Skripsi

Hubungan Faktor Sosiodemografis dengan Gejala Nonmotorik Pasien dengan Parkinsonisme di RSUP Nasional Dr. Cipto Mangunkusumo = Association of Sociodemographic Factors with Nonmotor Symptoms in Patients with Parkinsonism in Dr. Cipto Mangunkusumo National General Hospital.

Latar belakang: Gejala nonmotorik sangat umum ditemukan pada pasien dengan Parkinsonisme, dan bahkan dapat muncul sebelum onset gejala motorik. Gejala ini berpotensi memperburuk kualitas hidup pasien, tetapi sering kali terlewatkan pada pasien dengan Parkinsonisme dibandingkan gejala motoriknya. Interaksi berbagai faktor berperan penting dalam muncul dan beratnya gejala pada Parkinsonisme, salah satunya faktor demografis pasien. Oleh karena itu, penelitian ini dilakukan untuk melihat hubungan faktor demografis dengan gejala nonmotorik pasien dengan Parkinsonisme. Metode: Penelitian ini dilakukan pada 50 pasien dengan Parkinsonisme di RSUP Nasional Dr. Cipto Mangunkusumo dengan desain studi cross-sectional. Faktor sosiodemografis yang diambil meliputi usia, jenis kelamin, tingkat pendapatan, tingkat pendidikan, dan status pernikahan. Gejala nonmotorik diukur dengan kuesioner Movement Disoreder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Bagian I. Analisis bivariat dilakukan dengan uji t tidak berpasangan dan ANOVA, sedangkan regresi linear digunakan untuk analisis multivariat. Hasil: Karakteristik subjek penelitian mayoritas berusia ≤65 tahun (90%), laki-laki (56%), berpendidikan tinggi (50%), berpenghasilan Rp2.500.00 bersifat protektif terhadap beratnya gejala nonmotorik, sedangkan pendidikan rendah dan status sudah menikah meningkatkan beratnya gejala. Analisis tiap domain MDS-UPDRS Bagian I menemukan faktor usia berhubungan bermakna dengan gejala konstipasi; jenis kelamin berhubungan bermakna dengan nyeri; tingkat pendidikan berhubungan bermakna dengan halusinasi, depresi, gangguan tidur, dan konstipasi; tingkat pendapatan berhubungan bermakna dengan gangguan tidur dan pusing saat berdiri; serta status pernikahan berhubungan bermakna dengan gangguan tidur. Kesimpulan: Terdapat hubungan yang signifikan antara faktor demografis dengan beratnya gejala nonmotorik pada pasien dengan Parkinsonisme, terutama jenis kelamin, tingkat pendidikan, tingkat pendapatan, dan status pernikahan. Faktor demografis juga ditemukan berhubungan bermakna dengan domain gejala nonmotorik yang berbeda. Hasil studi ini diharapkan dapat meningkatkan perhatian terhadap gejala nonmotorik, serta memberikan data untuk pengobatan yang sifatnya terpersonalisasi terhadap faktor risiko sosiodemografis pasien dengan Parkinsonisme.
Kata kunci: faktor sosiodemografis, gejala nonmotorik, Parkinsonisme



Background: Nonmotor symptoms are commonly found in patients with Parkinsonism, and can even present itself before motor symptoms. These symptoms has the potential to impact patient's quality of life, yet are often overlooked in patients with Parkinsonism compared to its motor symptoms. Interaction of various factors play an important role in the appearance and severity of symptoms in Parkinsonism, one of which is patient sociodemographics factors. Therefore, this study was conducted to examine the relationship between sociodemographic factors and nonmotor symptoms in patients with Parkinsonism. Methods: This study was conducted on 50 patients with Parkinsonism at Dr. Cipto Mangunkusumo National General Hospital with a cross-sectional study design. Sociodemographic factors assessed include age, gender, income level, education level, and marital status. Nonmotor symptoms were measured using the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS Part I) questionnaire. Bivariate analysis was performed using independent t test and ANOVA, while linear regression was used for multivariate analysis. Results: Majority of research subjects were aged ≤65 years (90%), male (56%), highly educated (50%), income level < Rp 1,500,000 (44%), and married (86%). The mean value of MDS-UPDRS Part I was 19.86 ± 10.77. 100% of patients experienced nonmotor symptoms, with the highest proportion of symptoms being fatigue (94%) and depression (90%). Bivariate analysis found that high education level and unmarried or divorced status were associated with significantly lower MDS-UPDRS scores (p=0.012 and p=0.008). Linear regression found that male gender and income > Rp2.500.000 are protective against nonmotor symptoms, while lower education and married status increase nonmotor symptoms. Analysis of each domain of MDS-UPDRS Part I found that age was significantly associated with symptoms of constipation; gender is associated with pain; education is associated with hallucinations, depression, sleep disturbances, and constipation; income is associated with sleep disturbances and dizziness on standing; and marital status associated with symptoms of sleeping disturbance. Conclusion: There is a significant relationship between sociodemographic factors and the severity of nonmotor symptoms in patients with Parkinsonism, especially gender, education level, income, and marital status. Demographic factors were also found to be significant with different domains of nonmotor symptoms. Results of this study are expected to increase attention to nonmotor symptoms, as well as provide data for personalized treatment based on sociodemographic risk factors in patients with Parkinsonism.
Keywords: sociodemographic factors, nonmotor symptoms, Parkinsonism