Tingkat Depresi Pada Pasien

8/17/2019 Tingkat Depresi Pada Pasien

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TINGKAT DEPRESI PADA PASIEN-PASIENKANKER SERVIKS UTERI DI RSUPHAM DANRSUPM DENGAN MENGGUNAKAN SKALA BECKDEPRESSION INVENTORY-II

T E S I S

OLEH:

DUDY ALDIANSYAH

DEPARTEMEN OBSTETRI DAN GINEKOLOGIFAKULTAS KEDOKTERANUNIVERSITAS SUMATERA UTARARSUP. H. ADAM MALIK â€“ RSU. Dr. PIRNGADIMEDANMARET 200D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34

PENELITIAN INI DI BA5AH BIMBINGAN TIM-6

P78%78%'* : Dr. N&9&r!""%' &;;&r1 SOG


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D%&?!+&' !',!+ 7$'*+&% ,!*&(-,!*&( "&' 77'!)%(&$&) (&,! (#&r&, !',!+ 7'@&&% +&)$%&' "&$&7

8%"&'* O8(,,r% "&' G%'+$*%

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34ABSTRAK

T!?!&' P'$%,%&' : U',!+ 7'*,&)!% ,%'*+&, "r(% &"& &(%'-&(%'+&'+r (r/%+( !,r% 8&%+ r&>&, %'& 7&!!' r&>&, ?&$&'.

R&'@&'*&' P'$,%&' : Br(%;&, "(+r%,%; &'&$%,%+ "'*&' "%(&%' ,'*$%',&'*.S&7$ &"&$&) &(%'-&(%' +&'+r (r/%+( !,r%1 8&%+ r&>&, %'& 7&!!'r&>&,?&$&'1 "% RSUP. H. A"&7 M&$%+ "&' RSU. Dr. P%r'*&"% M"&'1 (?&+ N/78r200 (&7&% F8r!&r% 200. D&,&-"&,& "%+!7!$+&' "'*&' 7'*%(% +!%(%'r#&'* "%(r,&% $) S+&$& B@+ Dr((%' I'/',r#-II. D&,&-"&,& ,r(8!,"%(&?%+&' "&$&7 8',!+ ,&8$-,&8$ "%(,r%8!(% ;r+!'(%. A'&$%(& (,&,%(,%+7'**!'&+&' P&r(' 21 "'*&' 77&+&% SPSS /r. 6 &+,! "%&*'(& "%,*&++&' (?&+ ,&)!'1 (r,& "!+!'*&' !',!+8r8&, $) &'&+ "&' (!&7%


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USU -R(%,r# 34

KATA PENGANTAR

S*&$& P!?% "&' S#!+!r (& &'?&,+&' + )&"%r&, A$$&) S5T Y&'* M&)&P'*&(%) L&*% M&)& P'#&'*1 T!)&' Y&'* M&)& K!&(&1 8r+&, R%")& "&'

K&r!'%&-N#& '!$%(&' ,(%( %'% "&&, "%($(&%+&'.

T(%( %'% "%(!(!' !',!+ 7$'*+&% ,!*&(-,!*&( "&' 77'!)% (&$&) (&,!(#&r&,!',!+ 77r$) +&)$%&' "&$&7 8%"&'* O8(,,r% "&' G%'+$*%. S8&*&%7&'!(%& 8%&(&1 (& 7'#&"&r% 8&)>& ,(%( %'% 8&'#&+ ++!r&'*&''#& "&'7&(%) ?&!) "&r% (7!r'&1 '&7!' "7%+%&' 8(&r )&r&&' (& +%r&'#& ,!$%(&'("r)&'& %'% "&&, 8r7&';&&, "&$&7 7'&78&) r8'"&)&r&&' 8&@&&'+)!(!('#& ,',&'* :

â€ T%'*+&, Dr(% &"& P&(%'-P&(%' K&'+r Sr/%+( U,r% "% RSUPHAM"&' RSUPM "'*&' M'**!'&+&' S+&$& B@+ Dr((%' I'/',r#-IIâ€

D'*&' ($(&%'#& $&r&' '$%,%&' %'%1 r+'&'+&'$&) (& 7'#&7&%+&'r&(& ,r%7& +&(%) "&' '*)&r*&&' #&'* (,%'**%-,%'**%'#& +&"& #&'*,r)r7&, :

. R+,r U'%/r(%,&( S!7&,r& U,&r& "&' D+&' F&+!$,&( K"+,r&'U'%/r(%,&( S!7&,r& U,&r&1 #&'* ,$&) 778r%+&' +(7&,&' +&"&(& !',!+ 7'*%+!,% Pr*r&7 P'"%"%+&' D+,r S(%&$%( "% F&+!$,&(K"+,r&' USU M"&'.2. Pr;. Dr. D$;% L!,&'1 MS@1 SOG


4/60

($(&%.. Pr;. Dr. D$;% L!,&'1 M(@1 SOG &+,! "&' %+%r&'!',!+ 778%78%'* (& "&$&7 '#$(&%&' !?% (,&,%(,%+ ,(%( %'%.0. S$!r!) S,&; P'*&?&r "% D&r,7' O8(,,r% "&' G%'+$*% FK-USUM"&'1 #&'* (@&r& $&'*(!'* ,$&) 8&'#&+ 778%78%'* "&' 7'"%"%+ (&(?&+ &>&$ )%'**& &+)%r '"%"%+&'.. D%r+,!r RSUP H. A"&7 M&$%+ M"&' #&'* ,$&) 778r%+&' +(7&,&'

"&' (&r&'& !',!+ 8+r?& (&7& ($&7& 7'*%+!,% '"%"%+&' "% D&r,7'O8(,,r% "&' G%'+$*%.2. D%r+,!r RSU Dr. P%r'*&"% M"&' "&' K&$& SMF O8(,,r% "&' G%'+$*%RSU Dr. P%r'*&"% M"&' #&'* ,$&) 778r%+&' +(7&,&' "&' (&r&'&!',!+ 8+r?& ($&7& 7'*%+!,% '"%"%+&' "% D&r,7' O8(,,r% "&'G%'+$*%.. D%r+,!r RS. PTPN II T78&+&! D$%1 Dr. S;%&' A8"!$ I$&)1 SOG1 "&'Dr.N&9&r!""%' &;;&r1 SOG &'1 Dr. Err$ H&79&)1 ,r%7& +&(%) 8&'#&+&,&( 8&',!&'1 +r?&(&7&1 "&' +8r(&7&&' +%,& ($&7& %'%.. Dr. M. R%9+% Y&9'%$1 Dr. M&" S!r#& K!7&r&1 Dr. R%9+& Hr%&'(#&)1 Dr.Ir>&'(#&) P!,r&1 Dr. I(7&%$ U(7&'1 "&' Dr. A$% A+8&r1 ,r%7& +&(%) #&'*(8(&r-8(&r &,&( 8&',!&''#& "&$&7 7'#$(&%+&' ,(%( %'%.. Dr. U?&'* R%">&' Pr7&'&1 Dr. E+& P!r'&7& D>% R.1 Dr. H! L(,&r%H&r#'1 Dr. A8"!$ H&"%1 Dr. !'% H&r"% T&r%*&'1 Dr. A"r%&' S,%&>&'1 Dr.E"%)&'1 Dr. M%r&'"& D%9&1 Dr. R&@)7& B&@),%&r P&'?&%,&'1 Dr. T77#1 Dr.P&'!,!r% G,,$%8 S%"&8!,&r1 Dr. T.M. R%9+%1 Dr. M!&r& P. L!8%(1 Dr. )'N&$' T&78!'&'1 Dr. S%7' P. S&%'*1 Dr. M!$"& F. S%,!7r&'*1 Dr.D&/%" L!,)r L!8%(1 Dr. T. ;;r# A8"%$$&)1 Dr. R%9& H'"r&>&' N&(!,%'1"&'Dr. E$/%r& M!,%& S!'*+&r1 Dr. H'"r# A"% S#&)!,r&1 Dr. T%*r P. H&(!*%&'"&' ,7&'-,7&' $&%' #&'* ,%"&+ "&&, (& (8!,+&' (&,! r (&,!1 ,r%7&


