Tesis

Hubungan antara Aliansi Terapeutik dengan Kepatuhan Minum Obat pada Pasien Skizofrenia = Relationship between Therapeutic Alliance and Medication Adherence in Schizophrenic Patients.

Latar Belakang: Salah satu strategi dalam pengelolaan kasus skizofrenia yaitu dengan meningkatkan aliansi terapeutik antara terapis dan pasien. Terjalinnya aliansi terapeutik yang baik diketahui dapat memperbaiki gejala maupun fungsi pasien skizofrenia. Namun ternyata kepatuhan minum obat masih menjadi masalah dalam pengelolaan pasien Skizorenia. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara aliansi terapeutik dengan kepatuhan minum obat pada pasien skizofrenia. Metode: Penelitian potong lintang pada 32 pasien skizofrenia dengan luaran kuesioner Working Alliance Inventory (WAI) versi bahasa Indonesia dan Medication Adherence Rating Scale (MARS) versi bahasa Indonesia di Poliklinik Jiwa Dewasa RS Cipto Mangunkusumo, Jakarta. Analisis bivariat yang digunakan yaitu spearman test. Hasil: Rerata usia ialah 35,97 tahun, laki-laki (65,6%), tingkat pendidikan terbesar SMA (59,4%), dan status pekerjaan terbesar yaitu bekerja (62,5%). Persentase jenis psikoterapi terbesar yaitu psikoterapi suportif (68,75%). Skor WAI total dengan rerata 192,8 ± 32,9, skor WAI T 85,6 ±17.25, dan skor WAI C 114,06 ± 21,40 yang berarti aliansi terapeutik telah terjalin baik. Skor MARS median 9,00 (6,00 - 10,00), subskala perilaku terhadap pengobatan median 4,00 (1,00-4,00), subskala sikap terhadap pengobatan 3 (2,00-4,00) dan subskala efek samping obat 2,00 (0,00-2,00) yang menunjukkan kepatuhan minum obat baik. Hasil uji statistik didapatkan ada hubungan yang kuat dan signifikan antara aliansi terapeutik dengan kepatuhan minum obat (r= 0,558, p=0,001). Simpulan: Terdapat hubungan positif antara aliansi terapeutik dengan kepatuhan minum obat.
Kata Kunci : skizofrenia, aliansi terapeutik, kepatuhan minum obat.


Background: One strategy in the management of schizophrenia cases is to make the therapeutic alliance between the therapist and patient. A good therapeutic alliance is known to improve symptoms and function of schizophrenic patients. However, it turns out that medication adherence is still a problem in the management of schizophrenia patients. The purpose of this study is to determine whether there is a relationship between therapeutic alliances and medication adherence in schizophrenic patients. Methods: A cross sectional study was done on 32 schizophrenic patients at Cipto Mangunkusumo Hospital Jakarta, with the Indonesian version of Working Alliance Inventory (WAI) and Medication Adherence Rating Scale (MARS) as the outcome. Bivariate analysis Spearman test were employed to assess the relationship between therapeutic alliance and medication adherence. Results: The patients enrolled have the mean age of 35.97 years, male (65.6%), the highest education level is high school (59.4%), and the highest occupational status is working (62.5%). The largest percentage of types of psychotherapy is supportive psychotherapy (68.75%). The mean total WAI score was 192.8 ± 32.9, the mean WAI T score was 85.6 ± 17.25, and the mean WAI C score was 114.06 ± 21.40 which means the therapeutic alliance has been well established. The median MARS score was 9.00 (6.00 - 10.00), the median medication adherence behavior 4.00 (1.00-4.00), attitude to treatment subscale 3 (2.00-4.00) and subscale drug side effects 2.00 (0.00-2.00) which indicates good medication adherence. The results of statistical tests showed that there was a strong and significant relationship between therapeutic alliances and medication adherence (r = 0.558, p = 0.001). Conclusion: There is a positive relationship between therapeutic alliance and medication adherence.
keywords: schizophrenia, therapeutic alliance, medication adherence.