Tesis

Perubahan Status Depresi dan Hubungannya dengan Kualitas Hidup pada Pasien Tuberkulosis Multidrug Resistant = The Alteration of Depression Status and Its’ Relation to The Quality of Life Among Multidrug Resistant Tuberculosis Patients.

Pendahuluan: Pengobatan TB MDR yang berlangsung lama menimbulkan isolasi sosial, kehilangan pekerjaan, efek sosioekonomi dan psikologis jangka panjang pada pasien. Faktor individu, sosial budaya dan lingkungan serta kemungkinan efek samping psikiatri menjadikan pasien TB MDR cenderung mengalami gejala depresi. Depresi dapat mempengaruhi kualitas hidup. Penelitian ini menilai perubahan status depresi dan hubungannya dengan kualitas hidup pasien TB MDR. Metode: Penelitian ini menggunakan metode kohort observasional di Poliklinik TB MDR RSUP Persahabatan. Dua puluh sembilan subjek TB MDR dinilai status depresi dan kualitas hidupnya dengan kuesioner Beck Depression Inventory (BDI) dan WHOQOL BREF sebelum dan setelah 6 bulan pengobatan TB MDR. Hasil: Proporsi pasien depresi sebelum pengobatan sebesar 75,9% (22 subjek). Setelah 6 bulan pengobatan TB MDR, 13 orang skor BDInya menurun, 9 orang meningkat dan terdapat 4 orang yang sebelumnya tidak depresi mengalami depresi. Skor WHOQOL BREF mengalami peningkatan pada ranah fisis, psikologis dan peningkatan bermakna pada ranah lingkungan. Pada ranah sosial, skor kualitas hidup mengalami penurunan. Tidak didapatkan hubungan bermakna antara perubahan status depresi dan kualitas hidup. Keterkaitan antara faktor usia, jenis kelamin, tingkat pendidikan, status ekonomi, lama sakit TB dan atau TB MDR serta beratnya merokok dengan depresi tidak dapat dibuktikan pada penelitian ini. Kesimpulan: Sebanyak 22 subjek (75,9%) mengalami gejala depresi sebelum memulai pengobatan TB MDR. Setelah 6 bulan, 13 orang gejala depresinya membaik, 9 orang memburuk dan terdapat 4 orang mengalami onset baru depresi. Kualitas hidup ranah fisis, psikologis dan lingkungan mengalami kenaikan.
Kata kunci: tuberculosis multidrug resistant, depresi, kualitas hidup


Introduction: Treating drug resistant TB (MDR TB) which requires longer courses resulting in social isolation, loss of employment, and long-term socioeconomic and also psychological impacts for patients. Individual factors, sociocultural and environment condition also psychiatric adverse events lead the patients tend to have depression symptoms. Depression can majorly affects patients’ quality of life. This study assesses the alteration of depression and its’ relation to the quality of life among MDR TB patients. Methods: This study used observational cohort methods in MDR Outpatients Clinic of Persahabatan Hospital. Twenty nine patients were diagnosed with MDR, measured depression status and the quality of life with Beck Depression Inventory (BDI) and WHOQOL BREF questionnaire from baseline and after 6 months therapy. Results: Propotion of depression at baseline is 75,9% (22 subjects). After 6 months treatment, the BDI score of 13 subjects were decreased, 9 subjects were increased and there were 4 subjects experienced new onset depression. The WHOQOL BREF improved in physical, psychological and significantly increased in environmental domain. In social domain, it was decreasing. This study didn’t find the relation between depression status changes and the quality of life. The association between age, gender, level of education, economic status, duration of illness and smoking with depression could not be proven by this study. Conclusions: There are 22 subjects (75,9%) have already been depressed at baseline. After 6 months treatment, 13 subjects improving the symptoms, 9 subjects worsening and 4 subjects have experienced new onset depression. The quality of life in physical, psychological and environmental domain have improved.
Keywords: Drug resistant tuberculosis, depression, quality of life