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+&(%) &,&( +8r(&7&&'1 8&',!&'1 "&' "!+!'*&''#& ($&7& %'%.20. T7&' S?&>&,1 A(%(,' A)$%1 D+,r M!"&1 B%"&'1 P&r&7"%(1+&r#&>&'+&r#&>&,%1 "&' &(%'-&(%' #&'* ,$&) %+!, 778&',! "&'8+r?&(&7& "'*&' (& "&$&7 7'?&$&'% '"%"%+&' "% D&r,7'O8(,,r% "&' G%'+$*% FK-USURSUP H. A"&7 M&$%+ - RSU Dr. P%r'*&"%M"&'. Tr%7& +&(%) &,&( +r?&(&7& "&' (&$%'* '*r,%&' ($&7& %'%.

S78&) (!?!"1 )r7&, "&' ,r%7& +&(%) #&'* ,%"&+ ,r)%'**& (& (&7&%+&'+&"& +"!& Or&'* T!& S& #&'* ,r+&(%)1 Dr. H. M. Y&7%' M&)7!"1 SM"&' H?. H&;%9&)1 #&'* ,$&) 778(&r+&'1 778%78%'*1 7'"&+&'1 (r,&7'"%"%+ (& "'*&' '!) +&(%) (&'* "&r% 7&(& +&'&+-+&'&+ )%'**& +%'%.

K&"& #&'* (& )r7&,% "&' (&'*%1 B&&+ "&' I8! Mr,!& (&1 Pr;. H.Dr.D&r!$+!,'% N&(!,%'1 SS


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D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200

USU -R(%,r# 34

DAFTAR ISI

H&$&7&'KATAPENGANTAR ....................................................................................... %DAFTARISI .................................................................................................. /%%DAFTARTABEL ............................................................................................. DAFTARSINGKATAN ....................................................................................%DAFTARLAMPIRAN ..................................................................................... %%ABSTRAK ......................................................................................................%%%

BAB IPENDAHULUAN..............................................................................................A. LATARBELAKANG ..............................................................................B. IDENTIFIKASIMASALAH.....................................................................6C. KERANGKAMASALAH........................................................................6D. TUUANPENELITIAN..........................................................................E. MANFAAT

PENELITIAN.......................................................................F. KERANGKAKONSEP ..........................................................................

BAB IITINAUANPUSTAKA .....................................................................................A. GANGGUANMOOD.............................................................................


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B.DEPRESI .............................................................................................0. L&,&rB$&+&'* ...............................................................................0

2.P&,;%(%$*% .....................................................................................Fr+!'(%......................................................................................... Mr,&$%,&( "&'Mr8%"%,&(................................................................26. R&(1 S+( "&'U7!r ......................................................................2. G?&$&

K$%'%(.....................................................................................M&'&?7'......................................................................................P(%+;&r7&+&............................................................................D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34... S$@,%/ Sr,'%' R!,&+ I')%8%,r(


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D. KANKER SERVIKSUTERI ..................................................................2.P'*r,%&' ......................................................................................22.

E,%$*%............................................................................................2.Fr+!'(%........................................................................................2. G?&$& "&'T&'"& ...........................................................................26.S,&"%!7 ..........................................................................................2.D%&*'(%(..................................................................

.......................P'*8&,&' ....................................................................................2

BAB IIIMETODOLOGIPENELITIAN..........................................................................A. RANCANGANPENELITIAN ................................................................B. TEMPAT

PENELITIAN.........................................................................C. 5AKTUPENELITIAN ..........................................................................D. POPULASI DAN SAMPELPENELITIAN .............................................. P!$&(%P'$%,%&' .........................................................................2. S&7$P'$%,%&'...........................................................................

. Kr%,r%&P'r%7&&'........................................................................D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34E. ETIKAPENELITIAN.............................................................................F. BATASANOPERASIONAL..................................................................G. INSTRUMENPENELITIAN..................................................................


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H. PENGOLAHANDATA........................................................................... P7r%+(&&'D&,& ..........................................................................

2. P78r%&'K".............................................................................. T+'%+ A'&$%(%(D&,& .......................................................................

BAB IVHASIL DANPEMBAHASAN...........................................................................0. K&r&+,r%(,%+ S&7$P'$%,%&' ......................................................0

2. T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%............. S8&r&' U7!r "'*&' T%'*+&,Dr(% .......................................... S8&r&' T%'*+&, P'"%"%+&' "'*&' T%'*+&, Dr(%....................6. S8&r&' S,&,!( Pr+&>%'&' "'*&' T%'*+&, Dr(% ..................... S8&r&' S!+! "'*&' T%'*+&,Dr(% ..........................................60. S8&r&' P'"&&,&' Pr B!$&' "'*&' T%'*+&, Dr(% ..............62. S8&r&' S,&"%!7 "'*&' T%'*+&,Dr(% .....................................6. S8&r&' Tr&% "'*&' T%'*+&,Dr(% ........................................60. S8&r&' L&7&'#& 5&+,! D%&*'(& D%,*&++&' "'*&' T%'*+&,

Dr(% ............................................................................................ S8&r&' D!+!'*&' U',!+ Br8&, "'*&' T%'*+&, Dr(% ..........

BAB VKESIMPULAN DANSARAN...........................................................................A.KESIMPULAN......................................................................................B.

SARAN.................................................................................................

DAFTARPUSTAKA........................................................................................

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34


10/60

DAFTAR TABEL

H&$&7&'T&8$ K&r&+,r%(,%+ S&7$P'$%,%&' ...............................................0

T&8$ 2 T%'*+&, Dr(% &"& P&(%'-P&(%' K&'+r Sr/%+( U,r% .....T&8$ S8&r&' U7!r "'*&' T%'*+&,Dr(%...................................T&8$ S8&r&' T%'*+&, P'"%"%+&' "'*&' T%'*+&, Dr(% .............T&8$ 6 S8&r&' S,&,!( Pr+&>%'&' "'*&' T%'*+&, Dr(% .............T&8$ S8&r&' S!+! "'*&' T%'*+&,Dr(% ...................................60T&8$ S8&r&' P'"&&,&' Pr B!$&' "'*&' T%'*+&, Dr(% .......62T&8$ S8&r&' S,&"%!7 "'*&' T%'*+&,Dr(% ..............................6T&8$ . S8&r&' Tr&% "'*&' T%'*+&,Dr(% .................................6T&8$ .2 S8&r&' B$!7 D%,r&% "&' S!"&) D%,r&% "'*&' T%'*+&,

Dr(% ....................................................................................6T&8$ 0 S8&r&' L&7&'#& 5&+,! D%&*'(& D%,*&++&' "'*&' T%'*+&,

Dr(% ....................................................................................T&8$ S8&r&' D!+!'*&' U',!+ Br8&, "'*&' T%'*+&, Dr(% ...


