867 for 14.767, so it concluded psychoeducation effectively increase knowledge of predisposing factors in adolescents in the village of Sukoharjo Nguter. Psychoeducation about predisposing factors of mental disorder aims to provide information to adolescents about the understanding of mental disorders predisposing factors. With the provision of such information is expected to teen’s knowledge about mental disorders predisposing factor increased to well. This is in accordance with the opinion of Goldman (Bordbar & Faridhosseini 2010) that defines psychoeducation as a form of education or training of a person with a psychiatric disorder that is aimed at treatment and rehabilitation process. The goal of psychoeducation is to develop and increase patient acceptance of a disease or disorder that he experienced, increase patient participation in treatment, and the development of coping mechanisms when patients face the problems associated with the disease. The results support the research Yulita (2013) about the effectiveness of psychoeducation to parents in improving knowledge of teenage sexuality mild mental retardation. This study concluded that there is educational effectiveness in increasing knowledge of teenage sexuality mild mental retardation.

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Another study conducted by Farida (2012) regarding self-efficacy training to improve the career decision-making abilities of high school students. The study concluded that the effect of selfefficacy training to improve decisionmaking career in high school students.

Conclussion and Suggestions conclussion 1. Knowledge Nguter teenager In the village of Sukoharjo on predisposing factors of mental disorder before getting psychoeducation about mental disorders predisposing factors largely being. 2. Knowledge of teenagers in the village of Sukoharjo Nguter after getting psycho-education about mental disorders predisposing factors are mostly good. 3. There effectiveness of psychoeducation to increased knowledge of the predisposing factors of mental disorders in adolescents in the village of Sukoharjo Nguter. Suggestion 1. Suggestion for Teenenger Youth should increase their sensitivity to the environment, so that they can provide benefits to the surrounding environment. Youth should also increase their knowledge about psychiatric disorders, so that they can make an effort anticipation of his friends who are at risk of experiencing mental disorders.


2. Suggestion for Educational Institutions Nursing Studies Program Faculty of Health Sciences, University of Muhammadiyah Surakarta should also equip students with the ability to convey information to the public, so that when they’ve become a nurse is able to be a resource for the community, especially on health issues in the community. 3. Suggestion for researchers who will come Psychoeducation used in this study only used the lecture method using leaflets media. Expected future researchers using other teaching methods, in order to obtain better knowledge enhancement.

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Jombang: Kesehatan Ulum.

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*M. Fajar Sodiq: Student of Bachelor of Nursing FIK UMS. Jln A Yani Tromol Post 1 Kartasura ** Arum Pratiwi, S.Kp., M.Kes: Lecturer of Bachelor of Nursing FIK UMS. Jln A Yani Tromol Post 1 Kartasura. *** Wachidah Yuniartika, S.Kep, Ners: Lecturer of Bachelor of Nursing FIK UMS. Jln A Yani Tromol Post 1 Kartasura

PERBEDAAN TINGKAT PENGETAHUAN TENTANG FAKTOR PREDISPOSISI GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN PSIKOEDUKASI PADA REMAJA DI DESA NGUTER

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