TUGAS INDIVIDU Literature review : faktor faktor yang mempengaruhi seseorang memilih pengobatan komplementer

GALIH SETIA ADI 20121050053

PROGRAM MAGISTER KEPERAWATAN FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS MUHAMMADIYAH YOGYAKARTA 2012

A review of the literature on the multiple dimensions of anxiety and depression cancer Abstrak Tujuan : mengetahui factor factor yang mempengaruhi pasien memilih pengobatan komplementer Metode : memasukan kata kunci factor, mempengaruhi, seseorang, pemanfaatan terapi komplementer. Kemudian mengambil beberapa pustaka yang berhubungan dengan tema dan di cari jurnalnya. Hasil : skala ukur anxiety dan depressi lebih effecting menggunakan Hospital anxiety and depression scale (HADS). Latar Belakang Terapi alternatif komplementer adalah sebuah kelompok dari bermacam-macam konvensional (National Institute of Health, komplementer meningkat pesat sistem pengobatan dan perawatan kesehatan, praktek dan produk yang secara umum tidak menjadi bagian dari pengobatan diseluruh pelosok dunia. 2005). Frekuensi dari pemanfaatan terapi alternatif Perkembangan

tersebut tercatat dengan baik di afrika dan dan bahwa di prinsip-prinsip pemanfaatan negara-negara sistem terapi maju

populasi secara global antara 20% sampai dengan 80%. Hal yang menarik dari terapi alternatif komplementer ini didasarkan pada asumsi dasar yang beroperasi (Amira & Okubadejo, 2007). Terbukti alternatif diberikan pendorong obat modern komplementer oleh penyedia asuransi kesehatan

mengalami peningkatan secara global, dan pengakuan

(Eisenberg, Davis, Ettner, Appel, Wilkey, Van Rompay & Kessler, 1998). Faktor terjadinya untuk peningkatan penggunaan obat herbal dinegara maju adalah meningkat, adanya kegagalan penggunaan tertentu di antaranya kanker serta semakin luas akses usia harapan hidup yang lebih kronik penyakit

informasi mengenai obat herbal di seluruh dunia (Sukandar, 2006). Untuk itu penulis Untuk itu penulis tertarik menyajikan studi pustaka beberapa bukti ilmiah mengenai factor factor yang mempengaruhi seseorang memanfaatkan pengobatan atau terapi komplementer. Menurut kesehatan teori Lawrence atau yang dikutip Soekidjo oleh 2 Notoatmodjo faktor pokok, (Non-behavior (2003), yaitu causes), seseorang masyarakat dipengaruhi

perilaku (behavior causes) dan faktor dari luar

perilaku

selanjutnya perilaku itu sendiri terbentuk 3 faktor, yaitu: Faktor predisposisi yaitu faktor

yang mempermudah dan mendasari terjadinya perilaku tertentu yang terwujud dalam bentuk pengetahuan dari pendidikan formal, dan budaya serta alternatif komplementer; Faktor untuk sikap, kepercayaan, (Enabling keyakinan, nilai-nilai terapi factor) yaitu yang beberapa karakteristik individu yaitu: pengetahuan tentang pemungkin dan yang faktor

memungkinkan

terjadinya perilaku tertentu terbentuk yang berwujud dalam sarana yang kesehatan yaitu ketersediaan, berkaitan dengan kesehatan; Faktor teman, petugas kesehatan dan

lingkungan fisik dan ketersediaan fasilitas ketercapaian fasilitas dan ketrampilan pendorong (reinforcing factor) lain-lain yaitu tersebut yaitu mendapat dukungan

memperkuat terjadinya perilaku

dari keluarga/kerabat,

dibawah ini adalah berbagai jurnal dari beberapa penelitian tentang alas an seseorang memilih / memanfaatkan pengobatan herbal / terapi komplementer :

