Minggu, 25 Mei 2014
HUBUNGAN HUBUNGAN PENGETA PENGETAHUAN HUAN DAN DUKUNGAN DUKUNGAN KELUARGA KELUARGA TERHADAP TERHADAP KEPATUHAN MINUM OBAT PADA PASIEN SKIZOFRENIA DIKELURAHAN KANIGARAN Abstrak viii + 68 halaman + 8 Lampian + ! "a#$l S%i&'($n a)alah p$n*a%i" *an m$mp$na,hi '"a% )an p$n*$#a# "im#,ln*a pi%ian p$.$p.i- $m'.i- $a%an- )an p$ila%, *an an$h )an "$an,/ S%i&'($nia )i),a .$#aai .,a", .in)'m a"a, p'.$. p$n*a%i" *an m$n0a%,p #an*a% 1$ni. )an $1ala/ P$n$li"ian P$n$li"ian ini )ila%,%an )ila%,%an ,n",% m$n$"ah,i m$n$"ah,i h,#,nan h,#,nan p$n$"ah,an p$n$"ah,an )an ),%,nan ),%,nan %$l,aa "$ha)ap %$pa",han min,m '#a" pa.i$n .%i&'($nia )i RSUD Kaa2an)$nan m$n,na%an )$.ain )$.%ip"i( anali"i% p$n)$%a"an cross sectional / In.",m$n )i#,a" )alam #$n",% %,$.i'n$ *ai", #aian ,n",% m$n,%, p$n$"ah,an %$l,aa )an ),%,nan %$l,aa "$n"an p$n'#a"an pa.i$n .%i&'($nia/ 3,mlah .amp$l 45 'an )$nan m$n,na%an p'p'.iv$ .amplin .$#aai "$%ni% p$nam#ilan )a"a/ Ha.il Ha.il p$n$li" p$n$li"ian ian m$na m$nam#a m#a%a %an n 4-!7 4-!7 p$n$" p$n$"ah, ah,an an *an *an "i)a% "i)a% #ai%/ #ai%/ Anali. Anali.aa ."a"i."i% Chi-Square )$nan Chi-Square )$nan )$a1a" %$#$#a.an 9:-:! )ip$'l$h nilai pvalue nilai pvalue9 9 :-::: h,#,nan *an .ini(i%an an"aa p$n$"ah,an )an %$pa",han min,m '#a"/ H,#,nan an"aa ),%,nan %$l,aa "$ha)ap %$pa",han min,m '#a" )i)apa"%an p value :-4;8< value :-4;8< =:-:!>- #$a"i H' aal )i"'la% )apa" )i.imp,l%an #ah2a "i)a% a)a h,#,nan an"aa ),%,nan %$l,aa )anan %$pa",han min,m '#a" )i RSUD Kaa2an/ Saan ,n",% pa%"$% %$p$a2a"an )ihaap%an )apa" m$la%,%an .,p$vi.i )an m'ni"'in "$%ai" p$n$apan p$m#$)a*aan %$l,aa )alam p$m#$ian a.,han %$p$a2a"an pa)a %$l,aa/ Kata kunci: pengetahuan, dukungan, dukungan, kepatuhan, skizofrenia skizofrenia
Daftar pustaka: 15. tahun !!"-!1# !!"-!1#
BAB 1 PENDAHULUAN
A. Latar belakang S$ha" )alam .,a", $n"an a)alah "in%a" .$1ah"$a %li$n pa)a 2a%", "$"$n",-
*an "$)apa" )alam $n"an )ai %'n)i.i .$1ah"$a *an 'p"imal- )$nan $n$i *an ma%.im ma%.im,m,m- .ampai .ampai %'n)i.i %'n)i.i %$ma"ia %$ma"iann- *an *an m$nan) m$nan)a%an a%an ha#i.n* ha#i.n*aa $n$ $n$ii "'"al "'"al =N$,man-?55: )alam P'""$ an) F$*-@::!>/ F$*-@::!>/ K$.$ha" K$.$ha"an an 1i2a 1i2a )an an, an,an an 1i2a .$in .$in %ali %ali .,li" .,li" )i)$(i )i)$(ini. ni.i%a i%ann- 'an 'an )ianap .$ha" 1i%a m$$%a mamp, m$main%an p$an )alam ma.