Tesis

Pengaruh Terapi Musik terhadap Neutrophil Lymphocyte Ratio, Kadar Interleukin 6 dan Interleukin 10 Tenaga Kesehatan dengan Burnout Syndrome = The Effect of Music Therapy on Neutrophil Lymphocytes Raio, Interleukin 6 and Interleukin 10 Levels of Healthcare Workers with Burnout Syndrome.

Latar belakang: Tenaga kesehatan merupakan kelompok yang rentan mengalami Burnout Syndrome (BOS) akibat stress psikologis dan fisiologis sehubungan dengan pekerjaannya. Stress dapat menyebabkan gangguan sistem imun yang berperan sebagai pertahanan tubuh terhadap infeksi, dan terjadi inflamasi yang dapat dinilai dengan peningkatan sitokin proinflamasi dan penurunan sitokin anti inflamasi. Terapi musik pada penelitian sebelumnya menunjukkan dampak yang signifikan terhadap stress, dan tampaknya menjadi salah satu bentuk terapi yang cukup menjanjikan dalam menurunkan inflamasi. Metode: Penelitian ini merupakan Randomized controlled trial, open label pada tenaga kesehatan dengan Burnout Syndrome di RSUPN dr. Cipto Mangunkusumo dan RSUP Dr. Kariadi selama 2 bulan mulai Februari 2023 hingga Maret 2023. Subjek dibagi menjadi dua kelompok dengan cluster random sampling dengan jumlah subjek pada masingmasing kelompok 15 orang. Intervensi yang diberikan berupa terapi musik sebanyak 3 sesi dalam 1 minggu selama 4 minggu. Instrumen yang digunakan adalah kuesioner MBI-HSS, pemeriksaan NLR dengan Fluorescence Flow Cytometry, Interleukin 6 dengan Fluorescence Immunoassay. serta metode ELISA untuk Interleukin 10 serum. Analisis normalitas data dilakukan dengan SaphiroWilk. Jika distribusi data normal dilakukan analisis data uji T independent. Jika distribusi tidak normal, menggunakan uji Mann-Whitney. Hasil: Nilai Neutrophil Lymphocyte Ratio sebagian besar diatas nilai normal, sementara kadar Interleukin 6 dan Interleukin 1 0 pada seluruh subyek penelitian secara umum masih berada dalam rentang nilai rujukan untuk orang dewasa sehat. Pada kelompok intervensi yang mendapatkan terapi musik dan edukasi maupun kelompok kontrol yang mendapatkan edukasi saja didapatkan penurunan nilai MBI-HSS, Neutrophil Lymphocyte Ratio, Interleukin 6 dan Interleukin 10. Perbedaan penurunan MBIHSS berbeda bermakna secara statistik (p < 0,05), sedangkan penurunan Neutrophil Lymphocyte Ratio, Interleukin 6 dan Interleukin 10 tidak berbeda bermakna antara kelompok intervensi dan kelompok kontrol (p > 0,05). Simpulan: Profil NLR meningkat, sedangkan Interleukin 6 dan Interleukin 10 pada tenaga kesehatan dengan Burnout syndrome secara umum masih berada dalam rentang nilai normal. Terapi musik dapat memperbaiki nilai MBI-HSS, namun tidak bermakna menurunkan Neutrophil Lymphocyte Ratio, Interleukin 6 dan tidak meningkatkan Interleukin 10.
Kata Kunci: Burnout syndrome (BOS), Neutrophil Lymphocyte Ratio, Interleukin 6, Interleukin 10, terapi musik


Background: Healthcare workers are a group that is vulnerable to Burnout Syndrome (BOS) due to psychological and physiological stress related to their work. Stress can cause immune system disorders that act as the body's defense against infection, and inflammation occurs which can be assessed by an increase in pro-inflammatory cytokines and a decrease in anti-inflammatory cytokines. Music therapy in previous studies has shown a significant impact on stress, and appears to be one form of therapy that promising in reducing inflammation. Methods: This study is a randomized controlled trial, open label on healthcare workers with Burnout Syndrome at RSUPN dr. Cipto Mangunkusumo and RSUP Dr. Kariadi for 2 months from February 2023 to March 2023. The subjects were divided into two groups by cluster random sampling with each group consisting of 15 people. The intervention was music therapy 3 sessions in a week for 4 weeks. The instruments used are MBI-HSS questionnaire, NLR examination with Fluorescence Flow Cytometry, Interleukin 6 with Fluorescence Immunoassay. and ELISA method for Interleukin 10 serum. Depending on the data distribution analysis performed using the Shapiro-Wilk test, data analysis was performed using either the Mann-Whitney test or the independent T test. Results: Neutrophil Lymphocyte Ratio are higher than normal, Interleukin 6 and Interleukin 10 levels in all study subjects are within the range of referent values for healthy adults. In the intervention group and control group, there was a decrease in the value of MBI-HSS, Neutrophil Lymphocyte Ratio, Interleukin 6 and Interleukin 10. The difference in the decrease in MBI-HSS was statistically significant (p < 0.05), while the decrease in Neutrophil Lymphocyte Ratio, Interleukin 6 and Interleukin 10 levels was not significantly different between the intervention group who received both music therapy and education than the control group who received education only (p > 0.05). Conclusion: NLR is increase, but Interleukin 6 and Interleukin 10 in health workers with burnout syndrome is generally within the normal range. Music therapy can improve MBIHSS values, but does not significantly decrease Neutrophil Lymphocyte Ratio, Interleukin 6 and Interleukin 10.
Keywords: Burnout syndrome (BOS), Neutrophil Lymphocyte Ratio, Interleukin 6, Interleukin 10, music therapy