Respon Berduka Pada Pasien Stroke di RSUP Haji Adam Malik Medan

  Respon Berduka Pada Pasien Stroke di RSUP Haji Adam Malik Medan SKRIPSI Oleh Wita 111101093 FAKULTAS KEPERAWATAN UNIVERSITAS SUMATERA UTARA 2015

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  Bismillahirrahmaanirrahim, puji syukur kehadirat Allah SWT atas

  rahmad dan hidayah-Nya penulis dapat menyelesaikan skripsi dengan judul “Respon Berduka Pada Pasien Stroke di RSUP Haji Adam Malik Medan”, untuk memenuhi salah satu persyaratan memperoleh kesarjanaan pada Fakultas Keperawatan Universitas Sumatera Utara.

  Selama proses penulisan skripsi ini, penulis banyak mendapat bantuan, bimbingan, dan dukungan dari berbagai pihak dengan memberikan butir-butir pemikiran yang sangat berharga bagi penulis baik secara langsung maupun tidak langsung. Untuk itu, penulis mengucapkan terimakasih kepada:

  1. Bapak Dr. Dedi Ardinata, M.Kes, selaku Dekan Fakultas Keperawatan Universitas Sumatera Utara.

  2. Ibu Erniyati, S.Kp, MNS, selaku Pembantu Dekan Universitas Sumatera Utara.

  2. Ibu Rika Endah Nurhidayah, S.Kp, M.Pd, selaku dosen pembimbing yang telah memberikan pengetahuan, bimbingan, dorongan secara moral, masukan dan arahan yang sangat membantu sehingga penyusunan skripsi ini dapat diselesaikan.

  3. Ibu Sri Eka Wahyuni, S.Kep, Ns, M.Kep, dan ibu Fatwa Imelda, S.Kep, Ns, M.Biomed, selaku dosen penguji 1 dan dosen penguji 2 yang telah memberikan pengetahuan, bimbingan, masukan dan arahan yang sangat membantu sehingga penyusunan skripsi ini dapat diselesaikan.

  

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  4. Ibu Diah Arruum, S.Kep, Ns, M.Kep, selaku dosen pembimbing akademik, seluruh dosen dan pegawai Fakultas Keperawatan USU yang telah memberikan bimbingan selama masa perkuliahan. Semoga Allah membalas ilmu yang telah kalian berikan dengan keberkahan.

  5. Orang tua tercinta Alm Muhammad Ikhwan Pasaribu dan Ibunda Dahlia Suty Nasution terima kasih atas kasih sayang dan pengorbanan yang kalian berikan.

  Semoga anakmu ini bisa menjadi kebanggaan untuk kalian. Serta saudara tersayang kakak dan adik Liza Juliani, Dewi Sartika, dan Mega Silfia.

  6. Teman-teman seperjuangan angkatan 2011 dan teman-teman teristemewa Lady Diana Puspita Dewi, Putri Nanda Sari, Otania Hosiana, Yori, Indri, Anggi, Nidya, Mesya, Cici, serta sahabatku Edwar Randa. Semangat untuk meraih impian kita.

  Peneliti menyadari keterbatasan dalam skripsi ini, untuk itu peneliti mengharapkan adanya saran yang bersifat membangun untuk perbaikan yang lebih baik di masa yang akan datang.

  Medan, Agustus 2015 Peneliti

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  DAFTAR ISI

  Halaman

  

HALAMAN JUDUL ........................................................................................... i

HALAMAN ORISINALITAS............................................................................ ii

HALAMAN PENGESAHAN ............................................................................. iii

KATA PENGANTAR ......................................................................................... iv

DAFTAR ISI ........................................................................................................ vi

DAFTAR TABEL................................................................................................ ix

DAFTAR SKEMA .............................................................................................. x

ABSTRAK ........................................................................................................... xi

BAB 1. PENDAHULUAN .................................................................................. 1 1. Latar belakang ..................................................................................... 1 2. Perumusan masalah ............................................................................. 6 3. Pertanyaan penelitian .......................................................................... 6 4. Tujuan penelitian ................................................................................. 6 5. Manfaat penelitian ............................................................................... 7 BAB 2. TINJAUAN PUSTAKA ......................................................................... 9 1. Kehilangan .......................................................................................... 9

  1.1. Definisi kehilangan ...................................................................... 9

  1.2. Tipe kehilangan ............................................................................ 10

  1.2.1. Kehilangan objek eksternal ............................................... 10

  1.2.2. Kehilangan lingkungan yang telah dikenal ....................... 10

  1.2.3. Kehilangan orang terdekat ................................................. 11

  1.2.4. Kehilangan aspek diri ........................................................ 11

  1.2.5. Kehilangan hidup ............................................................... 12

  1.3. Faktor predisposisi yang mempengaruhi reaksi kehilangan ........ 14

  1.3.1. Genetik............................................................................... 14

  1.3.2. Kesehatan fisik .................................................................. 15

  1.3.3. Kesehatan jiwa/mental ....................................................... 15

  1.3.4. Pengalaman kehilangan di masa lalu ................................. 15

  1.4. Dampak kehilangan ...................................................................... 15

  2. Berduka ................................................................................................. 16

  2.1. Definisi berduka ........................................................................... 16

  2.2. Faktor penyebab berduka ............................................................. 16

  2.2.1. Patofisiologis ..................................................................... 16

  2.2.2. Terkait pengobatan ............................................................ 17

  2.2.3. Situasional ......................................................................... 17

  2.2.4. Maturasional ...................................................................... 17

  2.3. Tanda dan gejala berduka............................................................. 18

  2.3.1. Reaksi perasaan ................................................................. 18

  2.3.2. Reaksi fisik ........................................................................ 18

  2.3.3. Reaksi kognisi.................................................................... 18

  2.3.4. Reaksi perilaku .................................................................. 18

  2.4. Akibat berduka ............................................................................. 20

  2.5. Respon berduka ............................................................................ 20

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  2.5.1. Fase penyangkalan ............................................................. 20

  2.5.2. Fase marah ......................................................................... 21

  2.5.3. Fase tawar-menawar .......................................................... 21

  2.5.4. Fase depresi ....................................................................... 21

  2.5.5. Fase penerimaan ................................................................ 22

  3. Respon psikologis pasien stroke ........................................................... 23

  3.1. Kemarahan ................................................................................... 23

  3.2. Isolasi ........................................................................................... 24

  3.3. Kelabilan emosi ............................................................................ 24

  3.4. Depresi ......................................................................................... 24

  

BAB 3. KERANGKA PENELITIAN ................................................................ 26

  1. Kerangka konsep ................................................................................... 26

  2. Definisi operasional .............................................................................. 27

  

BAB 4. METODOLOGI PENELITIAN ........................................................... 28

  1. Desain penelitian ................................................................................... 28

  2. Populasi, sampel, dan teknik sampling ................................................. 28

  2.1. Populasi ...................................................................................... 28

  2.2. Sampel ........................................................................................ 28

  2.3. Teknik sampel............................................................................. 29

  3. Lokasi dan waktu penelitian.................................................................. 30

  4. Pertimbangan etik.................................................................................. 30

  4.1. Prinsip manfaat............................................................................. 30

  4.2. Prinsip menghargai martabat manusia ......................................... 32

  4.3. Prinsip keadilan ............................................................................ 33

  5. Instrumen penelitian .............................................................................. 34

  5.1. Kuesioner data demografi ........................................................... 34

  5.2. Kuesioner respon berduka .......................................................... 34

  6. Validitas dan reliabilitas ........................................................................ 35

  6.1. Validitas ...................................................................................... 35

  6.2. Reliabilitas .................................................................................. 36

  7. Pengumpulan data ................................................................................. 37

  7.1. Proses administrasi ..................................................................... 37

  7.2. Pengumpulan data pasien stroke................................................. 37

  8. Analisa data ........................................................................................... 38

  

BAB 5. HASIL DAN PEMBAHASAN .............................................................. 40

  1. Hasil penelitian...................................................................................... 40

  1.1. Distribusi fase penyangkalan ...................................................... 40

  1.2. Distribusi fase marah .................................................................. 41

  1.3. Distribusi fase tawar-menawar ................................................... 42

  1.4. Distribusi fase depresi ................................................................ 43

  1.5. Distribusi fase penerimaan ......................................................... 44

  2. Pembahasan ........................................................................................... 46

  2.1. Distribusi fase penyangkalan ...................................................... 46

  2.2. Distribusi fase marah .................................................................. 47

  2.3. Distribusi fase tawar-menawar ................................................... 49

  2.4. Distribusi fase depresi ................................................................ 50

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  2.5. Distribusi fase penerimaan ......................................................... 52

  

BAB 6. KESIMPULAN DAN SARAN .............................................................. 54

  1. Kesimpulan ........................................................................................... 54

  2. Saran ...................................................................................................... 54

  3. Keterbatasan penelitian ........................................................................ 56

  

DAFTAR PUSTAKA .......................................................................................... 57

LAMPIRAN

  1. Lembar persetujuan menjadi responden penelitian ............................... 61

  2. Instrumen penelitian .............................................................................. 63

  3. Jadwal tentative penelitian .................................................................... 65

  4. Ethical Clearance.................................................................................. 66

  5. Validitas isi instrument respon berduka (CVI) ..................................... 67

  6. Uji reliabilitas kuesioner respon berduka .............................................. 69

  7. Master tabel penelitian .......................................................................... 71

  8. Persetujuan validitas isi (content) ......................................................... 72

  9. Persetujuan izin penelitian .................................................................... 74

  10. Persetujuan izin pengambilan data ...................................................... 75

  11. Persetujuan telah menyelesaikan penelitian ........................................ 76

  12. Lembar terjemahan abstrak ................................................................. 77

  13. Taksasi dana penelitian ....................................................................... 78

  14. Lembar bukti bimbingan ..................................................................... 79

  15. Daftar riwayat hidup ........................................................................... 81

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DAFTAR TABEL

Tabel 2.1 Tabel tanda gejala berduka ................................................................... 19Tabel 3.1 Definisi operasional variable penelitian ................................................ 27Tabel 5.1 Tabel fase penyangkalan ....................................................................... 41Tabel 5.2 Tabel fase marah ................................................................................... 42Tabel 5.3 Tabel fase tawar-menawar .................................................................... 43Tabel 5.4 Tabel fase depresi.................................................................................. 44Tabel 5.5 Tabel fase penerimaan ........................................................................ 45

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  Skema 3.1. ............................................................................................................. 26

  x Judul : Respon berduka pada pasiien stroke di RSUP Haji Adam Malik Medan Nama : Wita Nim : 111101093 Jurusan : S1 Keperawatan Tahun : 2015

  ABSTRAK

  Respon berduka adalah respon emosional individu terhadap reaksi kehilangan yang dialaminya yang terdiri dari fase denial, anger, bargaining,

  depresion , dan acceptance. Stroke adalah penyakit yang dapat menimbulkan

  adanya kecacatan, kelemahan fungsi tubuh, atau dampak negatif lainnya sehingga menimbulkan respon berduka pada orang yang mengalaminya. Tujuan penelitian ini adalah untuk mengetahui respon berduka meliputi fase denial, anger,

  bargaining , depression, dan acceptance pada pasien stroke di RSUP Haji Adam

  Malik Medan. Penelitian ini menggunakan desain penelitian deskriptif. Lokasi penelitian di ruang neurologi RSUP Haji Adam Malik Medan. Pengumpulan data dilakukan dengan pemberian kuesioner dan wawancara terstruktur yang berpedoman pada kuesioner. Jumlah sampel dalam penelitian ini berjumlah 33 responden dipilih dengan purposive sampling. Hasil penelitian menunjukkan bahwa sebagian besar responden mengalami fase denial, fase bargaining, dan fase

  acceptance . Sebagian kecil responden mengalami fase anger, dan fase depression.

  Direkomendasikan kepada seluruh perawat agar memahami tentang respon berduka pada pasien stroke dan dapat memberikan asuhan keperawatan yang tepat sehingga pasien stroke dapat melewati proses berduka yang normal.

  Kata kunci: Respon Berduka, Pasien Stroke xi

  Title of the Thesis : Mournful Responses of Patients Affected by Stroke at RSUP Haji Adam Malik, Medan

  Name : Wita Std. ID Number : 111101093 Faculty : Undergraduate (S1) Nursing Academic Year : 2015

  ABSTRACT A mournful response is an individual emotional response toward a reaction of loss which consists of denial, anger, bargaining, depression, and acceptance phases. Stroke is a desease which can cause physical disability, weakness of body function, and other negative impacts that can cause mournful responses of a person affected by stroke. The objective of research was to find out the mournful responses which consisted of denial, anger, bargaining, depression, and acceptance phases of patients affected by stroke at RSUP Haji Adam Malik, Medan. The research used a descriptive research design. The location of research was in the Neuorology Room at RSUP Haji Adam Malik, Medan. Data were collected by distributing questionnares and conducted structured interviews based on the questionnaires. The samples were 33 respondents, taken by using purposive sampling technique. The results of research showed that most of the respondents suffered from denial, bargaining, and acceptance phases. Some of them suffered from anger and depression phases. It is recommended that all nurses understand mournful responses of patients affected by stroke and provide appropriate cares so that they can pass the mournful processes normally.

  Keywords: Mournful Responses, Patients Affected by Stroke xii