PERBEDAAN TINGKAT PENGETAHUAN TENTANG FAKTOR PREDISPOSISI GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN Perbedaan Tingkat Pengetahuan Tentang Faktor Predisposisi Gangguan Jiwa Antara Sebelum dan Sesudah Diberikan Psikoedukasi Pada Remaja di Desa Ng
PERBEDAAN TINGKAT PENGETAHUAN TENTANG FAKTOR PREDISPOSISI
GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN
PSIKOEDUKASI PADA REMAJA DI DESA NGUTER
NASKAH PUBLIKASI
Diajukan sebagai salah satu syarat
untuk meraih gelar Sarjana Keperawatan
Disusun Oleh :
M FAJAR SODIQ
J 210112004
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH SURAKARTA
2015
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
1
RESEARCH
DIFFERENCES LEVEL OF KNOWLEDGE ABOUT PREDISPOSING
FACTORS MENTAL DISORDERS BETWEEN BEFORE AND AFTER
PROVIDED PSYCHOEDUCATION IN TEENEGER GROUP IN THE
NGUTER VILLAGE
By:
M Fajar Sodiq
One of important factor to prevent increasing of mental illness is how to manage them.
Teenager is part of crusial thing that role in preventing of mental illness. So they need to
have knowledge about prevention of mental illness. This study purpose to analyze the
influence of psychoeducation toward the level of knowledge on teenager. The design of
study of quantitative with pre experimental methods. Sample in the research is number 30
teenagers, tehnique sampling in this research is purposive sampling. The collect of data
used quetionary level of knowledge and the data analyze utilized Wilcoxon Rank Test.
The result of the research show that there were different the level knowledge between
before and after study with the significance value 0,0001.
Keywords: psycheducation, mental disorders predisposing factor.
.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
INTRODUCTION
The phenomenon of mental
disorder at this time has increased
very significantly, and every year in
various parts of the world increases
the number of people with mental
disorders. Based on data from the
World Health Organization (WHO) in
Joseph
(2013),
there
are
approximately 450 million people
worldwide who experience mental
illness. WHO said at least one of the
four people in the world experiencing
mental health problems, and mental
health disorders problems that exist
around the world has become a very
serious problem for us examine.
The
high
number
of
inhabitants and the many problems
of both social and economic, some
communities had to struggle to
overcome the pressures of life and
be able to adapt to environmental
changes. In fact, with so many other
problems arise; causing not a few
people we finally have a degree of
frustration, depression and high
stress to cause mental health
problems.
Indonesia is not a taboo
anymore know someone who is
mentally
ill.
Mental
disorders
experienced by humans various
causes, one of which is a psychosis,
ie the types of diseases that interfere
with
brain
function.
Various
psychoses
include:
psychosis
relatively short, due to cannabis
psychosis,
organic
psychosis,
psychotic delusions, skizofreniform
psychosis,
schizophrenia,
skizofreniform
disorder,
bipolar
affective disorder, psychotic post
partum (Majid, 2004).
A mental disorder that is a
syndrome or pattern of behavior that
is
associated
with
clinically
significant distress or suffering and
causing disruption on one or more
2
functions of human life. (Keliat,
2011)
Not only had the health profile
of Indonesia in 2014 revealed that
mental illness is a health problem in
the community. It can be seen from
the data base of health (Riskesdas),
Bella (2014) The Department of
Health in 2014 said there were 1
million patients with severe mental
disorders and 19 million patients with
mild mental disorder in Indonesia.
Central Java is included in the 5
provinces
with
the
highest
prevalence figures in Indonesia with
prevalence figures reaching 2.3 %.
Central Java Province itself is
included in the 5 provinces with the
highest
prevalence
figures
in
Indonesia with prevalence figures
reaching 2.3 % (Riskesdas, 2013). In
Central Java alone there are 3
people per thousand residents who
are mentally handicapped and 50 %
is a result of job loss. Thus 32.95204
million residents of Central Java,
there are around 98 856 people
suffering from mental disorders. In
line with the health paradigm that
proclaimed
health
department
memekankan more proactive efforts
to prevent than to wait in hospitals,
mental health orientation is now
more on prevention (preventive) and
(promotive).
Based on preliminary studies
in the area Sukoharjo are still many
people who experience mental
illness at approximately 2778 cases
of people with mental disorders, or
about 0.6 % of the total population of
productive age amounted to 507 517
inhabitants
(DKK
Kabupaten
Sukoharjo, 2013). Based on data
from the mental hospital Surakarta
number of people with mental
disorders is hospitalized from
regions Sukoharjo many as 331
people,
while
the
outpatient
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
amounted (Rekam Medik RSJD
Surakarta, 2013).
Research concluded by Aji
(2013) Nguter in the district showed
that in 2013 obtained the data 152
mental patients and 43 patients
deprived who shackled
(Dinkes,
2013). At Nguter village found 22
peoples was who experience mental
ills Hartanto (2014) mentions that in
the treatment of patients with mental
disorders are rare families that bring
patients to the health service.
Treatment of mental disorders
requires different components. One
is the family support. But what
happened today is a lot of family
members who experience mental
illness precisely in exile by the family
or society. Though this will make
pasiean increasingly severe stress
and can worsen the disease.
