The 5th International Conference on Public Health 2024
Teuku Umar University, 25th-26th September 2024
ISSN: 2714-7045
Training for Rehabilitation Workers to Restore the Independence of Instrumental ADL in People With Mental Disorders Wiwik Widiyawati, 2Ervi Suminar, 3Firman Firdauz Saputra Ilmu Keperawatan.
Universitas Muhammadiyah Gresik.
Indonesia Fakultas Kesehatan Masyarakat.
Universitas Teuku Umar.
Indonesia Corresponding author: Wiwik Widiyawati, e-mail: wiwikwidiyawati@umg.
Abstract Many people with severe mental disorders (PWMI) have lost both basic and instrumental activity daily living (ADL) functions even though they have completed the rehabilitation process at the hospital, this is due to the lack of optimal variation of skills in vocational social rehabilitation in hospitals that have a significant impact in restoring PWMI instrumental ADL and being able to restore economic independence.
The purpose of this study is to analyze the success of skills training for rehabilitation personnel in order to restore the independence of instrumental ADL of PWMI.
The research method was carried out with a quasi-experiment design.
The research was conducted in the rehabilitation room of Menur Mental Hospital in July - August 2024.
The study population was rehabilitation personnel in the vocational The measuring instrument used a questionnaire containing indicators of training success in accordance with the material provided, namely about hydroponics.
The analysis was conducted using paired T test.
The results of the analysis that has been carried out show that the training provided shows that the training provided succeeds in improving the ability of rehabilitation workers related to ecoprint batik and hydroponics where the results of the paired T test analysis show p .
< .
The mean increase in scores before and after training was 26 points with a standard deviation of 20.
It is important to periodically evaluate, monitor and refresh the skills of rehabilitation officers to ensure that the outcomes of vocational workshops at Menur Mental Hospital are always optimal from the results of the and hydroponic training so that it is hoped that the knowledge provided by rehabilitation officers is always maintained and has maximum outcomes, namely the creation of independence of instrumental ADL for PWMI and the creation of economic independence which has an impact on reducing relapse rates.
Keywords: Activity Daily Living.
Mental Illnes.
Training.
Vocational Workshop Introduction One of the most important components of human life.
The Latin proverb says AuMens Sana In Corpore SanoAy which means that in a healthy body there is a strong soul.
The Latin proverb states that body and soul health are 2 important things that are mutually sustainable.
These two components will be the main point in carrying out daily activities.
(Devita Sari et al.
, 2.
The prevalence rate of mental disorders in Indonesia has an increasing trend from year to year.
According to the results of Riskesdas in 2018, the prevalence rate of schizophrenia cases in Indonesia reached 7 cases per mile.
The prevalence rate of schizophrenia cases in 2018 was much higher than in 2013, where in This article is licensed under CC BY- SA 4.
0 License The 5th International Conference on Public Health 2024
ISSN: 2714-7045
that year the prevalence rate of schizophrenia was 1.
7 cases per mile (Ministry of Health, 2.
Cases of mental disorders undergoing treatment at Menur Surabaya Mental Hospital (RSJ) also experienced an increasing trend of cases where in 2022 there were 3092 cases which then increased to 4349 cases in 2023.
People with mental disorders (PWMI) is a condition characterized by changes in body functions related to psychology where there is self-deterioration and loss of motivation related to responsibility followed by the loss of social skills both Basic Activity Daily Living (ADL) and Instrumental ADL.
(Hakim, 2.
The loss of ADL ability has an impact on the loss of daily productivity, including the loss of work ability, resulting in the inability of PMI to live independently.
In addition, loss of economic function can also be a factor in the onset of post-rehabilitation relapse in PWMI.
(David et al.
, 2.
Although they have participated in rehabilitation activities in the hospital, there are still quite a lot of PWMI who do not have good ADL skills, especially Instrimental ADL.
This is due to the fact that rehabilitation in mental hospitals in Indonesia has not been integrated and only focuses on medical treatment so that it does not have more attention to vocational social rehabilitation (Puspitasari, 2.
This has an impact on vocational social rehabilitation outcomes that cannot be optimally achieved.
Rehabilitation activities are still not in accordance with the vocational social rehabilitation continuum established by the Ministry of Health.
The lack of optimal rehabilitation in PWMI leads to the lack of post-rehabilitation skills possessed by PWMI, this has an impact on less than optimal labor market acceptance (Pedoman Pelayanan Kesehatan Jiwa, 2.
Menur Surabaya Mental Hospital as one of the hospitals that organizes rehabilitation for PWMI including vocational rehabilitation has activity outcomes that are not yet optimal, this is due to the lack of optimal development of vocational rehabilitation (Widiyawati et al.
, 2.
The development of vocational social rehabilitation is still not considered optimal because the focus of the hospital is still on medical This is indicated by the limited supporting facilities and infrastructure related to vocational social rehabilitation activities, which has an impact on the implementation of less diverse training.
With these conditions, the team wanted to carry out vocational rehabilitation training on hydroponics for PWMI patients at Menur Surabaya Mental Hospital and measure the effectiveness of these activities.
Methods The research was conducted in the rehabilitation room of Menur Mental Hospital in July - August The study population was rehabilitation personnel in the vocational workshop.
The implementation of training activities was carried out in 2 stages of activity, namely session 1 related to theory and session 2 related to practice.
The theory session was divided into 2 meetings, while the practical session was divided into 5 meetings.
Evaluation related to the implementation of phase one training was carried out in 3 stages of evaluation, namely structure evaluation, process evaluation and outcome evaluation.