Authors Ridlwan Kamaluddin

Country indonesia

Thema pertimbangan dan alasan pasien hipertensi menjalani terapi alternatif komplementer bekam di kabupaten banyumas

partisipant 6 partisipan. Dengan tekhnik purposive sapling

Methodology/ Study type Qualitative fenomenologi

Result Proses pengambilan keputusan pasien hipertensi yang menjalani terapi bekam mempertimbangkan faktor social dan faktor psikologis. Faktor social yang berpengaruh dalam proses pengambilan keputusan memilih terapi bekam adalah adanya dukungan dari keluarga dan dengan diskusi dengan anggota keluarga. Faktor psikologis yang mempengaruhi proses pengambilan keputusan memilih terapi bekam adalah karena adanya kepercayaan dengan orang lain. Alasan klien dalam menjalani terapi altertif komplementer digambarkan dalam satu tema yaitu alasan menjalani terapi bekam. Alasan menjalani terapi bekam meliputi aspek fisiologis, ekonomi, psikologis dan aspek spiritual. Aspek fisiologis yang menjadi alasan menjalani terapi bekam adalah keinginan untuk terbebas dari efek samping obat. Aspek ekonomi berupa harga terapi bekam yang terjangkau, aspek psikologis meliputi adanya kecocokan dengan terapi bekam serta adanya aspek spiritual berupa terapi bekam adalah salah satu ajaran agama tertentu.

Osamor PE , Owumi BE

Nigeria

Complementary and alternative medicine in the management of hypertension in an urban

Four hundred and forty hypertensiv e subjects in Idikan

In the study sample, 29% used CAM in the management of their hypertension. Among those using CAM, the most common forms used were herbs (63%) and garlic (21%). Logistic regression analysis revealed that four variables were independent predictors of CAM use: being male (OR 2.58, p < 0.0001), belief in supernatural causes of hypertension (OR 2.11, p = 0.012), lack of

Nigerian community.

community, Ibadan, were interviewed using a semistructured survey instrument Logistic regression analysis was done to identify independen t predictor variables of CAM use, with CAM use as the outcome variable and the demograph ic and belief items as predictor variables
The sample consisted of 150 diagnosed cancer patients and 268 participants A multi-centre, cross-sectional study

belief that hypertension is preventable (OR 0.57, p = 0.014) and having a family history of hypertension (OR1.78, p = 0.042). Other factors such as age, educational level and occupation were not independent predictors of CAM use. Interviews with CAM practitioners revealed that they believed hypertension was caused by evil forces, stress or "too much blood in the body".They also thought they could cure hypertension but that reduced costs (compared to hospitals) was one of the reasons most of their clients consult them.

Nauman A Jadoon,et.al.2010

No Stated

Assessment of depression and anxiety in adult cancer outpatients: a crosssectional study

Of the initial 752 persons, 580 were eligible, and 376 returned a completed survey, resulting in a response rate of 65%. When asked whether they had used an herb during the past 12 months, 230 respondents (61.2%) reported that they had. Prevalence of use of specific herbs ranged from

without cancer (control group).

Yuri N .et.al 2007

trinidad

Perceived efficacy of herbal remedies by users accessing primary healthcare in Trinidad

A total of 265 patients

descriptive crosssectional study

Setia adi. 2009

Sragen

faktor faktor yang berhubungan dengan pemanfaatan pelayanan pengobatan herbal pada pasien

320 orang

Deskriptif cross sectional

30.9% for ginseng to 3.0% for milk thistle. The most commonly reported reasons for using herbs varied by the type of herb, although for 5 of the herbs, the most frequently mentioned reason was to promote general health/well-being. For 11 of the 13 herbs, less than 60% of those who used the herb rated it as effective or very effective. Family, friends, and written materials were the leading sources of product information among those taking 9 of the 13 specific herbs. 265 herbal users entered the study and cited over 100 herbs for the promotion of health/wellness and the management of specific health concerns. Garlic was the most popular herb (in 48.3% of the sample) and was used for the common cold, cough, fever, as 'blood cleansers' and carminatives. It was also used in 20% of hypertension patients. 230 users (86.8%) indicated that herbs were efficacious and perceived that they had equal or greater efficacy than conventional allopathic medicines. Gender, ethnicity, income and years of formal education did not influence patients' perception of herb efficacy; however, age did (p = 0.036). Concomitant use of herbs and allopathic medicines was relatively high at 30%; and most users did not inform their attending physician. (1) sebagian besar responden (53%) memanfaatkan pelayanan pengobatan herbal (2) terdapat hubungan tingkat pendidikan dengan nilai pv=0,032, pengetahuan dengan nilai pv=0,001 dengan pemanfaatan pengobatan herbal di Balai Pengobatan Alternatif Sutardi di desa Teguh Jajar kecamatan Karang Malang kabupaten Sragen, dan (2) tidak terdapat hubungan tingkat pendapatan dengan nilai pv=0,444 dengan pemanfaatan