*aa%a" )an p$ila%, m$$% m$$%aa pan" pan"a. a. )an )an a)ap a)ap"i "i(/ (/ S$#a S$#ali li%n %n*a *a-- .$.$' .$.$'an an )ian )ian ap ap .a%i" .a%i" 1i%a 1i%a aa aall m$main m$main%an %an p$an p$an )an m$mi%, m$mi%,ll "an, "an,n n 1a2a# 1a2a# a"a, p$ila p$ila%,n %,n*a *a "i)a% "i)a% pan"a./ pan"a./ K$#, K$#,)a* )a*aan aan .$"ia .$"iap p ma.* ma.*aa aa%a" %a" .ana .ana"" m$mp m$mp$n $na a, ,hi hi )$(i )$(ini ni.i .i .$ha .$ha"" )an )an .a%i" .a%i" =i) =i)$#$ $#$0%0%-@:: @::8>/ 8>/ D$nan D$nan )$mi%i )$mi%ian an %$.$ha %$.$ha"an "an 1i2a 1i2a .$.$'a .$.$'an n m$,pa m$,pa%an %an .,a", .,a", %$a)aan *an )inami% a"a, .$lal, #$,#ah- M$lal,i p'.$. in"$a%.i *an %'n."an )ian"aa (a%"'(a%"' *an #$%'n"i#,.iM$n M$n,, ,," $orld %ealth %ealth &rganiza &rganization, tion, @::? @::? )alam )alam C'.$p.$p- @::8@::8- ma.alah ma.alah an,an an,an %$.$ha"an 1i2a )i.$l,,h )i.$l,,h ),nia m$man .,)ah m$n1a)i ma.alah *an .ana" .$i,.- palin "i)a% a)a .a", )ai $mpa" 'an )i),nia m$nalami an,an m$n"al m$n"al// HO HO m$mp$% m$mp$%ia% ia%an an a)a .$%i"a .$%i"a !: 1,"a 'an 'an
)i),ni )i),niaa m$nal m$nalami ami
an,an %$.$ha"an 1i2a/ Dalam Ri.%$.)a. @:?4 p$val$n.i p$n)$i"a an,an 1i2a #$a" ?-;?::: 'an/ Dalam )a"a Ri.%$.)a. @:?4- "$)apa" ?-4 p$.$na p$n)$i"a an, an,an an 1i2a 1i2a )i in)'n$ in)'n$.ia .ia )$nan )$nan p$n)$ p$n)$i"a i"a "$#an "$#an*a *a% % )ip$)$ )ip$)$.aan .aan )i#an) )i#an)in in )ip$%'"aan- .$)an%an p$val$n.i an,an m$n"al $m'.i'nal )ia"a. ,m, ?! "ah,n a"aa"a 6-: p$.$n/
S%i&' S%i&'($ ($ni niaa a)al a)alah ah p$n* p$n*a%i a%i"" *an m$mp m$mp$n $na a, ,hi hi '"a% '"a% )an )an p$n* p$n*$# $#a# a# "im#,ln*a pi%ian- p$.$p.i- $m'.i- $a%an )an p$ila%, *an an$h )an "$an,/ S%i&'($nia "i)a% )apa" )i)$(ini.i%an .$#aai p$n*a%i" "$.$n)ii- m$lain%an )i),a .$#aai .,a", .in)'m a"a, p'.$. p$n*a%i" *an m$n0a%,p #an*a% 1$ni. )$nan #$#aai $1ala =i)$#$0%-@::8>/ =i)$#$0%-@::8>/ Kli$n .%i&'($nia "i)a% lai )ih'.pi"ali.a.i ,n",% p$i')$ 2a%, *an lama"$"api %$m#ali %$m#ali hi),p )ima.*aa%a" )ima.*aa%a" )$nan )$nan ),%,nan *an )i#$i%an )i#$i%an 'l$h %$l,aa )an la*anan p$n),%,n/ Kli$n )apa" hi),p #$.ama an'"a %$l,aa- .$0aa man)iia"a, a"a, )$n )$nan an p' p'a am m residential .$p$ .$p$" "ii group ho'e "$mpa" "$mpa" m$$%a m$$%a m$n$im m$n$imaa la*anan *an )i#,",h%an "anpa p$l, )ima.,%an %$ ,mah .a%i"/ P'am (ssertive Co''unit) *reat'ent =AT> =AT>- "$#,%"i #$ha.il )alam m$n,ani an%a %li$n ma.,% ,ma ,mah h .a%i" .a%i" m$lal m$lal,i ,i p$na p$na"a "ala la%. %.an anaa aan n $1al $1alaa )an )an p$n p$n'# '#a" a"an an-- m$m# m$m#an" an", , %li$n %li$n m$m$n,hi %$#,",han .'