Psychoeducational Therapy Increase Self Efficacy in Patients with Pulmonary Tuberculosis Hapipah1.
Tedi Mahendra Efendi2.
Istianah3*.
Irwan Hadi4
1, 2, 3, 4
Nursing Departement.
Stikes Yarsi Mataram.
West Nusa Tenggara.
Indonesia Submited : 27 Ae 02 Ae 2023 .
Accepted : 21 Ae 04 - 2023 Doi : 10.
36858/jkds.
ABSTRACT
ABSTRAK
Pulmonary Tuberculosis is an infectious disease caused by the bacterium Mycobacterium tuberculosis.
Pulmonary TB can be cured with treatment carried out for 6-8 months.
To achieve healing, good self-efficacy is needed so that it will be motivated to complete the Increasing self-efficacy during the treatment period is important so that management of psychoeducational therapy is needed.
The purpose of this research is to determine the effect of psychoeducational therapy on self-efficacy in pulmonary TB patients in the work area of the Gerung Health Center.
This study uses a quantitative research type with the One Group Pre-Post Test Design approach.
The sample in this study were 16 The research instrument was the GFCSES (Guide For Constructing Self Efficacy Scal.
to measure selfefficacy in pulmonary TB patients.
Data analysis with Paired T Test.
The results showed a p-value of 0.
000 (<
, so it can be concluded that there is a significant effect between psychoeducational therapy on selfefficacy in pulmonary TB patients in the working area of the Gerung Public Health Center.
Based on the results of this study, it is necessary to include material related to psychological changes such as self-efficacy in pulmonary TB patients during the treatment process provided by health workers through education carried out in activities at the family integrated service post or health services.
Psychoeducational therapy can increase self-efficacy in pulmonary tuberculosis patients.
The results of this study can be applied as a program at the community health center to increase the cure rate and treatment success in pulmonary TB patients.
Tuberkulosis Paru merupakan penyakit menular disebabkan oleh bakteri Mycobacterium Tuberkulosis.
TB Paru bisa sembuh dengan pengobatan yang dilakukan selama 6-8 bulan.
Untuk mencapai kesembuhan diperlukan efikasi diri yang baik sehingga akan termotivasi untuk menuntaskan pengobatan.
Peningkatan efikasi diri selama masa pengobatan ini penting sehingga diperlukan penatalakasanaan terapi psikoedukasi.
mengetahui pengaruh terapi psikoedukasi terhadap self efficacy pada penderita TB Paru di wilayah kerja Puskesmas Gerung.
Penelitian ini menggunakan jenis penelitian kuantitaif dengan pendekatan One Group PrePost Test Design.
Sampel pada penelitian ini sebanyak 16 Instrumen penelitian ini adalah GFCSES (Guide For Constructing Self Efficacy Scal.
untuk mengukur self efficacy pada penderita TB Paru.
Analisis data dengan Uji Paired T Test.
Hasil penelitian menunjukkan p-value 0,000 (< 0,.
, sehingga dapat disimpulkan bahwa terdapat pengaruh yang signifikan antara terapi psikoedukasi terhadap self efficacy pada pasien TB Paru di wilayah kerja Puseksmas Gerung.
Berdasarkan hasil penelitian ini bahwa perlunya masukkan materi terkait perubahan psikologis seperti self efficacy pada penderita TB Paru selama peroses pengobatan yang diberikan oleh petugas kesehatan melalui edukasi yang dilakukan pada kegiatan-kegiatan di posyandu keluarga atau dipelayan Terapi psikoedukasi dapat meningkatkan self efficacy pada pasien tuberculosis paru.
Hasil penelitian ini dapat diaplikasikan sebagai salah satu program di puskesmas untuk meningkatkan angka kesembuhan dan keberhasilan pengobatan pada pasien TB Paru.
Keyword: Psychoeducational therapy, self efficacy, pulmonary TB Kata Kunci : Terapi psikoedukasi, self efficacy.
TB Paru *Correspondence author: savemeistya@gmail.
Jurnal Kesehatan dr.
Soebandi Vol.
No.
http://journal.
Publisher : LPPM Universitas dr.
Soebandi Jember How to Cite : Istianah, & hapipah.
Psychoeducational Therapy To Increase Self Efficacy In Patients With Pulmonary Tuberculosis.
Jurnal Kesehatan Dr.
Soebandi, 11.
, https://doi.
org/10.
36858/jkds.