Mental disorders can happen
to anyone, one of them in
adolescents. Adolescence is known
as a critical period in the
development of personality, as a
period of "storm and stress ". In this
period the individual faced with rapid
growth, changes bodily and sexual
maturation, At the same time social
status is also subject to change,
when first he was very dependent on
parents or others, now he must learn
to stand alone and responsible
brings its own problems of marriage,
employment, and general social
status. Greater freedom brings
greater
responsibility
anyway
(Yosep, 2013).
Factor that led to the
occurrence of mental disorders is a
lack of knowledge about family
pretisipasi and predisposing factors.
Given psychoeducation researchers
hope to provide education to the
youth in the village Nguter so that
when they get a stressor from
outside they could make copping
mechanisms themselves so that they
3
are not at risk of mental disorders,
and for adolescents who have family
members with mental illness they
can understand the situation her and
could provide the appropriate
treatment.
This study discussed the
differences in the level of adolescent
knowledge about mental disorders
predisposing factor between before
and after psychoeducation at -risk
groups in the Nguter.
THEORETICAL BASIS
The Concept of Mental Disorder
Mental
disorders
are
maladaptive response of the internal
and external environment, evidenced
through the thoughts, feelings and
behaviors that are not in accordance
with local norms or local culture and
disrupt the function of social,
occupational or physical (Townsend,
2008).
Farida (2010) claim that the
disorder occurs in people with
mental disorders, namely : Impaired
sensation, perceptual disorders,
attention
disorders,
memory
disorders,
disorders
of
the
association, impaired judgment,
impaired
thinking,
impaired
consciousness, orientation disorder,
impaired
volition,
emotional
disorders
and
affective,
and
impaired.
Yosep (2007) signs and
symptoms in patients with mental
disorders,
namely
:
Impaired
cognition,
attention
disorders,
memory disorders, disorders of the
association, impaired judgment,
impaired
thinking,
impaired
consciousness, volition disorders,
emotional disorders and affective,
psychomotor.
Stuart dan Laraia (2001) in
his book said predisposing factor is
the factors associated with risk
factors for mental disorders.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
Stuart & Sandine (2001) said
predisposing factor in one's patient
is the patient’s role as perpetrators,
victims, and witnesses, these factors
consist of:
a) Physical
Persecution:
Persecution own physical could
come later if the patient was on
the perpetrators, victims and
witnesses of the persecution
that occurred.
b) Sexual
Persecution
:
Persecution of sexual usually
often we know as rape, patients
themselves can be derived from
rape victims, perpetrators
c) Rejection: Rejection here can be
interpreted as an exile or
ignored someone in a society so
that it can to make someone’s
stress.
d) Violence in the family : Violence
in the family can occur not only
her husband's violence against
his wife, but also the parents
who do the wrong upbringing of
the child, when the child was a
child when the parents commit
violence that memory can be
stored until he was an adult and
until she had children of her
own.
e) The crimes: Patients with mental
disorders can occur due to
criminal acts which he found;
here the patient can be abusers,
victims
of
violence
and
witnesses of violence itself.
Erik Erikson who is also a
predisposing factor of mental
disorder is when the person's growth
and development within its phases.
The phases are:
a) 0 - 18 months at trust versus
Mistrust phase
b) 18 months until 3 years
autonomy versus shame and
doubt phase.
c) 3 years until 5 years inisiatif
versus guilty feeling.
d)
e)
f)
g)
h)
4
6 years - 10 years, Industry
versus inferiority phase.
10 years - 20 years, Identity
versus Identity confusion.
20 years - 30 years, intimacy
versus Isolation phase.
40 years - 50 years, Generativity
versus Stagnation phase.
60 years and olders, integrity
versus depair.
The
factor
of
mental
disorder’s are (Yosep, 2013) :
a) Heredity
b) Constitution factors
c) Congenital defects.
d) Incorrect
psychological
development.
e) Self deprivation
f) Who pathogenic family pattern
g) Adolescence
h) The wrong factor of sociological
development.
i) Genetics.
j) Neurobiologikal
k) Biochemestry body
l) Neurobehavioral
m) Stress
n) Drug abuse
o) Psikodinamic
Knowledge
Knowledge gained from the
results of curiosity, all of this
happens someone did sensing of
objects that happen. Out of curiosity
then one can take a decision faced
(Achmadi, 2013).
Knowledge generally comes
from experience myself for example
a child put his hand into the fire
stove heat will occur on the
knowledge gained in pain he will not
repeat (Irianto, 2014).
Achmadi
(2013)
argued
classified into 6 levels of knowledge,
namely :
1) Know
2) Comprehension
3) Application
5
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
4) Analysis
5) Synthesis
6) Evaluation
Sulihah (2002) knowlegde is
affected by the:
1) Level of education.
Educations are an attempt to
give the knowledge to change
attitudes for the better.
2) Information
More someone who gets it will be
clearer information he received
knowledge.
3) Culture
The behavior of the public in
making a habit that has an
attitude and confidence.
4) Experience
Events that have happened in
the past that can increase a
person's.
5) Social economic
A person's level of income that
can meet the needs.
Psycho education
Psychoeducation is a form of
education or training of a person with
a psychiatric disorder that is aimed
at treatment and rehabilitation
process.
The
goal
of
psychoeducation is to develop and
increase patient acceptance of a
disease or disorder that he
experienced,
increase
patient
participation in treatment, and the
development of coping mechanism
when patients face problems related
to the disease (Goldman, 1998
quoted
from
Bordbar
&
Faridhosseini, 2010).
The
purpose
of
psychoeducation
alone
is
to
enhance the adaptive function of the
family
and
meningakatkan
katrampilan
positive
coping
mechanisms. It is basically used to
help nurses identify problems in the
family (Stuart & Sundeen, 2005)
Framework
Psycho education
Pre test
knowledge
1.
2.
3.
4.
5.
Post test
knowledge
Confounding factors:
The level of education
Information
Culture
Experience
Social economic
Picture 1. Framework
Hypothesis
Ha : There are differences in the
level of knowledge about
mental disorders predisposing
factor between before and
after
psychoeducation
in
adolescents in the village
Nguter.
Methodology Research
Research Design
In this study, using a
quantitative
design
with
preexperimental research methods,
research design pretest - posttest
design group. Studies that provide
treatment without the use of a
control group to give a pretest before
treatment and ends with the
provision of post test after being
given treatment (Sugiono, 2014).
Population and sample
The population in this study is a
teenager who lives in the village
Nguter as many as 988 peoples.
The sample was 30 adolescents
with
determination
techniques
cluster random sampling.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
The Research Instruments
This study uses a measuring
instrument in the form of a
questionnaire.
6
RESULT AND DISCUSSION
Wilcoxon Rank Test results
obtained knowledge Zobs value of
4.791 and a significance value of
0.000. Because probability value <
0.05 (0.000 < 0.05), then the test is
concluded there are differences in
pre-test and post test knowledge.
The average value of knowledge is a
pre-test and post-test 12.867 for
14.767. Based on the average value
of the knowledge it appears that the
value of post test knowledge higher
than the value of pre-test knowledge.
Univariate Analysis
Discussion
Distribution
of
Pre
Test
Knowledge
Table 1. Distribution Frequency of
Pre Test Knowledge
The level of knowledge about
the predisposing factors of
mental
disorder
before
psychoeducation
The Data Analysis
Analysis of the data in this study is
bivariate. To be able to test and
analyze the data used technique
Wilcoxon Signed Rank Test.
No
1
2
3
Knowledge
Bad
Moderate
God
Total
F
6
21
3
30
%
20%
70%
10%
100%
Distribution
of
Pre
Test
Knowledge
Tabel 2. Distribution of Pre Test
Knowledge
No
1
2
3
Knowledge
Bad
Moderate
God
Total
F
4
8
18
30
%
13%
27%
60%
100%
Knowledge of the Effectiveness of
Psychoeducation
Against
Predisposition Factors Mental
Disorders in Teens in the village
of Sukoharjo Nguter
Table 3. Uji Wilcoxon Rank Test of
Knowledge
The result
Knowledg
e
Mean
Pre test
Post test
z-hit
p-v
Con
clus
sion
12,867
4,791 0,000 Sign
14,767
Distribution of adolescents
knowledge about the predisposing
factors of mental disorder before
being given psychoeducation mostly
being that 21 respondents (70 %)
and
10
%
of
respondents
berpengetahhuan well. Based on the
knowledge of the data, it was
concluded that the level of
knowledge about mental disorders
predisposing
fatkor
most
respondents before the study was
moderate with an average of 12.867.
The level of knowledge that
was the one caused by the level of
education is good enough most of
the
high
school
educated.
Respondents who are well educated
have the ability to examine or
analyze a question and find a
solution answers. In this study, the
question of knowledge using the
model of multiple choice, so that
respondents can make comparisons
of the answer choices and determine
the answers they think are
reasonable and the best, so
although previously they do not
know about that question, but the
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
answer choices lead respondents
could choose the best answer.
Knowledge
of
the
predisposing factors of mental
disorders
are
adolescent
understanding of the predisposing
factors of mental disorder, or
information obtained from a source
of the experience they gain in their
environment. When adolescents
have people around them are
mentally ill, there will be discussions
in the community about the person,
well why he had a mental disorder,
how it happened, what the cause
and so forth. When adolescents
obtain such information, then teens
will analyze it and making it into
knowledge of psychiatric disorders.
Relationship information and
experiences on knowledge as
expressed by Sulihah (2002) which
suggests that one of the factors that
influence knowledge is experience.
Experience that teens about mental
disorders around teenagers become
resources for teen’s knowledge
about mental disorders predisposing
factors. Research Vivin (2011)
concluded that there is a relationship
utilization of various media with
adolescent
reproductive
health
knowledge level of class XI SMA
Darul ' Ulum 3 Jombang.
Research also shows that
there are 10 % of respondents who
have knowledge of the predisposing
factors of mental disorders is
lacking. This condition is caused
there are 10 respondents (33 %)
junior high school education. The
education level of the respondents
that cause their ability to understand
information
about
predisposing
factors both from lessons at school
as well as from the mass media is
lower than the respondents had high
school, so that their level of
knowledge is low.