hipertensi di balai pengobatan alternatif sutardi desa teguh jajar kecamatan karang malang sragen.
Sharpe.M.et.al 2004 London Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs Prevalence of Depression in Patients With Cancer Depression Is a Risk Factor for Noncompliance with medical Treatment Is symptom burden a predictor of anxiety and depression in patients with cancer about to commence chemotherapy? 5613outpatients aged18 years or over Non Stated Description of attenders In order to characterise the sample A range of assessment methods Non Stated

pengobatan herbal di Balai Pengobatan Alternatif Sutardi di desa Teguh Jajar kecamatan Karang Malang kabupaten Sragen.

Mary J.2004

New York

Robin.D.et.al 2000 Sibilah,J.et.al 2009

US

Non Stated

New Zaeland

247 patients

RCT

a detailed case-note assessment, of 792 (14%) of the 5613 attenders screened. The majority (558 out of 792; 71%) were female with a mean age of 60 years. Breast cancer was the largest group (377 out of 792; 48%), with the remaining being approximately equally divided between prostate, bladder, testes, and colorectal and gynaecological cancers. Depression is highly associated with oropharyngeal (22%57%), pancreatic (33%50%), breast (1.5%46%), and lung (11%44%) cancers. A less high prevalence of depression is reported in patients with other cancers, such as colon (13%25%), gynecological (12%23%), and lymphoma (8%19%) the association between anxiety and noncompliance were variable, and their averages were small and nonsignificant. the relationship between depression and noncompliance, however, was substantial andsignificant, with an odds ratio of 3.03 (95% confidence interval, 1.96-4,89) Prevalence of anxiety was 45% and depression 25%. The most prevalent physical symptoms were pain (48%), feeling unusually tired (45%) and difficulty sleeping (45%). Physical symptoms rated as most severe were pain (28%), difficulty sleeping (26%) and feeling unusually tired (19%). Physical symptoms causing the most distress were pain (39%), constipation (18%) and nausea (16%). Factor analysis of symptom distress scores indicated that five factors explained 36.7% of the variance and included: gastrointestinal (nausea, vomiting, pain), general malaise (tiredness, feeling weak, headaches), emotional (feeling depressed, feeling anxious), nutritional (changes to appetite, weight loss or gain) and general physical (mouth/throat problems, shortness of breath). Regression analysis indicated that symptom distress for the malaise (=1.46; P< 0.001), nutritional (=0.70; P < 0.05) and gastrointestinal (=0.73; P< 0.05) factors were independent predictors of depression.

Diskusi Dari berbagai studi pustaka diatas menyajikan beberapa bukti ilmiah mengenai berbagai mengenai skala ukur anxiety dan depression terhadap pasient cancer. Dari beberapa telaah jurnah menunjukan tingkat kecemasan dan depresi lmayoritas efektif diukur menggunakan skala Hospital anxiety and depression scale (HADS). Diantaranya Rama,KR et.al,2011, Nauman A Jadoon,et.al.2010, Manoj Pandey.et.al 2006, Yohana.P.et.al. 2010, Sharpe.M.et.al 2004, Sibilah,J.et.al 2009, Mary J.2004. Kesimpulan Skala ukur kecemasan dan depresi ternyata mayoritas lebih efektif menggunakan Hospital anxiety and depression scale (HADS).