USU -R(%,r# 34DAFTAR LAMPIRAN

H&$&7&'L&7%r&' I LEMBARAN INFORMASIPASIEN......................................2L&7%r&' II LEMBAR PERSETUUAN UNTUK MENGIKUTIPENELITIAN SETELAH PENELASAN SECARA LISAN ...L&7%r&' III B@+ Dr((%' I'/',r#-II...............................................6L&7%r&' IV PERSETUUAN KOMITE ETIK TENTANGPELAKSANAAN PENELITIAN BIDANG KESEHATAN .......L&7%r&' V TABEL

INDUK .....................................................................2


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L&7%r&' VI KETERANGAN TABELINDUK ..........................................6


DAFTAR SINGKATAN

6-HT 6-H#"r#,r%,&7%'BDI B@+ Dr((%' I'/',r#DA D&7%'DNA D#r%8'!@$%@ A@%"DSM-IV D%&*'(,%@ &'" S,&,%(,%@&$ M&'!&$ ; M',&$ D%(r"r( â€“IVDSM-IV-TR D%&*'(,%@ &'" S,&,%(,%@&$ M&'!&$ ; M',&$ D%(r"r(-IV-T,R/%(%'ECT E$@,r@'/!$(%/ T)r&#FDA F" &'" Dr!* A"7%'%(,r&,%'

FIGO F4"4r&,%' I',r'&,%'&$ " G#'4@$*% , "O8(,4,r%Q!


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USU -R(%,r# 34

KETERANGAN TABEL INDUK

RM N7r R+&7 M"%+ P&(%'S,. P(' S,&,!( P&(%'1 R&>&, I'& &, &$&' S,&,!( Pr+&>%'&' P&(%'PB P'"&&,&' Pr B!$&' P&(%'S," S,&"%!7 K&'+r Sr/%+( U,r% P&(%'C& C K&'+r Sr/%+( U,r%T) '%( Tr&% &"& P&(%'L5D L&7& 5&+,! D%&*'(& D%,*&++&'PA H&(%$ P7r%+(&&' H%(,&,$*% &r%'*&' P&(%'SCC C SQ!&7!( C$$ C&r@%'7& Cr/%BDI II S+r B@+ Dr((%' I'/',r# IIDR Dr(% R%'*&'DS Dr(% S"&'*DB Dr(% Br&,A(&$ RS R!7&) S&+%, "%7&'& ,7&, &(%' "%r&>&,RSHAM R!7&) S&+%, U7!7 P!(&, H&?% A"&7 M&$%+ M"&'RSPM R!7&) S&+%, U7!7 Dr. P%r'*&"% M"&'


BAB IPENDAHULUAN

A. LATAR BELAKANG

K&'+r (r/%+( !,r% 7r!&+&' +&'+r +"!& #&'* &$%'* 8&'#&+ ,r?&"% &"&>&'%,& "% '*&r&-'*&r& 8r+78&'*. M'!r!, $&r&' 5r$" C&'@r 2001 0+&'+r (r/%+( !,r% ,r?&"% "% '*&r&-'*&r& 8r+78&'*. 12P&"& +8&'#&+&' >&'%,& #&'* "%"%&*'(%( "'*&' +&'+r *%'+$*% &+&'7'%78!$+&' (,r(( 7(%'&$ #&'* $!&r 8%&(&. E7(%-7(% #&'* "&&,"%,%78!$+&'1 ,r7&(!+ :. Dr(% +&r'& +,%"&+&(,%&' )%"! "&' +r&*!&' 7'*'&% 7&(& "&'.2. K@7&(&'.. K8%'*!'*&'.


13/60

. K7&r&)&' +&r'& +)%$&'*&' ;!'*(% rr"!+(% "&' $!&'* !',!+77!'#&% +,!r!'&'.6. Pr&(&&' 8r(&$&)1 +&r'& &+,%/%,&( (+(!&$ ,r"&)!$! #&'* "&&,7'#8&8+&' +&'+r. Pr&(&&' 8r(&$&) "&&, 8r@&7!r "'*&'++)&>&,%r&' 7'*'&% &+,%/%,&( (+(!&$ "% 7&(& "&' #&'* &+&',r*&'**! (,$&) '*8&,&' +&'+r.

A7r%@&' C&'@r S@%,# ,$&) 7'*%"',%;%+&(% 7&, ;&+,r #&'* "&&,77'*&r!)% +!&$%,&( )%"! &(%'-&(%' "'*&' +&'+r "&' +$!&r*&'#&1#&%,! ;&+,r ((%&$1 (%+$*%(1 ;%(%+1 "&' (%r%,!&$.D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34D%&*'(%( "&' '*8&,&' +&'+r "&&, 7'*&+%8&,+&' *&'**!&' +!&$%,&()%"! ,r7&(!+ ;%(%+1 (%+$*% "&' +$&'*(!'*&' ((%&$. A(+ (%+((%&$7$%!,% r!8&)&' $& )%"!1 +,&+!,&'1 (r,& +,%"&+'#&7&'&'(%+((%&$.K,%"&+'#&7&'&' (%+((%&$ ,r7&(!+ +@7&(&'1 +7&r&)&'1 r&(&&'8r(&$&)1 "&' "r(%. H&$-)&$ ,r(8!, "&&, 7',& "&' 8r!8&) (%r%'*>&+,! ,r*&',!'* "&r% ,%'*+&, +&r&)&' '#&+%,.6

S$&%' 7&(&$&) (%+((%&$1 r((% 7'*'&% &"&'#& )!8!'*&' &',&r& '#r%#&'* )8&, "'*&' '#&+%, +&'+r "&' &'**&&' 8&)>& +&'+r &"&$&)'#&+%, #&'* ,%"&+ "&&, "%(78!)+&'1 (r,& 778!,!)+&' 8%& #&'* 8(&r7r!&+&' (!&,! 7&(&$&) &"& +!&$%,&( )%"!.H&'#& ("%+%, '$%,%&' 7'*'&% +!&$%,&( )%"! &"& &(%' +&'+r. H&$%'%7'*&+%8&,+&' "r(% &"& &(%'-&(%' +&'+r 7&(%) (r%'* ,%"&+,r"%&*'(%( "&' ,%"&+ 7'"&&, '&'*&'&' #&'* (r%!(1 +&r'& &"&'#&&'**&&' 8&)>& "r(% 7r!&+&' (!&,! +&"&&' #&'* 'r7&$1 #&'*7r!&+&' (!&,! r&+(% !'%/r(&$ ,r)&"& '#&+%,-'#&+%, (r%!( "&'(8&*%&' r&+(% ,r(8!, ,%78!$ "&$&7 8',!+ ,&'"&-,&'"& '!r/*,&,%;&,% 7&(&-7&(& (!$%,'#&.01B8r&& '$%,% ,$&) 7$&r+&' &"&'#& r&+(% 7(%'&$ ((%;%+,r)&"&+&'+r *%'+$*%1 "&' ,$&) 7'7!+&' 8&)>& (,r(( (%+$*%( 7r!&+&'7&(&$&) #&'* (r%'* "%?!7&%. Dr*&,%( "++


14/60

r(%+ #&'* (&'*&, ,%'**% !',!+ ,r?&"%'#& "r(%. S,&,!( '&7%$&' #&'*8!r!+ ?!*& 8r)!8!'*&' "'*&' ,%'**%'#& "r(% "&' &'(%,&( &"& &(%'"'*&' +&'+r.12S+%,&r 26 &(%' +&'+r #&'* "%r&>&, %'&1 77!'#&% *?&$& "r(% #&'*77'!)% +r%,r%& "r(% 7r &,&! *&'**!&' 8r!& 7" "r(%.P'$%,%&' (8$!7'#& ?!*& 7'7!+&' 8&)>& 7" "r(% &$%'* (r%'*