The structure evaluation The 5th International Conference on Public Health 2024
ISSN: 2714-7045
was carried out by measuring the preparation of the training implementation.
Process evaluation is carried out by measuring the level of enthusiasm of training participants and their active involvement in the implementation of activities.
The result evaluation is carried out by measuring the output of the implementation of training activities, namely the increase in participant knowledge by analyzing the results of the pretest and posttest using the Paired T test statistical test.
Results The implementation of phase I training was carried out from June 24 to July 4, 2024.
Before carrying out the activities, the PkM team ensured the completeness and readiness of the tools and materials to be used in the implementation of phase I training.
The implementation of Hydroponic training was guided by a hydroponic expert.
Mr.
Widodo.
Kom and assisted by the entire PkM team as well as students who were also involved in stage I training activities.
Before the training began, the PkM team distributed the Pretest questionnaire that had been prepared to all participants.
The pretest questionnaire was prepared in the form of a google form.
Completion of the pretest is carried out within 5 minutes and consists of 30 question items.
The implementation of phase I activities was carried out into 2 .
types of stages, namely theory and practice.
Theoretical activities were carried out in 2 meetings with the implementation time of each meeting for 60 minutes with material on the introduction of hydroponics, how to plant and optimize hydroponic plants in urban areas.
The practical implementation was carried out in 5 meetings where each meeting was held for 90 minutes.
The practical implementation includes the introduction of tools and materials to be used, up to the making of tools and the planting process.
Evaluation The implementation of phase I training begins with a structural evaluation, where the results of the structural evaluation that have been carried out show that the implementation has gone quite This is indicated by the well-executed activity preparation process including the preparation of tools and materials as well as coordinating with speakers and hospitals regarding the details of the implementation of activities to be carried out.
Evaluation of the process of implementing phase I training showed that the activities went well where the attendance of participants in theory and practice sessions reached 100% and all participants showed an active attitude in carrying out activities, especially in practice.
Tabel 1.
Results of Paired T Test Analysis of Pretest and Posttest of Hydroponic Training Hasil Test Mean Min Max Std.
Confidence Interval
of Difference Lower
Upper
Sig
Pretest
0,000
Posttest Evaluation of the training results showed that there was a significant difference in participants' knowledge between before and after the training .
000 < 0.
The mean score of the participants before the training was 65.
44 while after the training it increased to 90.
55 where there was a difference in the The 5th International Conference on Public Health 2024
ISSN: 2714-7045
mean score of 26.
00 with the difference ranging from -35.
21 to -16.
The results of the analysis show that the training provided excellent results/outcomes.
Discussion Hydroponics is a form of plant cultivation without the use of soil.
Hydroponics utilizes water as the main medium instead of soil.
Therefore, hydroponics is one of the plant cultivation techniques that is suitable for use in areas that have narrow land but want to apply the concept of plant cultivation.
Hydroponics is one of the plant cultivation techniques that can be implemented in narrow areas such as home yards, parking lots, and other land.
(Siregar & Novita, 2.
With these advantages, hydroponics can be one of the plant cultivation techniques that can be implemented in the hospital environment as a form of training in a series of vocational social rehabilitation activities.
Menur Surabaya Mental Hospital is an implementer of rehabilitation activities for PWMI which is located in an urban environment, this has an impact on the limited area / land owned for the implementation of vocational social rehabilitation.
Hydroponics is one of the techniques that can be used for the implementation of vocational social rehabilitation at Menur Surabaya Mental Hospital.
Activities in plant cultivation using hydroponic techniques have a myriad of benefits for PWMI Gardening activities can provide positive effects and as a stress reliever.
Being in contact with nature in a green space can stimulate positive sensory.
In addition, gardening activities can be one of the 'recreational' activities for PWMI patients which can have a happy effect.
Hydroponic training for PWMI in vocational social rehabilitation efforts is a form of training that is suitable and can be used to increase patient independence, this is in line with research conducted by M.
Aulia .
which states that hydroponic training is one type of vocational training suitable for PWMI patients during the rehabilitation process at the Hospital.
(Aulia, 2.
Similar results were also found in the service carried out by Murdhiono .
where hydroponics is one of the businesses that can be used by PWMI after the implementation of rehabilitation.
(Murdhiono et al.
, 2.
Conclusion The results of the effectiveness analysis that has been carried out can be said that hydroponic training activities are very effective for increasing the knowledge and skills of rehabilitation personnel and PWMI patients at Menur Surabaya Mental Hospital.
The results of the structure evaluation at each stage of the activity implementation went quite well.
The results of the process evaluation of all stages also ran quite optimally where the participant participation rate was> 80% and the participants also participated in the activities very Regarding the outcome evaluation, it shows that the training provided is related to the increase in knowledge and skills of the participants.
However, even though all evaluations of the implementation of activities show good results, it is necessary to conduct periodic evaluations of the implementation of training results for PWMI patients in the rehabilitation room so that the implementation of vocational rehabilitation The 5th International Conference on Public Health 2024
ISSN: 2714-7045
for patients runs optimally which will have an impact on increasing PWMI Instrumental ADL when returning to the community and becoming productive on the economic side and can be accepted back in the social order of society so that it will reduce the chance of relapse.
Acknowledgment The author and the Community Service Team would like to thank Menur Surabaya Mental Hospital for facilitating and supporting the implementation of activities so that it can run well.
In addition, we would also like to thank the training resource persons and all other parties who encourage the successful implementation of community service activities and are able to achieve the desired outcomes.
References