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ABSTRAK

HUBUNGAN KECEMASAN DENGAN TINGKAT KEJADIAN GERD

PADA MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS

KRISTEN MARANATHA ANGKATAN 2014

Priscilia Agatha, 2017. Pembimbing I : Harry Tribowo Hadi, dr., Sp.KJ

Pembimbing II : Stella Tinia Hasianna, dr., M.Kes, IBCLC

Penyakit refluks gastroesofageal (GERD) merupakan gangguan saluran cerna

yang umum terjadi. GERD memiliki dampak yang dapat menurunkan kualitas

hidup pasien. Kejadian GERD dipengaruhi oleh berbagai faktor, salah satunya

adalah faktor psikologis. Penelitian ini bermaksud untuk mencari tahu hubungan

kecemasan dengan tingkat kejadian GERD.

Tujuan dari penelitian ini adalah untuk mengetahui hubungan faktor psikologis

khususnya kecemasan dengan tingkat kejadian GERD pada mahasiwa fakultas

kedokteran Universitas Kristen Maranatha.

Metode penelitian ini adalah penelitian observasional analitik dengan

rancangan penelitian cross sectional yang dianalisis dengan uji chi square. Subjek

penelitian ini adalah seluruh mahasiwa fakultas kedokteran Universitas Kristen

Maranatha angkatan 2014 dengan jumlah 160 orang yang mengisi dua kuesioner,

GERD-Q dan kuesioner ZSAS.

Pada penelitian ini, ditemukan sebanyak 41 orang subjek penelitian menderita

GERD dan didapatkan gangguan kecemasan (p=0,008; OR=3,269) memiliki

hubungan dengan kejadian GERD.

Simpulan dalam penelitian ini adalah kecemasan berhubungan dengan kejadian

GERD pada mahasiswa fakultas kedokteran Universitas Kristen Maranatha

angkatan 2014.

Kata kunci: GERD, kecemasan

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ABSTRACT

THE ASSOCIATION OF ANXIETY TOWARDS GERD INCIDENCE IN

MARANATHA CHRISTIAN UNIVERSITY MEDICAL STUDENTS

YEAR 2014

Priscilia Agatha, 2017. Perceptor I : Harry Tribowo Hadi, dr., Sp.KJ

Perceptor II : Stella Tinia Hasianna, dr., M.Kes, IBCLC

Gastroesophageal reflux disease (GERD) is one of the most common disorder in

gastrointestinal tract. GERD could give impacts that will lower a patient’s quality

of life. There are several risk factors that will increase GERD incidence, including

psychological factor. This study was meant to investigate how far psychological

condition, such as anxiety disorder play a role in increasing GERD incidence.

The objective of this study was to the determine the association between GERD

and anxiety disorder in Maranatha Christian University medical students year

2014.

The method of this study was an analytic observastional research with a cross

sectional model, analyzed with chi square test. This study examined data collected

from all Maranatha Christian University medical students year 2014 (160 people).

Data were collected in two questionairres. GERD-Q was used to determine GERD

diagnosis and ZSAS questionairres was used to determine anxiety disorder.

On this study, it was found that 41 subjects of study were afflicted by GERD.

Anxiety disorder also found to be related to GERD incidence (p=0,008;

OR=3,269).

The conclusion of this study, is that anxiety disorder were associated to GERD

incidence in Maranatha Christian University medical students year 2014.

Keywords: anxiety, GERD

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DAFTAR ISI

Halaman

LEMBAR PERSETUJUAN .................................................................................. ii

SURAT PERNYATAAN ..................................................................................... iii

ABSTRAK ........................................................................................................... iv

ABSTRACT ............................................................................................................. v

KATA PENGANTAR .......................................................................................... vi

DAFTAR ISI ...................................................................................................... viii

DAFTAR TABEL ................................................................................................ xi

DAFTAR GAMBAR .......................................................................................... xii

DAFTAR LAMPIRAN ....................................................................................... xii

BAB I PENDAHULUAN

1.1 Latar Belakang .................................................................................................. 1

1.2 Identifikasi Masalah .......................................................................................... 3

1.3 Maksud dan Tujuan ........................................................................................... 4

1.4 Manfaat Karya Tulis Ilmiah .............................................................................. 4

1.5 Kerangka Pemikiran ........................................................................................... 4

1.6 Hipotesis Penelitian............................................................................................5

BAB II TINJAUAN PUSTAKA

2.1 Anatomi Oesophagus dan Gaster ...................................................................... 6

2.2 Histologi Oesophagus dan Gaster ..................................................................... 8

2.3 Fisiologi Sekresi Asam Lambung ................................................................... 12

2.4 Gastroesophageal reflux disease (GERD) ....................................................... 16

2.4.1 Definisi GERD ...................................................................................... 16

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2.4.2 Epidemiologi GERD ............................................................................. 17

2.4.3 Patofisiologi GERD .............................................................................. 18

2.4.4 GERD-Q ............................................................................................... 20

2.5 Gangguan Kecemasan ............................................................................ 21

2.5.1 Definisi Gangguan Kecemasan ............................................................ 21

2.5.2 Epidemiologi Gangguan Kecemasan ................................................... 21

2.5.3 Patofisiologi Gangguan Kecemasan .................................................... 22

2.5.4 Klasifikasi Ganguan Kecemasan ......................................................... 25

2.5.5 Hubungan Stres/Kecemasan Dengan Patofisiologi GERD ................. 27

2.5.6 Kuesioner ZSAS .................................................................................. 29

BAB III BAHAN DAN METODE PENELITIAN

3.1 Alat dan Bahan ................................................................................................ 31

3.2 Lokasi dan Waktu Penelitian .......................................................................... 31

3.3 Subjek Penelitian ......................................................................................... 31

3.3.1 Kriteria Subjek Penelitian ........................................................................31

3.3.1.1 Kriteria Inklusi ............................................................................... 31

3.3.1.2 Kriteria Eksklusi............................................................................. 32

3.4 Besar Sampel .................................................................................................... 32

3.5 Rancangan Penelitian ....................................................................................... 32

3.5.1 Desain Penelitian .................................................................................. 32

3.5.2 Variabel Penelitian ................................................................................ 32

3.5.3 Definisi Operasional ............................................................................. 33

3.6 Prosedur Penelitian........................................................................................... 33

3.7 Analisis Data .................................................................................................... 34

3.8 Hipotesis Penelitian..........................................................................................34

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3.9 Aspek Etika Penelitian ..................................................................................... 35

BAB IV HASIL DAN PEMBAHASAN

4.1 Karakteristik Subjek Penelitian ....................................................................... 36

4.2 Hubungan Tingkat Kecemasan Terhadap Kejadian GERD ............................ 37

4.3 Uji Hipotesis Penelitian....................................................................................38

BAB IV SIMPULAN DAN SARAN

5.1 Simpulan ......................................................................................................... 40

5.2 Saran ................................................................................................................ 40

DAFTAR PUSTAKA ............................................................................................ 41

LAMPIRAN ........................................................................................................... 45

RIWAYAT HIDUP ................................................................................................ 56

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DAFTAR TABEL

Tabel Halaman

4.1 Karakteristik Subjek Penelitian ...................................................................... 36

4.2 Hubungan Tingkat Kecemasan dan GERD .................................................... 37

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DAFTAR GAMBAR

Gambar Halaman

2.1 Gaster ............................................................................................................... 7

2.2 Pendarahan Gaster ............................................................................................ 8

2.3 Histologi Oesophagus .................................................................................... 10

2.4 Histologi Gastrointestinal Secara Umum ......................................................... 11

2.5 Sel-sel di Dalam Gaster .................................................................................. 12

2.6 Mekanisme Sekresi Asam Lambung .............................................................. 14

2.7 Mekanisme Pertahanan Asam Lambung ........................................................ 16

2.8 Patofisiologi GERD ....................................................................................... 20

2.9 Gejala Kecemasan dengan Regio Otak dan Sirkuit yang Mengaturnya ........ 22

2.10 Regulasi Perasaan Takut Pada Amygdala .................................................... 23

2.11 Gejala Kecemasan dan Neurotransmitter yang Berperan ............................ 24

2.12 Regulasi Perasaan Khawatir Oleh Sirkuit CSTC ......................................... 24

2.13 Respon Stres dan Aksis HPA ....................................................................... 28

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DAFTAR LAMPIRAN

Lampiran Halaman

1. Ethical Approval ................................................................................................ 45

2. Kuesioner ........................................................................................................... 46

3. Karakteristik Subjek Penelitian .......................................................................... 49

4. Pengisian kuesioner ............................................................................................ 54

5. Hasil SPSS Hubungan Kecemasan dengan GERD .......................................... 55

Universitas Kristen Maranatha