Tesis

Uji Kesahihan dan Keandalan Instrumen Historical Clinical Risk Management Scale 20 Version 3 (HCR-20 V3 ) Versi Bahasa Indonesia = The Validity and Reliability Study of The Indonesian Version of Historical Clinical Risk Management Scale 20 Version 3 (HCR-20 V3 ).

Latar Belakang. Frekuensi kekerasan pada orang dengan gangguan jiwa (ODGJ) cukup sering dijumpai, sehingga menimbulkan permasalahan baik saat mereka berada dalam perawatan di rumah sakit ataupun saat mereka kembali ke komunitas. Dengan adanya suatu instrumen yang dapat menilai faktor-faktor risiko terjadinya kekerasan di masa mendatang serta diberikannya manajemen risiko dan tata laksana yang adekuat dapat mengurangi timbulnya risiko perilaku kekerasan atau kebeberbahayaan, serta menimbulkan rasa aman dan nyaman baik bagi ODGJ itu sendiri, keluarga atau pelaku rawat, komunitas serta tenaga medis. Tujuan. Penelitian ini dilakukan untuk mendapatkan instrumen yang sahih dan handal dalam menilai risiko kekerasan atau keberbahayaan di masa mendatang serta rencana tata laksananya terutama pada seting klinis, yakni Historical Clinical Risk Management Scale 20 Version 3 (HCR-20 V3 ) versi Bahasa Indonesia. Metode. Penelitian ini melibatkan 103 pasien dengan riwayat perilaku kekerasan yang datang ke Poli Jiwa Dewasa dan Unit Rawat Inap Departemen Psikiatri RSCM sejak bulan November 2018 dan berusia 18-59 tahun. Uji kesahihan yang dilakukan antara lain uji kesahihan isi dengan meminta pendapat dari 10 orang pakar di bidang Ilmu Kesehatan Jiwa, serta uji kesahihan konkuren yang membandingkan skala klinis pada instrumen HCR-20 V3 versi Bahasa Indonesia dengan instrumen standar yang telah divalidasi sebelumnya yakni PANSS dan OAS. Uji keandalan konsistensi internal dilakukan dengan melihat nilai Cronbach’s Alpha. Hasil. Uji kesahihan isi menunjukkan nilai content validity index for items (I-CVI) sebesar 0.97 dan nilai content validity index for scales (S-CVI) sebesar 0.80 yang menunjukkan bahwa butir-butir pada instrumen HCR-20 V3 versi Bahasa Indonesia memiliki relevansi terhadap penilaian risiko kekerasan/keberbahayaan pada seseorang. Uji kesahihan konkuren menunjukkan korelasi positif dan signifikan jika dibandingkan dengan instrumen PANSS dan OAS. Nilai koefisien Cronbach’s Alpha diperoleh hasil sebesar 0.758 yang menunjukkan hasil baik pada uji keandalan konsistensi internal. Simpulan. Penelitian ini menghasilkan instrumen HCR-20 V3 versi Bahasa Indonesia yang sahih dan andal dalam menilai risiko perilaku kekerasan atau keberbahayaan.
Kata Kunci: Historical Clinical Risk Management Scale 20 Version 3 (HCR-20 V3 ), kesahihan, keandalan, penilaian risiko perilaku kekerasan


Background. The frequency of violence in people with mental disorders is quite common, causing problems when they are in hospital care or when they return to the community. An instrument that can assess risk factors for future violence and provide adequate risk management can reduce the risk of violence or dangerous behavior, and create a sense of security and comfort for people with mental disorder, their families, the community and medical personnel. Aim. This research was conducted to obtain a valid and reliable instrument, namely the Indonesian version of the Historical Clinical Risk Management Scale 20 Version 3 (HCR20 V3 ), in assessing the risk of future violence or harm and its management, especially in clinical settings. Methods. The study involved 103 patients with a history of violent behavior who had come to the Adult Psychiatry Outpatient Unit and RSCM Department of Psychiatric Inpatient Unit since November 2018 until March 2019 and aged 18-59 years. Validity tests included the content validity test by collecting the opinions of 10 experts in the field of Mental Health, as well as concurrent validity test that compare the clinical scale of the Indonesian version of the HCR-20 V3 instrument with the previously validated standard instruments, Positive and Negative Syndrome Scale (PANSS) and Overt Agression Scale (OAS). Reliability testing of internal consistency was done by defining the value of Cronbach's Alpha. Results. The content validity index for items (I-CVI) was 0.97 and the content validity index for scales (S-CVI) value was 0.80, indicating that the items in the Indonesian version of the HCR-20 V3 instrument are relevant for asssessing risk of violent behavior. Concurrent validity test showed a positive and significant correlation when compared with PANSS and OAS instruments. The Cronbach's Alpha coefficient value was 0.758 which showed good result on the internal consistency reliability test. Conclusion. The Indonesian version of HCR20 V3 is a valid and reliable instrument for assessing risk of violent or dangerous behavior.
Keywords: Historical Clinical Risk Management Scale 20 Version 3 (HCR-20 V3 ), validity, reliability, violence risk assessment