7'**&78&r+&' +(!$%,&' (%+((%&$1 )&$ %'% "%$&r+&' &"& >&'%,&"'*&' +&'+r *%'+$*% &"& (&&, "%&*'(%( "%,*&++&' "&' ($&7&D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34r&>&,&'. S8&*&% ,&78&)&'1 "r(% "&&, 77r8r&, '#&+%, '#r,&"&' 7'%78!$+&' %" "&' !(&)& 8!'!) "%r%.1P&(%'-&(%' +&'+r (r/%+( !,r% (r%'* 7r&(&+&' '#r% #&'* 8r!$&'*8&%++r'%( &,&! &+!,1 7&(&$&) (+(!&$1 +$$&)&'1 r&(&&' 8r(&$&) +&r'&7'!'"& (+r%'%'* &,&! '*8&,&'1 r!8&)&' '&7%$&' ;%(%+1 "r(%1+(!$%,&' ,%"!r1 "&' 88&' ,r)&"& +!&'*&' "&' 7788&'% r&'* #&'*7r+& @%',&%.6

5&$&!!' "7%+%&'1 ,%"&+ (7!& &(%' +&'+r 7'*&$&7% '#r%. N#r% 7!'@!$&"& (+%,&r 26 &(%' #&'* 8&r! "%"%&*'(%(1 &(%' #&'* 7'?&$&'%'*8&,&'1 "&' 26 &(%' "'*&' '#&+%, #&'* (!"&) $&'?!,.M'*'&% $&7&'#& "r(% (?&+ "%&*'(%( +&'+r "%,*&++&'1 &r& '$%,%77!'#&% '"&&, #&'* 8r8"&. M&1 !' 1 "++ & '#r% "&' (,r(( (%+$*% 8r(%;&, 7',&. Br8"& "'*&' M&((%"++1 &$ "%&*'(%(. K$ M &&(%'+&'+r *%'+$*% 77!'#&% 7(% #&'* (,&8%$ "% "&$&7 r',&'* (&7&% 28!$&' (,$&) r&>&,&'.1M%r&'"& "++


15/60

Dr. P%r'*&"% M"&' "'*&' 7'**!'&+&' +!(%'r S+&$& B@+ Dr((%'I'/',r#-II.

C. KERANGKA MASALAH

P&"& ,&)!'-,&)!' 8$&+&'*&' %'%1 +!&$%,&( )%"! r&'* #&'* 7'"r%,& +&'+r

,$&) 7'"&&, r)&,%&' +)!(!(. S"%+%, (+&$% '$%,%&' #&'* 7'$%,%+&%,&'"r(% "'*&' '#&+%, +*&'&(&'. D&' ,%'*+&, &,&! (,&"%!7 +*&'&(&' ,%"&+D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 348r8&'"%'* $!r!( "'*&' ,%'*+&, "r(%. S?!7$&) '$%,%&' %"7%$*%,$&)"%$&+!+&' !',!+ 7'#$%"%+% +&%,&'-+&%,&' #&'* 7!'*+%'. B8r&& '$%,%&',$&) 7'!'?!++&' 8!+,% '%'*+&,&' %'(%"'( +&'+r &"& &(%'-&(%' #&'*"r(%1 "&' 88r&& 7'!'?!++&' )!8!'*&' ,r(8!,. B!+,%-8!+,% ,r(8!,(!$%, "%?$&(+&'1 +&r'& 8r7&@&7-7&@&7'#& (+&$&-(+&$& (%+7,r%+ #&'*"%*!'&+&' !',!+ 7'%$&% "r(%.16

D. TUUAN PENELITIAN

T!?!&' '$%,%&' %'% &"&$&) !',!+ 7'*,&)!% ,%'*+&, "r(% &"& &(%'-&(%' +&'+r (r/%+( !,r% #&'* "%r&>&, "% RSUP H. A"&7 M&$%+ "&' RSU Dr.P%r'*&"% M"&' 8&%+ &(%' r&>&, %'& 7&!!' r&>&, ?&$&'.

E. MANFAAT PENELITIAN

. D%"&&,+&' "&,& 7'*'&% ,%'*+&, "r(% &"& &(%'-&(%' +&'+r(r/%+(!,r% #&'* "%r&>&, "% RSUP H. A"&7 M&$%+ "&' RSUD Dr. P%r'*&"% M"&'8&%+ &(%' r&>&, %'& 7&!!' r&>&, ?&$&'.

2. Pr$!'#& '%'*+&,&' +!&$%,&( )%"! &"& &(%'-&(%' #&'* 7'"r%,&'#&+%, +*&'&(&' ,r!,&7& &"& &(%'-&(%' +&'+r (r/%+( !,r% !',!+7'*&,&(% "r(%. D&' r$!'#& '&'*&'&' (%+%&,r% &"& &(%'-&(%'"'*&' *?&$& "r(% 8r&,.

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34F. KERANGKA KONSEP


16/60

P&(%'-&(%'"'*&'K&'+r Sr/%+( U,r%

S+&$& B@+ Dr((%'I'/',r#-II

T%'*+&, Dr(%-R%'*&'-S"&'*-Br&,

T%'*+&, Dr(%-R%'*&'-S"&'*-Br&,

D%+$7++&' "&$&7 :- U7!r P&(%'- T%'*+&, P'"%"%+&'- S,&,!( Pr+&>%'&'- S!+!- P'"&&,&' r 8!$&'- S,&"%!7- Tr&%

- L&7&'#& "%&*'(%( "%,*&++&'- D!+!'*&' !',!+ 8r8&,D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34BAB IITINAUAN PUSTAKA

A. GANGGUAN MOOD

G&'**!&' M" ,r7&(!+ *&'**!&' "'*&' *&78&r&' !,&7& 8r!& +$&%'&'&"& 7". G&'**!&' 7" "%8&*% &,&( ,%*& 8&*%&'. Y&'* r,&7&7'**&78&r+&' E%(" M"


17/60

&,= E%(" Dr(% Mr.D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34G&'**!&' Dr(% Mr "%@%r%+&' (8&*&% (&,! &,&! $8%) E%(" Dr(%Mr #&+'%1 ("%+%,'#& 2 7%'**! "%?!7&% 7" "r(% &,&! +)%$&'*&'

+('&'*&' "&' "%(r,&% ("%+%,'#& 7&, *?&$& ,&78&)&' "r(%.G&'**!&' D%(,%7%& "%@%r%+&' ("%+%,'#& ($&7& 2 ,&)!' "%?!7&% 7" "r(%($&7& $8%) "&r% 8r)&r%-)&r% #&'* "%(r,&% "'*&' *?&$& "r(% ,&78&)&'(r,& ,%"&+ 77'!)% +r%,r%& !',!+ E%(" Dr(% Mr.G&'**!&' Dr(% Y&'* T%"&+ Tr+$&(%;%+&(%+&' &"&$&) #&'* ,r7&(!+*&'**!&'-*&'**!&' #&'* 7r!&+&' *&78&r&' "r(% #&'* ,%"&+ 77'!)%+r%,r%& !',!+ G&'**!&' Dr(% Mr1 G&'**!&' D%(,%7%&1 G&'**!&'P'#(!&%&' "'*&' M" Dr(%1 &,&! G&'**!&' P'#(!&%&' "'*&'K@7&(&' C&7!r&' "&' M" Dr(% &,&'. P&r&7"%( ()&r!('#&77r,%78&'*+&' &"&'#& "r(% &"& &(%'-&(%' #&'* 7r+& +$$&.D%"!*& &"&'#& r/&$'(% #&'* ,%'**% &"& *&'**!&' &;+,%; &"& &(%' #&'*"&,&'* + r&+,+-r&+,+ +$%'%+.20


2. P&,;%(%$*%


18/60

P&,;%(%$*% G&'**!&' Dr(% Mr

D% A7r%+& Sr%+&,1 r/&$'(% MDD (+%,&r 20 &"& >&'%,& "&' 2 &"&$&+%-

$&+%. P&"& &(%' #&'* "%8(r/&(% !',!+ r&>&,&' 7"%( "%"&&,+&'r/&$'(%'#& (+%,&r 0. 20. Mr,&$%,&( "&' Mr8%"%,&(

I" 8!'!) "%r%1 '#&+%, 7"%(1 *&'**!&' )!8!'*&' %',rr('&$1'#&$&)*!'&&' 9&,-9&, ,r$&r&'*1 "&' +)%$&'*&' >&+,! 8+r?& 7'%'*+&,+&'7r,&$%,&( "&' 7r8%"%,&( MDD.20B!'!) "%r% 7r!&+&' '#8&8 +7&,%&' !,&7& "% A7r%+& Sr%+&,1 "'*&'&'*+& r&,&-r&,& (+%,&r 200.000 !(&)& 8!'!) "%r%. B!'!) "%r% 7'?&"%'#8&8+7&,%&' +"!& &"& r&'* ">&(& "&' "%r+%r&+&' 0-0 +7&,%&' ,r?&"%&"& !(%& 20-6 ,&)!'. MDD 77!'#&% r&'&' ',%'* &"& $8%) "&r% 60!(&)& 8!'!) "%r%. A'*+& +7&,%&' 8!'!) "%r% &"& *&'**!&' &;+,%; "&&,

7$8%)% 6. S$&%' %" 8!'!) "%r%1 "r(% ?!*& "&&, 7'#8&8+&'*&'**!&'%',rr('&$1 7%(&$'#& '!r!'&' $%8%"1 *&'**!&' 8r+'(',r&(%1 *&'**!&'"&$&7 +r?&&'1 "&' *&'**!&' ;!'*(%'&$ $&%''#&. P'$%,%&' ?!*&7'!'?!++&'8&)>& MDD 7'&78&) 7r,&$%,&( "&' 7r8%"%,&( #&'* ,%'**% &"& '#&+%,7"%( $&%'1 (r,% %';&r+ 7%+&r"1 "&' +8r)&(%$&' '*8&,&' %(""r(%77r8&%+% $!&r&' 7"%( "&' 78"&)&'.20

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 346. R&(1 S+( "&' U7!r


19/60

Dr(% ?&r&'* "%?!7&% &"& !$&(% +!$%, )%,&7. MDD $8%) (r%'*"%"%&*'(%(&"& >&'%,&1 "'*&' r/&$'(% "!& +&$% $%&, "%8&'"%'*+&' r%&. D%?!7&%r/&$'(% #&'* (&7& &',&r& $&+%-$&+% "&' r7!&' &"& !(%& r!8r,&(.G?&$& "r(% (@&r& +$%'%( 7'%'*+&, (%r%'* "'*&' 7'%'*+&,'#& !(%&1

+)!(!('#& 8%$& "%(r,&% "'*&' '#&+%, 7"%(. B&*&%7&'&!' ?!*&1 "r(%"&&, ,%"&+ 77'!)% +r%,r%& !',!+ "r(% 7r +&r'& +&"&'*-+&"&'*"%?!7&% *&78&r&' "r(% #&'* &,%%+&$ &"& &(%' #&'* $8%) ,!&.20

. G?&$& K$%'%(

Kr%,r%& "%&*'(,%+ DSM-IV-TR


20/60

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34(%+;&r7&+& "&' (%+,r&% 778r%+&' $!&r&' '*8&,&' #&'* $8%) 8&%+.U',!+ *?&$& "r(% 8r&, #&'* ,%"&+ r('( "'*&' (%+;&r7&+& 7&!!'(%+,r&% "&&, "%,r&% "'*&' $+,r+'/!$(%;.20

. P(%+;&r7&+&

A',%"r(&' "&$&7 2- 7%'**! &+&' 7'@&&% "(%( ,r&!,%+ #&'*"%8!,!)+&' !',!+ 7'%$&% r('( +$%'%(. P%$%)&' 7"%+&(% ()&r!('#&77r,%78&'*+&' +($&7&,&' "&' ,$r&'(% 8&,1 +&,!)&' &(%'1+8%&(&&' "+,r1 "&' r%>&, '*8&,&' (8$!7'#&. K*&*&$&' '*8&,&'(r%'* "%(8&8+&' $) +,%"&+&,!)&' "&$&7 7&+&%&' 8&,1 "!r&(% ,r&%#&'* ,%"&+ &"+!&,1 &,&! "(%( #&'* ,%"&+ &"+!&,.20

... S$@,%/ Sr,'%' R!,&+ I')%8%,r


21/60

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34..2. A',%"r(&' Tr%(%+$%+


22/60

7'*&',!+1 +'(,%&(%1 '&!(&1 "%&r&1 +$$&)&'1 7!$!, +r%'*1 !(%'*1,+&'&'"&r&) r'"&)1 '!r!'&' !r%' !,!,1 '!r!'&' ;!'*(% (+(!&$1 *&'**!&'$&,%"!r1 ++?&'*&' ,,1 '&78&)&' 8r&, 8&"&'1 &"&'*&' +&8!r1 (&+%,+&$&1

'%'*+&,&' ($r& 7&+&'1 r&(&&' ,%"&+ 8%(& 8r%(,%r&)&,1 ,r7r1+$7&)&'1"&' 8r+r%'*&, 8&'#&+.2

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34.2. P(%+,r&%

P(%+,r&% 7r!&+&' 8',!+ '*8&,&' #&'* "%r+7'"&(%+&' r,&7& +&$%!',!+ "r(%. S$&7& (%+,r&%1 ((r&'* #&'* 7'"r%,& "r(%8r8%@&r&&"& &)$% (%+,r&% &*&r 778&',! '"r%,& !',!+ 7'*%"',%;%+&(%

;&+,r-;&+,r #&'* 77%@! "r(%. B8r&& ;&+,r %'% 8+r?& (@&r& +78%'&(%"'*&' ;&+,r )r"%,r "&' +,%"&+(%78&'*&' +%7%& "% "&$&7 ,&+ #&'*"&&,77%@! "r(%. P(%+,r&% 778&',! &(%' "r(%1 "'*&' 77&)&7%,%'*+&) $&+!1 7(%1 "&' %" #&'* 8rr&' &"& +&"&&' "r(%'#&. D'*&'77&)&7% "&' 7'*%"',%;%+&(% 7&(&$&)-7&(&$&) &,&! r%(,%>& "&$&7 )%"!#&'* 8rr&' "% "&$&7 "r(% '"r%,& "&' 778&',! '"r%,& 77&)&7%&(+-&(+ "&r% 7&(&$&) %'% ()%'**& 7r+& "&&, 7'#$(&%+&' "&'77r8&%+%'#&.22

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34.2. T%-,% P(%+,r&%

Tr&% "&&, "%8r%+&' "&$&7 8',!+ #&'* 8r/&r%&(%1 ,r7&(!+ :22

I'"%/%"!&$K$7+

M&r%,&$ P&(&'*&'


23/60

K$!&r*&

::

:

:Tr&% %'% 7$%8&,+&' )&'#& &(%' "&' &)$% ,r&%Tr&% %'% 7$%8&,+&' "!& &,&! $8%) &(%' #&'*"&&, 8r&r,%(%&(% &"& >&+,! #&'* (&7&.