Introduction:
Pulmonary Tuberculosis known as Pulmonary TB is caused by the bacterium Mycobacterium Tuberculosis (M.
Tuberculosi.
and is an infectious disease.
Pulmonary TB easily infects people with HIV AIDS, people with poor nutritional status and is affected by a person's immune system.
Pulmonary TB is contagious when positive smear positive pulmonary TB sufferers speak, sneeze or cough and indirectly the patient is through sputum splashes in the air and there are A 3000 sputum splashes containing bacteria (Kristini & Hamidah, 2.
According to the latest WHO global tuberculosis there has been a decrease in the incidence of pulmonary TB in 2020, decreasing from six countries in the East Asia and West Pacific region by 84%, in the African region a slow decline of 2.
The countries that contributed the most to the global downturn between 2019 and 2020 were India .
%).
Indonesia .
%), the Philippines .
%).
China .
%), and 12 other countries contributing 93% (WHO, 2.
The Indonesian Ministry of Health reported that there were 351,936 cases of tuberculosis (TB) found in Indonesia in 2020.
This number decreased by 38% from the previous year of 568,987 cases.
The majority of TB sufferers come from productive age, namely 17.
3% aged 4554 years, 16.
8% aged 25-34 years, 16.
7% aged 1524 years, 16.
3 aged 35-44 years.
TB sufferers aged 0-14 years or not yet entering productive age 3% and another 9% aged 65 years.
Based on gender, more men were infected, reaching 203,243 people, women reaching 148,693 people.
The Ministry of Health noted that the success rate for TB patient treatment has decreased since 2016.
The success rate for treating TB patients is 82.
7% in 2020, this rate has not yet reached the national target.
determined in the strategic planning of the Ministry of Health, namely 90% (Ministry of Health Republic of Indonesia, 2.
The total number of TB patients .
ll type.
in NTB Province in 2020 was reported to have reached 5,430 people.
The Case Notification Rate (CNR) in 2018 was 123 and increased in 2019 to 144 and decreased in 2020 to 106.
The proportion of pediatric TB patients among all TB patients for Jurnal Kesehatan dr.
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The mortality rate during TB treatment was 3.
90% in 2018, decreased to 3.
46% in 2019 and increased in 2020 to 3.
Meanwhile, the Cure Rate in 2019 34%, increasing to 93.
0% in 2020.
This shows that the government needs to improve health services for TB treatment (NTB Health Office, 2.
Gerung Health Center, in 2019 the number of new positive smear tuberculosis (CDR) patients was 65 cases.
The cure rate was 26 cases .
%), the treatment success rate was 39 cases .
%).
2020 there were 39 cases of TB sufferers, 19 people .
3%) male .
3%) female 22 people .
7%).
In 2021 there will be an increase in TB cases with a total of 48 cases, 20 men .
7%) and 28 women .
7%).
Patients in the treatment phase from December 2021 to May 2022 totaled 24 This shows that the Gerung Health Center needs more optimal management so that the cure rate for TB patients increases (Health Profile of the Gerung Health Center, 2.
Pulmonary Tuberculosis is an infectious disease caused by the bacterium Mycobacterium Tuberculosis which can cause more severe complications and even result in death if not treated immediately.
Pulmonary TB treatment is carried out in a period of 6-8 months, during treatment the patient will experience various complications such as physical and psychological Over a long period of time, pulmonary TB treatment can cause complaints of anxiety, boredom, feelings of helplessness, and others.
What can affect the patient's recovery, so far the programs carried out by the community health center have focused on physical complaints, not many programs have focused on the psychological For this reason, education is needed that focuses more on the problems experienced by pulmonary TB sufferers so that stressor coping is adaptive, namely through increasing self-efficacy, self-efficacy can be carried out in various ways, one of which is through psychoeducational To achieve recovery, patients must have high self-efficacy, low self-efficacy will result in treatment failure.
Self-efficacy is a cognitive process related to the level of individual confidence in doing something so that it influences motivation, thought processes, emotional conditions and the social environment that shows a specific behavior (Hasanah, et al.
One of the ways to achieve self-confidence of sufferers is through cognitive or care provided by health workers (Herawati, et al.
Self-efficacy is needed by people with pulmonary TB to increase independence in managing their disease so that it can lead to great trust and confidence.
In the treatment of pulmonary TB, the patient's selfconfidence is also very necessary to achieve recovery (Hanif, 2.
Therefore, pulmonary TB sufferers need self-efficacy in the treatment process to achieve optimal recovery rates (NTB Health Office, 2.
