SELF-EFFICACY PASIEN LIFE-THREATENING ILLNESS DALAM MENJALANI TERAPI: ANALISIS PADA ENAM KASUS UTAMA

Abstract

Kasus-kasus Non-Communicable Diseases (NCDs) seperti stroke, diabetes mellitus, dan kanker dilaporkan oleh WHO menyebabkan 71% kematian di seluruh dunia setiap tahunnya. Selain NCDs, HIV AIDS dan tuberculosis paru juga masih menjadi beban kesehatan, khususnya di negara-negara berkembang. Kasus-kasus tersebut mempunyai berbagai tantangan dalam perawatannya, menimbulkan berbagai ketidaknyamanan, serta memerlukan pengobatan yang lama, sehingga aspek kepatuhan menjadi sangat penting bagi perawatan kesehatan pasien. Setelah menjalani berbagai perawatan dan pengobatan, bagaimana self-efficacy pasien terhadap program yang sedang dijalankan. Penelitian ini dilaksanakan dengan menggunakan desain deskriptif, survei pada berbagai kasus Life-Threatening Illness (LTI) yaitu HIV AIDS (11%), kanker (8%), diabetes mellitus (27%), stroke (12%), tuberculosis paru (9%), dan gagal ginjal kronik (32%). Responden penelitian adalah 368 pasien di empat pusat perawatan kesehatan swasta di Yogyakarta yang dipilih secara purposive dan mengisi angket General Self-Efficacy (Ralf Schwarzer) berisi 10 pernyataan. Bandura, tokoh self-efficacy, menyampaikan bahwa budaya, usia, gender, sifat kegiatan, insentif, peran individu, dan reinforcement merupakan hal-hal yang dapat mempengaruhi self-efficacy seseorang. Penelitian ini lebih banyak melibatkan responden laki -laki (60%), lanjut usia akhir (44%), menikah (54%), dengan pendidikan menengah (39%), dan bekerja formal (60%). Faktor faktor gender, usia, dan status peran individu tersebut yang kemungkinan menyebabkan pasien memiliki self-efficacy yang tinggi (89%) terhadap pengobatan dan perawatan yang sedang dijalankan, meskipun ada 11% yang kurang yakin terhadap terapi. Meskipun pasien-pasien LTI telah menjalankan terapi anti -retroviral, fisioterapi, insulin, kemoterapi, fixed-dose combination, dan hemodialisis dalam kurun waktu yang cukup lama, mereka masih mempunyai keyakinan tinggi terhadap pengobatan. Persuasi sosial merupakan aspek yang harus terus -menerus disampaikan kepada pasien supaya mempunyai self-efficacy yang tinggi. Kesejahteraan psikis akan mempengaruhi keberhasilan program perawatan pasien.

Kata kunci: keyakinan, perilaku kesehatan, penyakit terminal

Cases of Non-Communicable Diseases (NCDs) such as stroke, diabetes mellitus, and cancer reported by WHO caused 71% of deaths worldwide each year. In addition to NCDs, HIV AIDS and pulmonary tuberculosis are still a health burden, especially in developing countries. These cases have various challenges in their care, caused various inconveniences, and require long treatments, so that the compliance aspect becomes very important for patient s’ health care. After undergoing various treatments, how is the patient's self -efficacy towards the program undertaking. This study was conducted using descriptive design, a survey of various cases of Life-Threatening Illness (LTI), namely HIV AIDS (11%), cancer (8%), diabetes mellitus (27%), stroke (12%), pulmonary tuberculosis (9%), and chronic renal failure (32%). The study respondents we re 368 patients in four private health care centers in Yogyakarta who were selected purposively and filled out the General Self-Efficacy (Ralf Schwarzer) questionnaire containing 10 statements. Bandura, a figure of self efficacy, said that culture, age, gender, nature of activities, incentives, individual roles, and reinforcement are things that can affect one's self -efficacy. This study mostly involved male respondents (60%), advanced elderly (44%), married (54%), with secondary education (39%), and formal work (60%). The factors of gender, age, and role status of the individual that are likely to cause patients to have high self-efficacy (89%) for treatment and care that are being carried out, although there were 11% who were less certain about therapy. Al though LTI patients have carried out anti-retroviral therapy, physiotherapy, insulin, chemotherapy, fixed -dose combinations, and hemodialysis for a considerable period of time, they still have high confidence in treatment. Social persuasion is an aspect that must be continuously conveyed to patients in order to have high self efficacy. Psychological well-being will affect the success of the patient care program.

Keywords: beliefs, health behavior, terminal illness