P&(%' "&&, 778&*% '*&$&7&' "&' 8$&?&r"'*&' r&'* $&%' #&'* 77!'#&% r&(&&'"&' '*&$&7&' #&'* (&7& "'*&''#&.Tr&% %'% 8r*!'& !',!+ 778&',! &(&'*&'"&' &r,'r &*&r $8%) 77&)&7% 7'*&&r&'* #&'* 7r+& @%',&% 7'*&$&7% "r(%1r!8&)&' && #&'* "%$&+!+&' "&$&7 +7!'%+&(%"&' ,%'*+&) $&+! #&'* "&&, 778&',!'"r%,&.K$!&r*& 7r!&+&' ;&+,r +!'@% !',!+778&',! '"r%,& #&'* 7'*&$&7% "r(%&*&r 7'?&"% $8%) 8&%+1 )&$ %'% "&&, 778&',!&'**,& +$!&r*& !',!+ 7'*r,% && #&'*

"%&$&7% $) r&'* #&'* 7r+& @%',&%1 "&' &&(8&%+'#& #&'* &'**,&-&'**,& +$!&r*&$&+!+&' !',!+ 778&',! '"r%,&.

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34.2.2. P'"+&,&' Tr&%

5&$&!!' ,r&% "&&, "%$&+!+&' "&$&7 8',!+ +$!&r*&1 +$7+1 "&'%'"%/%"!&$ ?!*& &"& 88r&& '"+&,&' #&'* "%$&+!+&' $) &)$%(%+,r&%.S,$&) 8r8%@&r& "'*&' &(%' ,',&'* r%)&$ "r(%'#&1 &)$%

(%+,r&%&+&' 77!,!(+&' '"+&,&' 7&'& #&'* "%*!'&+&' 8r"&(&r+&' +@!r%*&&'&"& ;&+,r-;&+,r #&'* 7'#8&8+&' "r(%.22

.2.2.. Tr&% P(%+"%'&7%+

Tr&% (%+"%'&7%+ 8r"&(&r+&' &(!7(% 8&)>& r&'* #&'* 7'*&$&7% "r(%"%(8&8+&' +&r'& +';$%+ #&'* ,%"&+ ,r@&)+&' #&'* (r%'* 7!'@!$ &"&7&(& +&'&+-+&'&+. T!?!&' "&r% ,r&% %'% &"&$&) &*&r &(%' 7'*r,% $8%)8&%+"'*&' 778%@&r&+&' '*&$&7&' 7r+&. Tr&% (%+"%'&7%+ "%8r%+&'($&7& ,%*& (&7&% 7&, 8!$&' &,&! 8r,&)!'-,&)!'.22

.2.2.2. Tr&% I',rr('&$


24/60

Tr&% %',rr('&$ 77;+!(+&' &"& ,%'*+&) $&+! "&' %',r&+(% (r&'*'"r%,& "r(% "'*&' +$!&r*& "&' ,7&''#&. T!?!&' !,&7& "&r% ,r&%%'%&"&$&) 77r8&%+% +,r&7%$&' +7!'%+&(% "&' 7'%'*+&,+&' +r@&&'"%r% ($&7& r%" #&'* (%'*+&,. Tr&% ($&$! 8r$&'*(!'* ($&7& ,%*&(&7&%

7&, 8!$&' "&' 8r)&(%$ "'*&' 8&%+ !',!+ "r(% #&'* "%(8&8+&' $)D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34"!+&@%,&1 +';$%+ "&$&7 )!8!'*&' %',rr('&$1 r%(,%>& )%"! #&'* 8(&r1"&'%($&(% ((%&$.22.2.2.. Tr&% T%'*+&) L&+! K*'%,%;

Tr&% ,%'*+&) $&+! +*'%,%; 778&',! '"r%,& "r(% !',!+7'*%'"',%;%+&(%"&' 7r!8&) r((% #&'* ,%"&+ &+!r&, #&'* ,r"&&, &"& "%r% 7r+& "&'"%

(+$%$%'* 7r+&. A)$% ,r&% 778&',! &(%' !',!+ 7'*&++&' @&r& 8&r!!',!+ 8r%+%r "'*&' 7'*&r&)+&' r)&,%&' &"& &(!7(% 8&%+ #&'* (&$&)7&!!' #&'* 8'&r1 #&'* 7r+& 8!&, &"& "%r% 7r+& ('"%r% &,&! r&'*$&%'.22

.. Tr&% E$+,r+'/!$(%; &(%.K($!r!)&' r("!r 77&+&' >&+,! (+%,&r 0 7'%,. ECT ($&$! "%8r%+&'"!& &,&! ,%*& +&$% r 7%'**!. K8&'#&+&' &(%' 778!,!)+&' (&7&% 2+&$% '*8&,&'1 ,,&% &"& 88r&& &(%' 778!,!)+&' r("!r ECT #&'*$8%) 8&'#&+.2

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34C. BECK DEPRESSION INVENTORY


25/60

!',!+ 7'*%"',%;%+&(% r'#&,&&' #&'* &$%'* 8&%+ #&'* 7'**&78&r+&'r&(&&''#& â€ (&&, %'%â€ . I,7-%,7 +7!"%&' "%,',!+&' (+r'#& "&' "%?!7$&)+&'!',!+ 77r$) ,,&$ (+r. T,&$ (+r %'% &+&' 7'**&78&r+&' ,%'*+&,+&r&)&' *?&$& "r(%. P&"& ,&)!' 1 BDI +7!"%&' "%r/%(% 7'?&"%BDI-

IA1 r/%(% %'% "%$&+!+&' !',!+ 7'*)%$&'*+&' r'#&,&&'-r'#&,&&' #&'*7%r%(r,& !',!+ 7'#!(!' +78&$% +&,&-+&,& &"& %,7 ,r,',!. S8&*&%,&78&)&'18&,&(&' >&+,! !',!+ '%$&%&' "%r&'?&'* (&7&% â€ (7%'**! #&'* $&$!1,r7&(!+ )&r% %'%â€ . P&"& ,&)!' 1 &'"!&' !',!+ 7'',!+&' (+rD!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34"%7"%;%+&(%1 *!'&'#& !',!+ 7'**&78&r+&' "&,&-"&,& #&'* "%+!7!$+&' &"&C',r ;r C*'%,%/ T)r&#. 2P&"& ,&)!' 1 (8!&) BDI /r(% 8&r! &+,! !',!+ '%$&%&'"%r&'?&'* (&7&% â€ "!& 7%'**! #&'* $&$!1 ,r7&(!+ )&r% %'%.â€ 2 5&$&!!' "&,&-"&,& (%+7,r%+ #&'* &"& &"& BDI-II (r,%'#& (&'*&,7'?&'?%+&' "'*&' ?&'*+& >&+,! "%r&'?&'* (&7&% "!& 7%'**! #&'* $&$!1,&% 778!&, %'(,r!7' %'% +!r&'* 8r7&';&&, !',!+ 7'%$&% $& r!8&)&'*?&$& "r(% (&'?&'* >&+,!.2

2. D(+r%(%BDI-IA 7'*&'"!'* 2 %,7 #&'* 7&(%'*-7&(%'* (r% ,r"%r% "&r% 7&,r'#&,&&'. Pr'#&,&&'-r'#&,&&' 7'**&78&r+&' +&r&)&' *?&$& "r(%"&r% #&'* r%'*&' & BDI "&&, 778"&+&' &(%'-&(%' (%+%&,r%+ "'*&' (!8?+ +',r$ #&'* (@&r& (%+$*% ()&,1 "'*&'&(%'-&(%' "%(,%7%&1 (r,& "'*&' &(%'-&(%' *&'**!&' "r(% 7r.B@+1 "++ &$&!!' (+r r&,&-r&,& $8%),%'**%&"& +$7+ *&'**!&' "r(% 7r. S)%'**& &"& (&7$-(&7$


26/60

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27/60

%,7 +)%$&'*&' ($r& 7&+&'1 "%r/%(% !',!+ 7'%$&% '%'*+&,&' 7&!!''!r!'&' $& ,%"!r "&' ($r& 7&+&'. K,%*& %,7 ,r(8!, "%r/%(%1 )&'#&%,7#&'* 8r+&%,&' "'*&' r&(&&' 7r&(& "%)!+!71 %+%r&' 8!'!) "%r%1 "&'7%'&,,r)&"& (+( #&'* ,,& "%r,&)&'+&'. A+)%r'#&1 (!8#+ "%,&'#&+&'

8&*&%7&'& r&(&&' 7r+& ($&7& "!& 7%'**! ,r&+)%r %'%. 8r8"& "'*&'BDI &($% #&'* 7'&'#&+&' )&'#& (&,! 7%'**! ,r&+)%r (&?&. Sr,% BDI1 BDI-II?!*& 7'*&'"!'* 2 r'#&,&&'1 7&(%'*-7&(%'* ?&>&8&' "%8!&, (+r "&r% 0 +. @!,;; #&'* "%*!'&+&' 8r8"& "&r% #&'* &($%. M&+%' ,%'**% ,,&$ (+r7'*%'"%+&(%+&' 7&+%' 8r&, *?&$& "r(%.2

D. KANKER SERVIKS UTERI

. P'*r,%&'L)r r&)%7 &,&! (r/%+( !,r% &"&$&) (r,%*& 8&*%&' 8&>&) !,r!(.B',!+'#&(@&r& +&(&r &"&$&) (%$%'"r%(1 8r)!8!'*&' "'*&' /&*%'& 7$&$!% (8!&)

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34r%;%@%!7 #&'* "%(8!, +(,r'&$ (. K&'+r (r/%+( !,r% "&&, 8r&(&$"&r%r7!+&&' /&*%'& &,&! "% "&$&7 +&'&$%( (r/%+&$%(.2S$ +&'+r (r/%+( !,r% &"& &>&$'#& 8r&(&$ "&r% ($ %,$ (r/%+( #&'*7'*&$&7% 7!,&(% *',%+ ()%'**& 7'*!8&) r%$&+!'#&. S$ #&'* 8r7!,&(%%'% 7$&+!+&' 78$&)&' ($ #&'* ,%"&+ ,r+'"&$% "&' 7'*%'/&(% ?&r%'*&'(,r7& "%8&>&)'#&. K&"&&' %'% 7'#8&8+&' 7!,&(% *',%+ #&'* ,%"&+ "&&,"%r8&%+% &+&' 7'#8&8+&' ,r?&"%'#& r,!78!)&' +&'+r.2

2. E,%$*%

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28/60

Pr"&r&)&' r/&*%'&7 #&'* &8'r7&$ 7r!&+&' *?&$& #&'* &$%'* (r%'*"%?!7&%1 7'&'"&+&' &"&'#& +&'+r (r/%+( !,r% #&'* %'/&(%;. 5&'%,& #&'*(+(!&$ &+,%;1 )&$ %'% ,r7&(!+ r"&r&)&' &(+& +%,!(1 "%?!7&%r"&r&)&'%',r7'(,r!&$ &,&! &(@& 7'&!(. T!7r #&'* 8(&r (r%'* ,r%';+(%1"&'

"'*&' &"&'#& /&*%'&$ "%(@)&r* #&'* 8r8&!1 "&&, ,r?&"% (8$!7 '(,r"&r&)&'. P&"& +&(!(-+&(!( "'*&' (,&"%!7 $&'?!,1 '#r% &"& $/%(1*?&$&'+&'&' ,r)&"& +&'"!'* +7%)1 !r,r "&' !(!(1 "&' +&"&'*-+&"&'* "&&,+$!&r !r%' "&' ;@( "&r% /&*%'&.P'$%,%&' &"& &(%' #&'* "%"%&*'(%( +&'+r (r/%+( !,r% "%C&$%;r'%&S$&,&'1 $) Pr,r%!( "++. &) '*&r!) &'(,(%& !7!7. P'',!&' (,&"%!7 +&'+rD!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34(r/%+( !,r% 7'!r!, FIGO 7&(%) 8r"&(&r+&' 7r%+(&&' +$%'%( r&r&,%;"%,&78&) "'*&' ;, ,r&+( "&' (%(,(+% (r,& r+,(+%.2S,&"%!7 K&'+r Sr/%+( U,r% M'!r!, FIGO S,&"%!7 0 K&r(%'7& %' (%,!1 +&r(%'7& %',r&%,$%&$. K&(!(-+&(!( S,&"%!7

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29/60

S,&"%!7 II8 K,r$%8&,&' &r&7,r%!7.D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34S,&"%!7 III K&r(%'7& ,$&) 7$!&( (&7&% + "%'"%'* $/%(J &"&7r%+(&&'

r+,!71 ,%"&+ &"& "&r&) #&'* 88&( +&'+r &',&r& ,!7r "&' "%'"%'*$/%(J ,!7r 7$%8&,+&' 8&*%&' 8&>&) /&*%'&J (7!& +&(!( "'*&')%"r';r(%( "&' *&'**!&' ;!'*(% *%'?&$1 +@!&$% "%+,&)!% +&r'&'#8&8 $&%'.S,&"%!7 III& T%"&+ &"& r$!&(&' + "%'"%'* $/%(1 ,&% +,r$%8&,&' 8&*%&'8&>&) /&*%'&.S,&"%!7 III8 Pr$!&(&' + "%'"%'* $/%( &,&! )%"r';r(%( &,&! *&'**!&';!'*(%*%'?&$.S,&"%!7 IV K&r(%'7& ,$&) 7$!&( 7$>&,% $/%( &,&! (@&r& +$%'%( ,$&)7$%8&,+&' 7!+(& +&'"!'* +7%) &,&! r+,!7.S,&"%!7 IV& M,&(,&( "&' r,!78!)&' &"& r*&'-r*&' ,r"+&,..

S,&"%!7 IV8 M,&(,&( ?&!).

S,&"%!7 K&'+r Sr/%+( U,r% M'!r!, FIGO 2000 2S,&"%!7 0 K&r(%'7& %' (%,!1 +&r(%'7& %',r&%,$%&$S,&"%!7 I K&r(%'7& 7&(%) ,r8&,&( "% (r/%+(


30/60

?&r%'*&' 8%(%. P&"& "&(&r'#& 8%$& "%?!7&% $(% (r,% +&'+r (@&r&+&(&,7&,& )&r!( "%$&+!+&' 8%(% >&$&!!' )&(%$ 7r%+(&&' & (7&r 7&(%)"&$&7 8&,&( 'r7&$. S7',&r& %,!1 8%(% $(% #&'* ,%"&+ +&(&, 7&,&"%$&+!+&'"'*&' 8&',!&' +$(+%. K@!r%*&&' &"&'#& $(% #&'* ,%"&+ +&(&, 7&,&

"%"&(&r+&' "&r% )&(%$ 7r%+(&&' (%,$*% (r/%+( &, ?&$&'. Pr"&r&)&' #&'* ,r?&"% "&&, "%&,&(%"'*&' '+&'&' &,&! 7'%'**&$+&' ,&7' /&*%'&. L+&(% 8%(% (8&%+'#&"&&, "%&78%$ "&r% ?&r%'*&' #&'* 7&(%) ()&, "&' )%'"&r% 8%(% ?&r%'*&''+r(%(D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200

USU -R(%,r# 34&"& $(% #&'* 8(&r. B%$& )&(%$ 8%(% "%@!r%*&% &"&'#& 7%+r%'/&(%1"%$&'?!,+&'"'*&' +'%(&(%. K'%(&(% "&&, "%$&+!+&' "'*&' %(&!