.ial- $%$a.i'nal- )an v'%a.i'nal- .$"a m$m#$i ),%,nan %$pa %$pa)a )a %li$ %li$n n )an )an %$l, %$l,a aa a m$$ m$$%a %a =M0G =M0G$ $2 2- il.'n l.'n B'n) B'n)-? -?55 556 6 )ala )alam m i)$#$0%-@::8>/ K$l,aa m$,pa%an (a%"' *an .ana" p$n"in )alam p'.$. %$.$m#,han pa.i$n .%i&'($nia/ . %i&'($nia/ K$l,aa m$,pa%an lin%,nan "$)$%a" "$ )$%a" pa.i$n- )$nan %$l,aa *an #$.i%ap "$,ap$,"i% )an m$n),%,n pa.i$n- ma.a %$.$m#,han pa.i$n )apa" )ip$"ahan%an .$lama m,n%in/ S$#ali%n*a- 1i%a %$l,aa %,an m$n),%,n- an%a %$%am#,han a%an l$#ih 0$pa"/ B$)a.a%an p$n$li"ian #ah2a an%a %$%am#,han pa)a pa.i$n an,an 1i2a "anpa "$api %$l,aa .$#$.a @!!:7- .$)an%an an%a %am# %am#,h ,h pa)a pa)a pa.i pa.i$n $n *an *an m$n) m$n)ap apa" a"%a %an n "$ap "$apii %$l, %$l,a aa a a)al a)alah ah .$#$.a .$#$.a !?: !?:7 7 =K$lia"-@::5>/ K'n",ini"a. p$n'#a"an )alam p$na"ala%.anaan .%i&'($nia m$,pa%an .alah .a", (a%"' (a%"' %$#$h %$#$ha.il a.ilan an "$api "$api// Pa.i$n Pa.i$n *an *an "i)a% "i)a% pa",h pa",h )alam )alam p$n'# p$n'#a"an a"an a%an a%an
m$mil%i $.i%' %$%am#,han l$#ih "ini )i #an)in%an )$nan pa.i$n *an pa",h )alam p$n'#a"an/ K$"i)a%pa",han #$'#a" ini *an m$,pa%an ala.an %$m#ali )ia2a" )i,mah .a%i"/ Pa.i$n *an %am#,h m$m#,",h%an 2a%", *an l$#ih lama )an )$nan %$%am#,han *an #$,lan- %'n)i.i pa.i$n #i.a .$ma%in m$m#,,% )an .,li" ,n",% )i%$m#ali%an %$ %$a)aan .$m,la/ P$n'#a"an .%i&'($nia ini ha,. )ila%,%an "$,. m$n$,. .$hina pa.i$n nan"in*a )apa" )i0$ah )ai %$%am#,han p$n*a%i" )an )apa" m$n$m#ali%an (,n.i ,n",% p'),%"i( .$"a a%hin*a )apa" m$nin%a"%an %,ali"a. hi),p =C,lian"i%a )%%-@:?@>/ Ha.il p$n$li"ian Si ,lan.ih- "ah,n @::8- %$l,aa #$.i%ap #ai% *ai", @!7 a"a, !: 7 m$mp$liha"%an #ah2a %$l,aa )$nan $%.p$.i $m'.i *an "ini =#$m,.,han- m$n%i"i%> )ip$%ia%an %am#,h )alam 2a%", 5 #,lan- !; 7 %$m#ali )i a2a"/ A)an*a h,#,nan *an .ini(i%an an"aa .i%ap %$l,aa )$nan %$%am#,han pa.i$n .%i&'($nia/ Pa)a "in%a" p$n$"ah,an %$l,aa )i)apa" ha.il nilai a.i' pav$l$n.i .$#$.a - apa#ila a.i' p$val$n. < ? )an $n"an in"$val %$p$0a*aan "i)a% m$n0a%,p an%a ?- #$a"i vaia#$l "$.$#," m$,pa%an (a%"' $.i%' "$1a)in*a .$.,a", hal/ Hal ini m$n,n1,%%an #ah2a p$n$"ah,an pa.i$n *an #$%'n"i#,.i "$ha)ap %$%am#,han pa.i$n .%i&'($nia/ S$1alan )$nan p$n$li"ian- Na"alia P )%%- "ah,n @:?4- m$n1$la.%an #ah2a a)a !6- 7 $.p'n)$n m$mili%i p$n$"ah,an *an #ai% m$n$nai p$n'#a"an pa.i$n .%i&'($nia- 4-! 7 $.p'n)$n m$mili%i p$n$"ah,an .$)an m$n$nai p$n'#a"an pa.i$n .%i&'($nia- 8-6 7 $.p'n)$n pa",h )alam m$n1alan%an p$n'#a"an )an .$#an*a% ?!- 7 "i)a% pa",h )alam p$n'#a"an/ Di.imp,l%an #ah2a a)a h,#,nan *an .ini(i%an an"aa "in%a" p$n$"ah,an )$nan %$pa",han min,m '#a" pa.i$n .%i&'($nia/
3,mlah %,n1,nan pa.i$n an,an 1i2a %$
P'li%ini% P.i%ia"i RSUD
Kaa2an pa)a "ah,n @:?@ #$1,mlah ?86! *an "$)ii )ai %,n1,nan #a, 6?4%,n1,nan lama ?@!@/ S$)an%an pa)a "ah,n @?:4- 1,mlah %,n1,nan ?5;5%,n1,nan #a, .$#an*a% 45 'an )an %,n1,nan lama ?!8!- )$nan .%i&'p$nia #$#aai "ip$ an,an/ .$)an%an pa)a "ah,n @:? pa)a #,lan 1an,ai 1,mlah %,n1,nan .$#an*a% ?6?/ B$)a.a%an 0a"a"an m$)$% RSUD Kaa2an "$)apa" %$nai%an %,n1,nan 6-?7 pa)a "ah,n @:?@@:?4 pa)a K$l,ahan Kaniaan- hal ini m$m,n%in%an "$1a)in*a %$"i)a%pa",han min,m '#a" %a$na %,ann*a p$n$"ah,an %$l,aa "$n"an 0aa p$m#$ian '#a" *an "i)a% .$.,ai )$nan in",%.i )'%"$ .$"a p$m#$h$n"ian a"a, m$n,ani )'.i. '#a" 'l$h %$l,a )an pa.i$n i", "$.$#,"/ B$)a.a%an ha.il .",)i p$n)ah,l,an )i K$l,ahan Kaniaan pa)a n'v$m#$ @:?4- "ia )ai .$p,l,h p$n)$i"a .%i&'($nia- p$nah m$nalami %$%am#,han/ K$%am#,han *an "$1a)i )ai #$#$apa p$mi0, .alah .a",n*a )i.$#a#%an %a$na %$"i)a%pa",han pa.i$n min,m '#a" a"a, %a$na ),%,nan %$l,aa "$ha)ap an'"a %$l,aa *an .a%i"- )an m$nalami p,",. '#a" / B$)a.a%an la"a #$la%an )ia"a.- ma%a p$n$li"i "$"ai% ,n",% m$la%,%an p$n$li"ian "$n"an “Hubungan Pengetauan !an Dukugan "eluarga #era!a$ "e$atuan Minu% &bat Pa!a Pasien 'ki()*renia !i "eluraan "anigaran.
B. 1.
2.
#u+uan Penelitian #u+uan U%u% M$n$"ah,i h,#,nan p$n$"ah,an %$l,aa )an ),%,nan %$l,aa "$ha)ap
%$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia )ip'li%lini% 1i2a RSUD Kaa2an/ #u+uan "usus ?/ M$n)$.%ip.i%an p$n$"ah,an %$l,aa "$n"an %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia/ @/ M$n)$.%ip.i%an ),%,nan %$l,aa "$ha)ap %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia/
4/ T$i)$n"i(i%a.in*a h,#,nan p$n$"ah,an %$l,aa )$nan %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia/ / T$i)$n"i(i%a.in*a h,#,nan ),%,nan %$l,aa )$nan %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia/ /
u%usan Masala Ha.il p$n$li"ian Si ,lan.ih- "ah,n @::8- %$l,aa #$.i%ap #ai% *ai", @!