Psychoeducation is in the form of education or training for a person or group with psychiatry in the form of stress, anxiety, and selfdoubt which aims to process treatment and Psychoeducation can be provided one way through the lecture method and leaflets.
The material is delivered communicatively, using simple language, easy to understand according to Psychoeducation focuses on increasing selfacceptance and confidence in something that is being experienced (Bhakti & Kurniawan, 2.
Increasing self-efficacy through psychoeducation can be influenced by factors of one's own success experiences, the experiences of others, social (Kusumaningrum, 2.
Rita, et al, .
said that the use of psychoeducational methods can Changes related to certain problems in a relatively short time.
Self-efficacy is formed from a direct social learning process during the life of individuals with productive age who have more experience in overcoming all kinds of problems (Islami, 2.
Pulmonary TB sufferers with good self-efficacy will be motivated and strengthen themselves to take treatment.
Psychoeducation provides information and builds resilience in individuals which is useful for changing individual self-efficacy (Anggrawati, 2.
Research (Sitio, et al.
entitled the effect of psychoeducation-based health education Jurnal Kesehatan dr.
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Soebandi Jember on the self-efficacy of post-stroke patients.
The results of the hypothesis test showed that the pvalue = 0.
001 <0.
Another study (Anggraini, 2.
with the title Audio Visual Psychoeducation Based on Implementation Intention Against Intentions and Behavior Compliance with Taking Medication for Tuberculosis (TB) Patients.
The mean value of intention and medication adherence behavior in TB patients was obtained using the Mann Withney test with a Z value = -7.
359 with a p-value = 0.
000 <0.
Another study was conducted (Bangun, et al.
With the title The Effect of Psychoeducational Therapy on Self Care Activity in Patients with Diabetes Mellitus.
The results obtained after the administration of psychoeducational therapy were p-value = 0.
Based on a preliminary study conducted by researchers in the working area of the Gerung Health Center on January 20 2022 using interview techniques with 5 people with pulmonary TB, it was found that 4 out of 5 people said the lack of exposure to information was related to selfconfidence and increased effective coping during and complaints that are felt, for example drug side effects, anxiety and anxiety, the community health center program only focuses on counseling on signs and symptoms of TB, adherence to taking medication, & monitoring taking medication.
From the description above it appears that the increase in self-efficacy of pulmonary TB sufferers while undergoing treatment is not optimal so that researchers are interested in conducting a study entitled The Influence of Psychoeducational Therapy on selfefficacy in TB sufferers in the working area of the Gerung Health Center.
Methods:
The research design used in this study was the Pre Experiment using the One Group Pre-Post Test Design approach.
This design uses only one subject group without a control group.
Measurements were made before and after the intervention was given.
The pre-test in this study was a measure of self-efficacy before being given psychoeducational therapy and the post-test in this study was a measure of self-efficacy after being given psychoeducational therapy.
This research was conducted in the work area of the Gerung Public Health Center.
West Lombok with a sample of 16 people who were determined by purposive sampling technique.
The inclusion criteria in this study were pulmonary TB patients who had low self-efficacy scores of 10-20 or moderate 21-40 in the working area of the Gerung Health Center.
TB patients who were still on treatment, willing to be respondents, able to communicate well and aged 30-60 years .
The exclusion criteria were pulmonary TB sufferers who had hearing impairments, pulmonary TB sufferers who had communication disorders and TB sufferers who had high self-efficacy.
Respondents were chosen for this study by the inclusion and exclution The intervention in this study was given for 15 minutes using the lecture and leaflet method.
The material was delivered communicatively using language that was easy for the respondents to understand, carried out for 3 weeks which was divided into 4 sessions consisting of the first session is identifying problems, the second session is cognitive, the third session is motivational and the fourth session is affective.
Data analysis in this study used a paired t test.
Results:
Table 1.
Characteristics of Respondents Variable Mean
Age
Long
Suffering from TB
Gender
Male
Female Total
51,25
6,006
2,88
1,147
Frequency Percentage 87,5 % 12,5 % Total Data on the characteristics of respondents based on age shown in table 1 shows that the average respondent is 51 years old, most respondents were 14 men .
5%) and the average duration of suffering from pulmonary TB is 3 months, with the lowest patient being 1 month, and the highest being 5 months.
Jurnal Kesehatan dr.
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No.
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Publisher : LPPM Universitas dr.