7
Research
shows
teens
knowledge about the distribution of
predisposing factors are mostly
moderate. These results support the
research Nopyawati (2013) which
revealed
that
knowledge
of
communities in the PHC Colomadu
Karanganyar Work on mental
disorders is largely sufficient. This
study states that the factors that
shape public knowledge about
mental disorders, among others, the
level of public education, and
information that affect the public
opinion.
Increasing the effectiveness of
psychoeducation for
Knowledge
Research in a comparative
study
comparing
adolescent’s
knowledge about mental disorders
predisposing factors before and after
getting psychoeducation about the
predisposing factors of mental
disorder. Testing is done by
comparing the scores of knowledge
before and after psychoeducation.
Comparative
analysis
techniques used in this study were
paired samples t -test if the data
were
normally
distributed
or
Wilcoxon rank test if the data is not
normally distributed. Testing data
normality using the Kolmogorov Smirnov test at a significance level
of 5 %. Furthermore normality test
results show that knowledge of both
the
research
data
before
psychoeducation and data after
psychoeducation is not normal
because it has a p-value less than
0.05. Based on the results of the
data normality test, the comparison
test techniques used in this study is
the Wilcoxon rank test.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
Wilcoxon rank test results
concluded
that
there
psychoeducation effectiveness of the
increased knowledge about mental
disorders
predisposing
to
an
increased level of adolescent
knowledge Nguter In the village of
Sukoharjo (p - value = 0.000). The
average value of knowledge is a pretest and post-test 12.867 for 14.767,
so it concluded psychoeducation
effectively increase knowledge of
predisposing factors in adolescents
in the village of Sukoharjo Nguter.
Psychoeducation
about
predisposing factors of mental
disorder aims to provide information
to
adolescents
about
the
understanding of mental disorders
predisposing factors. With the
provision of such information is
expected to teen’s knowledge about
mental disorders predisposing factor
increased to well. This is in
accordance with the opinion of
Goldman (Bordbar & Faridhosseini
2010) that defines psychoeducation
as a form of education or training of
a person with a psychiatric disorder
that is aimed at treatment and
rehabilitation process. The goal of
psychoeducation is to develop and
increase patient acceptance of a
disease or disorder that he
experienced,
increase
patient
participation in treatment, and the
development of coping mechanisms
when patients face the problems
associated with the disease.
The results support the
research Yulita (2013) about the
effectiveness of psychoeducation to
parents in improving knowledge of
teenage sexuality mild mental
retardation. This study concluded
that
there
is
educational
effectiveness
in
increasing
knowledge of teenage sexuality mild
mental retardation.
8
Another study conducted by
Farida (2012) regarding self-efficacy
training to improve the career
decision-making abilities of high
school
students.
The
study
concluded that the effect of selfefficacy training to improve decisionmaking career in high school
students.
Conclussion and Suggestions
conclussion
1. Knowledge Nguter teenager In
the village of Sukoharjo on
predisposing factors of mental
disorder before getting psychoeducation
about
mental
disorders predisposing factors
largely being.
2. Knowledge of teenagers in the
village of Sukoharjo Nguter after
getting psycho-education about
mental disorders predisposing
factors are mostly good.
3. There
effectiveness
of
psychoeducation to increased
knowledge of the predisposing
factors of mental disorders in
adolescents in the village of
Sukoharjo Nguter.
Suggestion
1. Suggestion for Teenenger
Youth should increase their
sensitivity to the environment, so
that they can provide benefits to
the surrounding environment.
Youth should also increase their
knowledge about psychiatric
disorders, so that they can make
an effort anticipation of his
friends who are at risk of
experiencing mental disorders.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
2. Suggestion
for
Educational
Institutions
Nursing Studies Program Faculty
of Health Sciences, University of
Muhammadiyah
Surakarta
should also equip students with
the ability to convey information
to the public, so that when
they’ve become a nurse is able
to be a resource for the
community, especially on health
issues in the community.
3. Suggestion for researchers who
will come
Psychoeducation used in this
study only used the lecture
method using leaflets media.
Expected future researchers
using other teaching methods, in
order to obtain better knowledge
enhancement.
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Kasus Gangguan Jiwa. Jakarta
: EGC.
Keliat.
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Lukens & McFarlane. 2004. Psycho
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Practice, Research, and Policy.
Brief Treatment and Crisis
Intervention Vol. 4 No.
Oxford University Press.
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Mulyatiningsih
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Nopyawati, S. 2013. Hubungan
Pengetahuan
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Penderita Gangguan Jiwa Di
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Kerja
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Colomadu 1. Naskah Publikasi.
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Universitas
Muhammadiyah
Notoadmodjo, S. 2007. Pendidikan
dan
Perilaku
Kesehatan.
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Notoatmodjo, S. 2010. Metodologi
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Kesehatan. Jakarta. Rineka
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Surakarta. Tidak dipublikasikan
Riskesdas. 2013. Profil Kesehatan
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/note/184.
diunduh
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tanggal 10 oktober 2014 jam
20.00 WIB.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
Sarwono. 2007. Psikologi Remaja.
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Resnayati. 2002. Penyuluhan
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Diunduh 22 September 2014.
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Terhadap
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1.
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E.R.
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11
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Retardasi
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Ringan. Jurnal Psikologi. Riau:
Fakultas Psikologi UIN Sultan
Syarif Kasim.
*M. Fajar Sodiq: Student of
Bachelor of Nursing FIK UMS. Jln A
Yani Tromol Post 1 Kartasura
** Arum Pratiwi, S.Kp., M.Kes:
Lecturer of Bachelor of Nursing FIK
UMS. Jln A Yani Tromol Post 1
Kartasura.
*** Wachidah Yuniartika, S.Kep, Ners:
Lecturer of Bachelor of Nursing FIK
UMS. Jln A Yani Tromol Post 1
Kartasura
GANGGUAN JIWA ANTARA SEBELUM DAN SESUDAH DIBERIKAN
PSIKOEDUKASI PADA REMAJA DI DESA NGUTER
NASKAH PUBLIKASI
Diajukan sebagai salah satu syarat
untuk meraih gelar Sarjana Keperawatan
Disusun Oleh :
M FAJAR SODIQ
J 210112004
FAKULTAS ILMU KESEHATAN
UNIVERSITAS MUHAMMADIYAH SURAKARTA
2015
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
1
RESEARCH
DIFFERENCES LEVEL OF KNOWLEDGE ABOUT PREDISPOSING
FACTORS MENTAL DISORDERS BETWEEN BEFORE AND AFTER
PROVIDED PSYCHOEDUCATION IN TEENEGER GROUP IN THE
NGUTER VILLAGE
By:
M Fajar Sodiq
One of important factor to prevent increasing of mental illness is how to manage them.
Teenager is part of crusial thing that role in preventing of mental illness. So they need to
have knowledge about prevention of mental illness. This study purpose to analyze the
influence of psychoeducation toward the level of knowledge on teenager. The design of
study of quantitative with pre experimental methods. Sample in the research is number 30
teenagers, tehnique sampling in this research is purposive sampling. The collect of data
used quetionary level of knowledge and the data analyze utilized Wilcoxon Rank Test.
The result of the research show that there were different the level knowledge between
before and after study with the significance value 0,0001.
Keywords: psycheducation, mental disorders predisposing factor.
.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
INTRODUCTION
The phenomenon of mental
disorder at this time has increased
very significantly, and every year in
various parts of the world increases
the number of people with mental
disorders. Based on data from the
World Health Organization (WHO) in
Joseph
(2013),
there
are
approximately 450 million people
worldwide who experience mental
illness. WHO said at least one of the
four people in the world experiencing
mental health problems, and mental
health disorders problems that exist
around the world has become a very
serious problem for us examine.
The
high
number
of
inhabitants and the many problems
of both social and economic, some
communities had to struggle to
overcome the pressures of life and
be able to adapt to environmental
changes. In fact, with so many other
problems arise; causing not a few
people we finally have a degree of
frustration, depression and high
stress to cause mental health
problems.
Indonesia is not a taboo
anymore know someone who is
mentally
ill.
Mental
disorders
experienced by humans various
causes, one of which is a psychosis,
ie the types of diseases that interfere
with
brain
function.
Various
psychoses
include:
psychosis
relatively short, due to cannabis
psychosis,
organic
psychosis,
psychotic delusions, skizofreniform
psychosis,
schizophrenia,
skizofreniform
disorder,
bipolar
affective disorder, psychotic post
partum (Majid, 2004).
A mental disorder that is a
syndrome or pattern of behavior that
is
associated
with
clinically
significant distress or suffering and
causing disruption on one or more
2
functions of human life. (Keliat,
2011)
Not only had the health profile
of Indonesia in 2014 revealed that
mental illness is a health problem in
the community. It can be seen from
the data base of health (Riskesdas),
Bella (2014) The Department of
Health in 2014 said there were 1
million patients with severe mental
disorders and 19 million patients with
mild mental disorder in Indonesia.
Central Java is included in the 5
provinces
with
the
highest
prevalence figures in Indonesia with
prevalence figures reaching 2.3 %.
Central Java Province itself is
included in the 5 provinces with the
highest
prevalence
figures
in
Indonesia with prevalence figures
reaching 2.3 % (Riskesdas, 2013). In
Central Java alone there are 3
people per thousand residents who
are mentally handicapped and 50 %
is a result of job loss. Thus 32.95204
million residents of Central Java,
there are around 98 856 people
suffering from mental disorders. In
line with the health paradigm that
proclaimed
health
department
memekankan more proactive efforts
to prevent than to wait in hospitals,
mental health orientation is now
more on prevention (preventive) and
(promotive).
Based on preliminary studies
in the area Sukoharjo are still many
people who experience mental
illness at approximately 2778 cases
of people with mental disorders, or
about 0.6 % of the total population of
productive age amounted to 507 517
inhabitants
(DKK
Kabupaten
Sukoharjo, 2013). Based on data
from the mental hospital Surakarta
number of people with mental
disorders is hospitalized from
regions Sukoharjo many as 331
people,
while
the
outpatient
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
amounted (Rekam Medik RSJD
Surakarta, 2013).
Research concluded by Aji
(2013) Nguter in the district showed
that in 2013 obtained the data 152
mental patients and 43 patients
deprived who shackled
(Dinkes,
2013). At Nguter village found 22
peoples was who experience mental
ills Hartanto (2014) mentions that in
the treatment of patients with mental
disorders are rare families that bring
patients to the health service.
Treatment of mental disorders
requires different components. One
is the family support. But what
happened today is a lot of family
members who experience mental
illness precisely in exile by the family
or society. Though this will make
pasiean increasingly severe stress
and can worsen the disease.
Mental disorders can happen
to anyone, one of them in
adolescents. Adolescence is known
as a critical period in the
development of personality, as a
period of "storm and stress ". In this
period the individual faced with rapid
growth, changes bodily and sexual
maturation, At the same time social
status is also subject to change,
when first he was very dependent on
parents or others, now he must learn
to stand alone and responsible
brings its own problems of marriage,
employment, and general social
status. Greater freedom brings
greater
responsibility
anyway
(Yosep, 2013).
Factor that led to the
occurrence of mental disorders is a
lack of knowledge about family
pretisipasi and predisposing factors.
Given psychoeducation researchers
hope to provide education to the
youth in the village Nguter so that
when they get a stressor from
outside they could make copping
mechanisms themselves so that they
3
are not at risk of mental disorders,
and for adolescents who have family
members with mental illness they
can understand the situation her and
could provide the appropriate
treatment.
This study discussed the
differences in the level of adolescent
knowledge about mental disorders
predisposing factor between before
and after psychoeducation at -risk
groups in the Nguter.
THEORETICAL BASIS
The Concept of Mental Disorder
Mental
disorders
are
maladaptive response of the internal
and external environment, evidenced
through the thoughts, feelings and
behaviors that are not in accordance
with local norms or local culture and
disrupt the function of social,
occupational or physical (Townsend,
2008).
Farida (2010) claim that the
disorder occurs in people with
mental disorders, namely : Impaired
sensation, perceptual disorders,
attention
disorders,
memory
disorders,
disorders
of
the
association, impaired judgment,
impaired
thinking,
impaired
consciousness, orientation disorder,
impaired
volition,
emotional
disorders
and
affective,
and
impaired.
Yosep (2007) signs and
symptoms in patients with mental
disorders,
namely
:
Impaired
cognition,
attention
disorders,
memory disorders, disorders of the
association, impaired judgment,
impaired
thinking,
impaired
consciousness, volition disorders,
emotional disorders and affective,
psychomotor.
Stuart dan Laraia (2001) in
his book said predisposing factor is
the factors associated with risk
factors for mental disorders.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
Stuart & Sandine (2001) said
predisposing factor in one's patient
is the patient’s role as perpetrators,
victims, and witnesses, these factors
consist of:
a) Physical
Persecution:
Persecution own physical could
come later if the patient was on
the perpetrators, victims and
witnesses of the persecution
that occurred.
b) Sexual
Persecution
:
Persecution of sexual usually
often we know as rape, patients
themselves can be derived from
rape victims, perpetrators
c) Rejection: Rejection here can be
interpreted as an exile or
ignored someone in a society so
that it can to make someone’s
stress.
d) Violence in the family : Violence
in the family can occur not only
her husband's violence against
his wife, but also the parents
who do the wrong upbringing of
the child, when the child was a
child when the parents commit
violence that memory can be
stored until he was an adult and
until she had children of her
own.
e) The crimes: Patients with mental
disorders can occur due to
criminal acts which he found;
here the patient can be abusers,
victims
of
violence
and
witnesses of violence itself.
Erik Erikson who is also a
predisposing factor of mental
disorder is when the person's growth
and development within its phases.
The phases are:
a) 0 - 18 months at trust versus
Mistrust phase
b) 18 months until 3 years
autonomy versus shame and
doubt phase.
c) 3 years until 5 years inisiatif
versus guilty feeling.
d)
e)
f)
g)
h)
4
6 years - 10 years, Industry
versus inferiority phase.
10 years - 20 years, Identity
versus Identity confusion.
20 years - 30 years, intimacy
versus Isolation phase.
40 years - 50 years, Generativity
versus Stagnation phase.
60 years and olders, integrity
versus depair.
The
factor
of
mental
disorder’s are (Yosep, 2013) :
a) Heredity
b) Constitution factors
c) Congenital defects.
d) Incorrect
psychological
development.
e) Self deprivation
f) Who pathogenic family pattern
g) Adolescence
h) The wrong factor of sociological
development.
i) Genetics.
j) Neurobiologikal
k) Biochemestry body
l) Neurobehavioral
m) Stress
n) Drug abuse
o) Psikodinamic
Knowledge
Knowledge gained from the
results of curiosity, all of this
happens someone did sensing of
objects that happen. Out of curiosity
then one can take a decision faced
(Achmadi, 2013).
Knowledge generally comes
from experience myself for example
a child put his hand into the fire
stove heat will occur on the
knowledge gained in pain he will not
repeat (Irianto, 2014).
Achmadi
(2013)
argued
classified into 6 levels of knowledge,
namely :
1) Know
2) Comprehension
3) Application
5
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
4) Analysis
5) Synthesis
6) Evaluation
Sulihah (2002) knowlegde is
affected by the:
1) Level of education.
Educations are an attempt to
give the knowledge to change
attitudes for the better.
2) Information
More someone who gets it will be
clearer information he received
knowledge.
3) Culture
The behavior of the public in
making a habit that has an
attitude and confidence.
4) Experience
Events that have happened in
the past that can increase a
person's.
5) Social economic
A person's level of income that
can meet the needs.
Psycho education
Psychoeducation is a form of
education or training of a person with
a psychiatric disorder that is aimed
at treatment and rehabilitation
process.
The
goal
of
psychoeducation is to develop and
increase patient acceptance of a
disease or disorder that he
experienced,
increase
patient
participation in treatment, and the
development of coping mechanism
when patients face problems related
to the disease (Goldman, 1998
quoted
from
Bordbar
&
Faridhosseini, 2010).
The
purpose
of
psychoeducation
alone
is
to
enhance the adaptive function of the
family
and
meningakatkan
katrampilan
positive
coping
mechanisms. It is basically used to
help nurses identify problems in the
family (Stuart & Sundeen, 2005)
Framework
Psycho education
Pre test
knowledge
1.
2.
3.
4.
5.
Post test
knowledge
Confounding factors:
The level of education
Information
Culture
Experience
Social economic
Picture 1. Framework
Hypothesis
Ha : There are differences in the
level of knowledge about
mental disorders predisposing
factor between before and
after
psychoeducation
in
adolescents in the village
Nguter.
Methodology Research
Research Design
In this study, using a
quantitative
design
with
preexperimental research methods,
research design pretest - posttest
design group. Studies that provide
treatment without the use of a
control group to give a pretest before
treatment and ends with the
provision of post test after being
given treatment (Sugiono, 2014).
Population and sample
The population in this study is a
teenager who lives in the village
Nguter as many as 988 peoples.
The sample was 30 adolescents
with
determination
techniques
cluster random sampling.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
The Research Instruments
This study uses a measuring
instrument in the form of a
questionnaire.
6
RESULT AND DISCUSSION
Wilcoxon Rank Test results
obtained knowledge Zobs value of
4.791 and a significance value of
0.000. Because probability value <
0.05 (0.000 < 0.05), then the test is
concluded there are differences in
pre-test and post test knowledge.
The average value of knowledge is a
pre-test and post-test 12.867 for
14.767. Based on the average value
of the knowledge it appears that the
value of post test knowledge higher
than the value of pre-test knowledge.
Univariate Analysis
Discussion
Distribution
of
Pre
Test
Knowledge
Table 1. Distribution Frequency of
Pre Test Knowledge
The level of knowledge about
the predisposing factors of
mental
disorder
before
psychoeducation
The Data Analysis
Analysis of the data in this study is
bivariate. To be able to test and
analyze the data used technique
Wilcoxon Signed Rank Test.
No
1
2
3
Knowledge
Bad
Moderate
God
Total
F
6
21
3
30
%
20%
70%
10%
100%
Distribution
of
Pre
Test
Knowledge
Tabel 2. Distribution of Pre Test
Knowledge
No
1
2
3
Knowledge
Bad
Moderate
God
Total
F
4
8
18
30
%
13%
27%
60%
100%
Knowledge of the Effectiveness of
Psychoeducation
Against
Predisposition Factors Mental
Disorders in Teens in the village
of Sukoharjo Nguter
Table 3. Uji Wilcoxon Rank Test of
Knowledge
The result
Knowledg
e
Mean
Pre test
Post test
z-hit
p-v
Con
clus
sion
12,867
4,791 0,000 Sign
14,767
Distribution of adolescents
knowledge about the predisposing
factors of mental disorder before
being given psychoeducation mostly
being that 21 respondents (70 %)
and
10
%
of
respondents
berpengetahhuan well. Based on the
knowledge of the data, it was
concluded that the level of
knowledge about mental disorders
predisposing
fatkor
most
respondents before the study was
moderate with an average of 12.867.
The level of knowledge that
was the one caused by the level of
education is good enough most of
the
high
school
educated.
Respondents who are well educated
have the ability to examine or
analyze a question and find a
solution answers. In this study, the
question of knowledge using the
model of multiple choice, so that
respondents can make comparisons
of the answer choices and determine
the answers they think are
reasonable and the best, so
although previously they do not
know about that question, but the
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
answer choices lead respondents
could choose the best answer.
Knowledge
of
the
predisposing factors of mental
disorders
are
adolescent
understanding of the predisposing
factors of mental disorder, or
information obtained from a source
of the experience they gain in their
environment. When adolescents
have people around them are
mentally ill, there will be discussions
in the community about the person,
well why he had a mental disorder,
how it happened, what the cause
and so forth. When adolescents
obtain such information, then teens
will analyze it and making it into
knowledge of psychiatric disorders.
Relationship information and
experiences on knowledge as
expressed by Sulihah (2002) which
suggests that one of the factors that
influence knowledge is experience.