31/60

K7,r&% 8r8&(%(+&' @%($&,%' "%+78%'&(%+&' "'*&' r&"%&(% &"&&(%'-&(%' "'*&' +&'+r (r/%+( !,r% (,&"%!7 $&'?!, 7r!&+&''*8&,&' (,&'"&r.0â€ S,&"%!7 IV8 "&' +&'+r #&'* r+!r'(S$&7& 8r,&)!'-,&)!' &(%' "%8r%+&' "'*&' +7,r&%. A*' ,!'**&$@%($&,%' 7r!&+&' '*8&,&' (,&'"&r. B&r!-8&r! %'%1 +78%'&(%

'**!'&&' @%($&,%' "&' ,@,&' 7'!'?!++&' r8&%+&' +,&)&'&')%"! (@&r& (%*'%;%+&' "%8&'"%'*+&' &*' ,!'**&$ @%($&,%'. R&"%&(%&$%&,%;(r%'* "%*!'&+&' (@&r& %'"%/%"!&$ !',!+ 7'*',r$ r"&r&)&'1 '#r%$/%(1 &,&! 8(,r!+(% !r%' &,&! 8(,r!+(% !(!(.0D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34BAB IIIMETODOLOGI PENELITIAN

A. RANCANGAN PENELITANP'$%,%&' %'% 7r!&+&' '$%,%&' "(+r%,%; &'&$%,%+ "'*&' "%(&%'

,'*$%',&'*.

B. TEMPAT PENELITIANP'$%,%&' "%$&+!+&' "% RSUP H. A"&7 M&$%+ M"&' "&' RSU Dr. P%r'*&"%M"&'.

C. 5AKTU PENELITIANB!$&' N/78r 200 (&7&% ($!r!) (&7$ ,r'!)%.

D. POPULASI DAN SAMPEL PENELITIAN. P!$&(% P'$%,%&'S7!& P&(%' #&'* "%"%&*'(%( "'*&' K&'+r Sr/%+( U,r% (@&r&

)%(,&,$*%( (r,& (7!& (,&"%!7 #&'* "%+$$& $) RSUP H. A"&7M&$%+ M"&' "&' RSU Dr. P%r'*&"% M"&'.

2. S&7$ P'$%,%&'S8&*%&' &(%' #&'* "%"%&*'(%( "'*&' K&'+r Sr/%+( U,r% (@&r&)%(,&,$*%( (r,& (7!& (,&"%!7 #&'* "%+$$& $) RSUP H. A"&7D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34M&$%+ M"&' "&' RSU Dr. P%r'*&"% M"&'1 "'*&' 8(&r (&7$ ,!'**&$!',!+ (,%7&(% rr(% (!&,! !$&(% 7'**!'&+&' +,&,&' &8($!,1"'*&' 77r,%78&'*+&' : - Prr(% '#&+%, &,&! +&"&&' #&'* &+&' "%@&r%1 P &) "&r% ,&8$ #&'* 8(&r'#& ,r*&',!'* &"& '%$&%WX #&'* "%,',!+&' J !',!+ '%$&% WX 0106 â[\ WX 1P Prr(% "r(% &"& '"r%,& K&'+r Sr/%+( U,r%1 216Q - : -0126 016" +,&,&' '$%,%&'


32/60

&8&' #&'*"%8r%+&'.. P'$%,%1 '*$$& "&,& &,&! (%&&!' #&'* ,r$%8&, "&$&7 '$%,%&'

%'%>&?%8 7r&)&(%&+&' (,%& ?&>&8&' #&'* "%8r%+&' r('"'.. S,%& r('"' ,%"&+ "%+'&+&' 8%&.

F. BATASAN OPERASIONAL&. U7!r : $&7&'#& )%"! (?&+ $&)%r #&'* "%'#&,&+&' "&$&7 (&,!&' ,&)!'.D%+$7++&' "&$&7 +&,*r%1 #&%,! :â€ U7!r 0 ,&)!'â€ U7!r 0-0 ,&)!'â€ U7!r 0 ,&)!'

8. P'"%"%+&' : ?'?&'* '*&?&r&' #&'* ,$&) "%%+!,% &,&! ("&'* "%?&$&'%r('"' 7$&$!% '"%"%+&' ;r7&$.

D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34P'"%"%+&' "%8&*% &,&( :â€ T%"&+ (+$&)â€ SD %'&' %'&' : ?&'"&1 @r&% "&',%"&+ +&>%'=.

". S!+! : (!+! &"& &(%' "%&78%$ "&r% *&r%( (!+! &)


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D!"# A$"%&'(#&) : T%'*+&, Dr(% P&"& P&(%'-P&(%' K&'+r Sr/%+( U,r%D% RSUPHAM D&' RSUPM D'*&'â€1 200USU -R(%,r# 34(,&"%!7'#& +&r'& ,$&) "%$&+!+&' r&(% )%(,r+,7%1 "%*$'*+&' (,&"%!7#&'* ,%"&+ ,r+$&(%;%+&(%+&'.

*. Tr&% : (&7$ "%+$7++&' "&r% #&'* 8$!7 "%,r&% &,&! (!"&)"%,r&% :+'%(&(%1 r&"%+&$ )%(,r+,7%1 +7,r&%1 r&"%&(%1 r&"%+&$ )%(,r+,7%"'*&' +7,r&%1 r&"%+&$ )%(,r+,7% "'*&' r&"%&(%1 +7,r&% "'*&'r&"%&(%1 r&"%+&$ )%(,r+,7%1 +7,r&% "&' r&"%&(%1 "&' &$%&,%;.

). L&7&'#& >&+,! (?&+ "%&*'(%( "%,*&++&'1 "%";%'%(%+&' (8&*&% >&+,!"&r%(?&+ "%$&+!+&' '',!&' (,&"%!7 $) (!r/%(r (!8 "&r,7''+$*%-*%'+$*%1 "%8&*% &,&( :â€ ,&)!'â€ -2 ,&)!'â€ -6 ,&)!'

â€ 6 ,&)!'

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G. INSTRUMEN PENELITIAND&,& !',!+ '$%,%&' %'% "%+!7!$+&' "'*&' 7'**!'&+&' +!%(%'r B@+Dr((%' I'/',r# II


34/60

A'&$%(%( "%$&+!+&' "'*&' 7'**!'&+&' !?% (,&,%(,%+ 21 "'*&'+7&+'&&' 61 "&' "'*&' 77&+&% &$&, 8&',! SPSS &, 8&%+"%!'%, r&>&, %'& 7&!!' r&>&, ?&$&' "% RSUP H. A"&7 M&$%+ M"&' "&' RSU Dr.P%r'*&"% M"&'. P'$%,%&' 8r$&'*(!'* "&r% 8!$&' N/78r 200 (&7&%"'*&' 8!$&' F8r!&r% 200. P'#&?%&' )&(%$-)&(%$ '$%,%&' "&$&7 8',!+,&8$-,&8$ "%(,r%8!(% ;r+!'(%.

. K&r&+,r%(,%+ S&7$ P'$%,%&'


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K&r&+,r%(,%+ R('"' !7$&) U7!r 0 ,&)!' 1

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D$$. 10 R. 600 r%8! 221R.600 r%8! (" R. ?!,& 62 1P'"&&,&' PrB!$&'R. ?!,& 100 1I& 0 0I&2 0 0I8 61I82 1II& 2 21II8 21

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S!&7%]K$!&r*& 0 0Or&'* ,!&]K$!&r*& 0 0A'&+]S!&7%]Or&'* ,!& 1A'&+]S!&7%]K$!&r*& 0 0D!+!'*&'U',!+Br8&,Y&A'&+]S!&7%]Or&'* ,!& ]K$!&r*& 0 0

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54/60

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55/60

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