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Average Self-Efficacy Before and After Given Psychoeducational Therapy to Patients with Pulmonary TB in the Work Area of the Gerung Health Center in 2022.
Self
Mean
CI 95%
Efficacy Pretest
32,38
2,419
29 Ae 37 Posttest 44,31 1,448 42 - 47 Based on table 2 above, it is obtained that the average value of self-efficacy before being given psychoeducational therapy is 32.
88 with a standard deviation of 2,419, the lowest value is 29, and the highest is 37.
Where these values are included in the medium category.
The average value of self-efficacy after being given psychoeducational therapy is 44.
31 with a standard deviation of 1.
448, the lowest score is 42 and the highest score is 47.
Tabel 3.
The effect of psychoeducational therapy on self-efficacy in pulmonary TB patients in the working area of the Gerung Health Center Mean P-value Pretest16 Postest Based on table 3 above, the results of the Paired sample T test statistical test obtained a Pvalue below 0.
05, namely 0.
00 (< 0.
, then Ho was rejected and Ha was accepted.
Based on these results it can be concluded that there is an effect of psychoeducational therapy on self-efficacy in patients with pulmonary TB in the work area of the Gerung Health Center.
Discussion:
Characteristics of respondents in this study shows that the average respondent is 51 years old, most respondents were 14 men .
5%) and the average duration of suffering from pulmonary TB is 3 months, with the lowest patient being 1 month, and the highest being 5 months.
The results of the analysis of the Pired Sample T Test Statistical Test in Pulmonary TB patients with an average value of -8,875 out of a total sample of 16 thus obtained a p-value of 0.
00 (< 0.
because the value is smaller , then Ho is rejected and Ha is accepted .
Based on these results it can be concluded that there is an effect of psychoeducational therapy on self-efficacy in pulmonary TB patients in the working area of the Gerung Health Center.
Self-efficacy is an individual's belief in his ability to do the task entrusted to him.
In difficult situations, people with less self-efficacy will easily reduce their efforts or give up (Lianto, 2.
According to Bordbar & Faridhosseini .
Psychoeducation in the form of education or training for a person or group with psychiatry in the form of stress, anxiety, and self-doubt which aims to process treatment and rehabilitation, psychoeducation can be carried out through a training with methods of exploration, assessment, discussion, role playing and demonstration (Bhakti & Kurniawan, 2.
Psychoeducation is in the form of education or training for a person or group with psychiatry in the form of stress, anxiety, and Psychoeducation is focused on increasing self-acceptance and confidence in Psychoeducation can explore perceptions, opinions, attitudes, motivation, knowledge, problems and hopes.
Self-efficacy is formed from a direct social learning process during the life of individuals with productive age who have more experience in overcoming all kinds of problems.
Psychoeducation provides information and builds resilience in individuals which is useful for changing individual understanding to increase self-efficacy (Bhakti & Kurniawan, 2.
This research is in line with Heri, et al.
, entitled increasing self-efficacy in families with pulmonary TB through psychoeducational therapy, obtained the results of a statistical analysis that there was a significant effect of increasing self-efficacy in families with pulmonary TB at Kertha Usada General Hospital with P- values<0.
Other researchers conducted Purbasafir .
, entitled psychoeducation to increase parenting self-efficacy in mothers of children with autism.
It can be concluded that psychoeducation has an influence on parenting self-efficacy with a P-value <0.
Other researchers conducted Rahayu, .
, entitled the effect of psychoeducation on self-efficacy and Jurnal Kesehatan dr.
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000 ( <0.
that psychoeducation has an influence on self-efficacy and motivation in cancer patients.
Based on the researcher's analysis the effect of psychoeducation on self-efficacy in pulmonary TB sufferers can affect the level of selfefficacy, this is influenced by pulmonary TB sufferers who are respondents in this study and follow according to implementation guidelines, participate in activities for 3 weeks with 3 meetings, and attend activities to completion.
addition, the application of psychoeducational interventions is something new in the working area of the Gerung Health Center so that pulmonary TB sufferers are enthusiastic and enthusiastic about participating in activities, this is because pulmonary TB sufferers have not received psychoeducational interventions from the elderly integrated service post.
Conclusions:
There is an effect of psychoeducational therapy on self-efficacy in pulmonary TB patients in the working area of the Gerung Health Center with a P-value of 0.
00 (< 0.
The results of this study can be applied as a program at the community health center to increase the cure rate and treatment success in pulmonary TB patients.
References: