Skripsi

The association between sleep problems and general mental health among preclinical medical students in Indonesia during COVID-19 pandemic = Hubungan antara gangguan tidur dan kesehatan mental mahasiswa preklinik kedokteran Indonesia saat pandemi COVID-19.

Introduction: COVID-19 has brought about tremendous changes that affect many aspects including the mental health of preclinical medical students, who have been one of the most vulnerable groups to psychosocial changes even before the pandemic. Amongst those changes, sleep might be one of the most important factors as it is physiologically correlated with mental states through various pathways. In Indonesia specifically, there has been no study which explains this relationship in the preclinical medical students. Method: This cross-sectional study was conducted involving 285 preclinical medical students across Indonesia. After simple random sampling, data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24 for Mac. General mental health was assessed using General Health Questionnaire-12 (GHQ-12), while the sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Analysis of association between these scores employed Chi-square statistics, while correlations between domains were investigated through Spearman’s rank-order correlation coefficient. Results: The proportion of Indonesian preclinical medical students who experience psychosocial disturbances was 96.5%, while those experiencing sleep disturbances was as high as 61.8%. Significant association was discovered between poor sleep quality and psychosocial disturbance (OR=3.96; p=0.04). Weak correlations were found between general mental health and subjective sleep quality, sleep latency, and daytime activity dysfunction domains of PSQI. The strongest correlation between domains existed between daytime activity dysfunction and social dysfunction. Conclusion and recommendation: This study revealed significant association between poor sleep quality and psychosocial disturbance. Thus, more attention should be allocated in order to improve sleep quality, and hence mental health, of preclinical medical students in the current pandemic. Further studies are recommended to strengthen the evidence and explore other factors that might affect the mental health of preclinical medical students.
Keywords: COVID-19, Indonesia, General mental health, GHQ-12, preclinical medical students, PSQI, Sleep quality


Pendahuluan: COVID-19 telah mengakibatkan berbagai perubahan yang memengaruhi berbagai aspek dari kesehatan mental mahasiswa preklinik kedokteran, yang merupakan salah satu subset populasi paling rentan terhadap gangguan psikososial bahkan sebelum pandemi. Di antara perubahan tersebut, kualitas tidur adalah salah satu faktor yang kemungkinan berperan besar karena kaitan fisiologisnya dengan status mental. Di Indonesia, belum ada studi yang menganalisis hubungan antara kualitas tidur dan kesehatan mental ini pada mahasiswa kedokteran preklinik. Metode: Studi potong lintang ini melibatkan 285 mahasiswa kedokteran preklinik di Indonesia. Setelah simple random sampling, data yang didapatkan dianalisis dengan Statistical Package for Social Sciences (SPSS) version 24 for Mac. Kesehatan mental umum dinilai dengan menggunakan General Health Questionnaire-12 (GHQ-12), sedangkan kualitas tidur dengan Pittsburgh Sleep Quality Index (PSQI). Analissi asosiasi di antara kedua skor ini dilakukan dengan statistik Chi-square, sedangkan korelasi andtara domain-domain yang ada diinvestigasi berdasarkan Spearman’s rank-order correlation coefficient. Hasil: Proporsi mahasiswa preklinik kedokteran Indonesia yang mengalami masalah psikososial adalah 96.5%, sedangkan yang mengalami gangguan tidur adalah 61.8%. Asosiasi yang signifikan ditemukan antara kualitas tidur buruk dan gangguan psikososial (OR=3.96; p=0.04). Korelasi lemah ditemukan antara kesehatan mental dan domain-domain kualitas tidur subjektif, latensi tidur, dan disfungsi aktivitas siang hari pada PSQI. Korelasi terkuat ditemukan antara disfungsi aktivitas siang hari dan disfungsi sosial. Simpulan dan saran: Pada studi ini ditemukan asosiasi yang signifikan antara kualitas tidur buruk dan gangguan psikososial. Dengan demikian, lebih banyak perhatian seharusnya diberikan untuk meningkatkan kualitas tidur mahasiswa preklinik kedokteran sehingga kesehatan mentalnya baik pula. Penelitian lebih lanjut dibutuhkan untuk memperkuat bukti serta mengeksplorasi faktor-faktor lain yang mungkin berpengaruh pada kesehatan mental mahasiswa preklinik kedokteran saat pandemi COVID-19.
Kata kunci: COVID-19, Indonesia, kesehatan mental, kualitas tidur, mahasiswa preklinik kedokteran, GHQ-12, PSQI