Experience that teens about mental
disorders around teenagers become
resources for teen’s knowledge
about mental disorders predisposing
factors. Research Vivin (2011)
concluded that there is a relationship
utilization of various media with
adolescent
reproductive
health
knowledge level of class XI SMA
Darul ' Ulum 3 Jombang.
Research also shows that
there are 10 % of respondents who
have knowledge of the predisposing
factors of mental disorders is
lacking. This condition is caused
there are 10 respondents (33 %)
junior high school education. The
education level of the respondents
that cause their ability to understand
information
about
predisposing
factors both from lessons at school
as well as from the mass media is
lower than the respondents had high
school, so that their level of
knowledge is low.
7
Research
shows
teens
knowledge about the distribution of
predisposing factors are mostly
moderate. These results support the
research Nopyawati (2013) which
revealed
that
knowledge
of
communities in the PHC Colomadu
Karanganyar Work on mental
disorders is largely sufficient. This
study states that the factors that
shape public knowledge about
mental disorders, among others, the
level of public education, and
information that affect the public
opinion.
Increasing the effectiveness of
psychoeducation for
Knowledge
Research in a comparative
study
comparing
adolescent’s
knowledge about mental disorders
predisposing factors before and after
getting psychoeducation about the
predisposing factors of mental
disorder. Testing is done by
comparing the scores of knowledge
before and after psychoeducation.
Comparative
analysis
techniques used in this study were
paired samples t -test if the data
were
normally
distributed
or
Wilcoxon rank test if the data is not
normally distributed. Testing data
normality using the Kolmogorov Smirnov test at a significance level
of 5 %. Furthermore normality test
results show that knowledge of both
the
research
data
before
psychoeducation and data after
psychoeducation is not normal
because it has a p-value less than
0.05. Based on the results of the
data normality test, the comparison
test techniques used in this study is
the Wilcoxon rank test.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
Wilcoxon rank test results
concluded
that
there
psychoeducation effectiveness of the
increased knowledge about mental
disorders
predisposing
to
an
increased level of adolescent
knowledge Nguter In the village of
Sukoharjo (p - value = 0.000). The
average value of knowledge is a pretest and post-test 12.867 for 14.767,
so it concluded psychoeducation
effectively increase knowledge of
predisposing factors in adolescents
in the village of Sukoharjo Nguter.
Psychoeducation
about
predisposing factors of mental
disorder aims to provide information
to
adolescents
about
the
understanding of mental disorders
predisposing factors. With the
provision of such information is
expected to teen’s knowledge about
mental disorders predisposing factor
increased to well. This is in
accordance with the opinion of
Goldman (Bordbar & Faridhosseini
2010) that defines psychoeducation
as a form of education or training of
a person with a psychiatric disorder
that is aimed at treatment and
rehabilitation process. The goal of
psychoeducation is to develop and
increase patient acceptance of a
disease or disorder that he
experienced,
increase
patient
participation in treatment, and the
development of coping mechanisms
when patients face the problems
associated with the disease.
The results support the
research Yulita (2013) about the
effectiveness of psychoeducation to
parents in improving knowledge of
teenage sexuality mild mental
retardation. This study concluded
that
there
is
educational
effectiveness
in
increasing
knowledge of teenage sexuality mild
mental retardation.
8
Another study conducted by
Farida (2012) regarding self-efficacy
training to improve the career
decision-making abilities of high
school
students.
The
study
concluded that the effect of selfefficacy training to improve decisionmaking career in high school
students.
Conclussion and Suggestions
conclussion
1. Knowledge Nguter teenager In
the village of Sukoharjo on
predisposing factors of mental
disorder before getting psychoeducation
about
mental
disorders predisposing factors
largely being.
2. Knowledge of teenagers in the
village of Sukoharjo Nguter after
getting psycho-education about
mental disorders predisposing
factors are mostly good.
3. There
effectiveness
of
psychoeducation to increased
knowledge of the predisposing
factors of mental disorders in
adolescents in the village of
Sukoharjo Nguter.
Suggestion
1. Suggestion for Teenenger
Youth should increase their
sensitivity to the environment, so
that they can provide benefits to
the surrounding environment.
Youth should also increase their
knowledge about psychiatric
disorders, so that they can make
an effort anticipation of his
friends who are at risk of
experiencing mental disorders.
Differences Level of Knowledge About Predisposing Factors Mental Disorders Between
Before and After Provided Psychoeducation in teeneger Group in the Nguter Village (M.
Fajar Sodiq)
2. Suggestion
for
Educational
Institutions
Nursing Studies Program Faculty
of Health Sciences, University of
Muhammadiyah
Surakarta
should also equip students with
the ability to convey information
to the public, so that when
they’ve become a nurse is able
to be a resource for the
community, especially on health
issues in the community.
3. Suggestion for researchers who
will come
Psychoeducation used in this
study only used the lecture
method using leaflets media.
Expected future researchers
using other teaching methods, in
order to obtain better knowledge
enhancement.
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*M. Fajar Sodiq: Student of
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** Arum Pratiwi, S.Kp., M.Kes:
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*** Wachidah Yuniartika, S.Kep, Ners:
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