Tesis

Uji Kesahihan serta Keandalan Multimorbidity Treatment Burden Questionnaire Bahasa Indonesia dan Hubungan antara Beban Terapi dengan Kualitas Hidup Pasien Gagal Jantung Kronis Multimorbiditas di RSCM = Validity and Reliability Testing of the Indonesian Version of the Multimorbidity Treatment Burden Questionnaire and Associations between Treatment Burden and Quality of Life in Patients with Chronic Heart Failure and Multimorbidity at Cipto Mangunkusumo Hospital.

Latar Belakang: Multimorbiditas pada pasien gagal jantung kronis menuntut regimen pengobatan yang kompleks, yang secara signifikan meningkatkan beban terapi dan berpotensi menurunkan kualitas hidup. Tujuan: Penelitian ini bertujuan untuk melakukan penerjemahan, uji kesahihan, dan keandalan kuesioner Multimorbidity Treatment Burden Questionnaire (MTBQ) versi Bahasa Indonesia, serta menganalisis hubungan antara beban terapi dengan kualitas hidup pasien gagal jantung kronis dengan multimorbiditas. Metode: Penerjemahan MTBQ dilakukan melalui proses penerjemahan dua arah diikuti pre-test. Uji kesahihan dan keandalan kuesioner melibatkan 139 responden di IPKT RSCM. Selanjutnya, studi potong lintang dilakukan pada 130 responden untuk menilai hubungan antara beban terapi dengan kualitas hidup (Short Form-36 dan Minnesota Living with Heart Failure Questionnaire/MLHFQ). Analisis data mencakup statistik deskriptif, korelasi bivariat, dan multivariat. Hasil: Uji kesahihan isi menunjukkan seluruh 13 item MTBQ Bahasa Indonesia relevan. Uji kesahihan konstruksi mengidentifikasi dua dimensi utama. Kuesioner ini menunjukkan keandalan internal yang tinggi (Cronbach-α = 0,85), korelasi antar item konsisten dan bermakna, uji keandalan antar waktu yang baik (ICC = 0,958). Hasil korelasi pada responden (rata-rata usia 63 tahun, mayoritas laki-laki 61,5%, HFrEF 61,5%) menunjukkan hubungan bermakna antara peningkatan beban terapi dengan penurunan kualitas hidup yang diukur menggunakan instrumen MLHFQ (PR=1,914 p=0,008), yang tetap signifikan setelah dilakukan penyesuaian statistik variabel perancu. Namun, tidak ditemukan hubungan bermakna dengan SF-36. Simpulan: MTBQ Bahasa Indonesia terbukti sahih dan andal untuk mengukur beban terapi pada pasien gagal jantung kronis multimorbiditas. Peningkatan beban terapi berkaitan erat dengan penurunan kualitas hidup pada populasi pasien ini.
Kata Kunci: beban terapi, gagal jantung kronis, multimorbiditas, kualitas hidup


Background: Multimorbidity in chronic heart failure (CHF) patients, coupled with complex treatment regimens, increases treatment burden, consequently reducing the patients' quality of life (QoL). Objective: This study aimed to validate the Indonesian version of the Multimorbidity Treatment Burden Questionnaire (MTBQ) and analyze its association with QoL in multimorbid CHF patients. Methods: This mixed-methods study involved a methodological stage for MTBQ validation and a cross-sectional stage for association analysis. The MTBQ translation included forward-backward translation and pre-testing. Validity and reliability tests were conducted on 139 respondents at IPKT RSCM. The crosssectional study (n=130) assessed the association between treatment burden and QoL using bivariate and multivariate correlation. Results: Content validity testing indicated that all items of the Indonesian MTBQ were relevant. Construct validity testing identified two dimensions. The questionnaire demonstrated high internal reliability (Cronbach's α = 0.85), consistent and significant inter-item correlation, and good test-retest reliability (ICC = 0.958). Correlation results in the respondents (mean age 63 years, majority male 61.5%, HFrEF 61.5%) showed a significant associations between increased treatment burden and decreased quality of life, as measured using the MLHFQ instrument (PR=1.914, p=0.008), which remained significant after statistical adjustment for confounding variables. However, no significant associations was found with the SF-36. Conclusion: The Indonesian version of the MTBQ is a valid and reliable tool for assessing treatment burden. Increased treatment burden in multimorbid CHF patients is significantly associated with a reduced quality of life, particularly when assessed using the disease-specific MLHFQ.
Keywords: treatment burden, chronic heart failure, multimorbidity, quality of life