a"a, !: 7 m$mp$liha"%an #ah2a %$l,aa )$nan $%.p$.i $m'.i *an "ini =#$m,.,han- m$n%i"i%> )ip$%ia%an %am#,h )alam 2a%", 5 #,lan- !; 7 %$m#ali )i a2a"/ A)an*a h,#,nan *an .ini(i%an an"aa .i%ap %$l,aa )$nan %$%am#,han pa.i$n .%i&'($n/ Pa)a "in%a" p$n$"ah,an %$l,aa )i)apa" ha.il nilai a.i' pav$l$n. .$#$.a - apa#ila a.i' p$val$n. < ? )an $n"an in"$val %$p$0a*aan "i)a% m$n0a%,p an%a ?- #$a"i vaia#$l "$.$#," m$,pa%an (a%"' $.i%' "$1a)in*a .$.,a", hal/ Hal ini m$n,n1,%%an #ah2a p$n$"ah,an m$man #$na#$na (a%"' $.i%' *an m$n*$#a#%an %$%am#,han pa.i$n .%i&'($nia/ Dai ($n'm$na )ia"a.- ma%a p$n,li. m$n0'#a m$nali ,n",% m$n$"ah,i %$"$%ai"an h,#,nan p$n$"ah,an %$l,aa )$nan p$ila%, %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia )i K$l,ahan Kaniaan- )$nan p$"an*aan p$n$li"ian ?/ A)a%ah h,#,nan "in%a" p$n$"ah,an %$l,aa "$ha)ap %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia @/ A)a%ah h,#,nan ),%,nan %$l,aa )$nan %$pa",han min,m '#a" pa)a pa.i$n .%i&'($nia
BAB -#-NAUAN PU'#A"A
Pa)a #a# ini a%an )i1$la.%an #$#aai "$'i "$%ai" %'n.$p p$n$"ah,an%$l,aa- %$pa",han min,m '#a" )an %'n.$p an,an 1i2a )an p$n)i)i%an %$.$ha"an 1i2a/
2.1 ")nse$ Pengetauan
Kam,. B$.a Baha.a In)'n.ia- @::@ m$n*$#,"%an #ah2a p$n$"ah,an a)alah .$ala .$.,a", *an )i%$"ah,i- %$pan)aian )an .$ala .$.,a", *an )i%$"ah,i #$)a.a%an )$nan hal =ma"a p$la1aan>/ P$n$"ah,an a)alah ha.il )ai "ah, )an "$1a)i .$"$lah 'an m$la%,%an p$nin)aan "$ha)ap '#1$% "$"$n",/ P$nin)aan "$1a)i m$lal,i pan0a in)a man,.ia *ai", in)$a p$nliha"an- p$n)$naan p$n0i,man- a.a )an a#a/ S$#aian #$.a p$n$"ah,an man,.ia )ip$'l$h m$lal,i
ma"a )an "$lina =N'"'a"m')1'-@::4>/ Ma%a p$n$"ah,an m$,pa%an .,a", in('ma.i a"a, (a%"a *an )ip$'l$h )ai p'.$. #$la1a )an p$nalaman/ D$nan m$mili%i p$n$"ah,an
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M$n$"ah,i =Kn'2l$)$>
Pa)a "in%a" ini .$.$'an mamp, m$nina" %$ma#ali ma"$i *an "$lah )ip$la1ai .$#$l,mn*a "$ma.,% halhal *an .p$.i(i% )ai .$l,,h *an )ip$la1ai a"a, an.anan *an "$lah )i"$ima/ Ol$h %a$na i", "ah, m$,pa%an "in%a" p$n$"ah,an *an palin $n)ah/ Ka"a %$1a ,n",% m$n,%, #ah2a .$.$'an "ah, "$n"an apa *an )ip$la1ai an"aa lain m$n*$#,"%an- m$n,ai%an- m$n)$(ini.i%an- )an m$n*a"a%an/ @/
M$mahami =0'mp$h$n.i'n>
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M$napli%a.i%an =Apli0a"i'n>
Pa)a "ahap ini .$.$'an mamp, m$n,na%an ma"$i *an "$lah )ip$la1ai pa)a .i",a.i a"a, %'n)i.i *an n*a"a/ Apli%a.i )i.ini )apa" )ia"i%an .$#aai apli%a.i a"a, p$n,naan h,%,mh,%,m- ,m,.- m$"')$ )alam %'n"$%. a"a, .i",a.i *an lain/ /
M$nanali.i. =Anal*.i.>
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m$mi.ah%an/ !/
M$n.in"$.i. =S*n"$.i.>
Sin"$.i. m$n,n1,%an %$pa)a .,a", %$mamp,an ,n",% m$l$"a%an a"a, m$nh,#,n%an #aia#aian )alam .,a", #n$",% %$.$l,,han *an #a,/ D$nan %a"a lain .in"$.i. a)alah .,a", %$mamp,an ,n",% m$n*,.,n ('m,la.i #a, )ai ('m,la.i('m,la.i *an a)a/ 6/
M$n$val,a.i =$val,a.i>
Eval,a.i ini #$%ai"an )$nan %$mamp,an ,n",% m$la%,%an 1,."i(i%a.i a"a, p$nilaian "$ha)ap .,a", a#1$% a"a, ma"$i/ P$nilaianp$nilaian i", )i)a.a%an pa)a .,a", %i"$ia *an )i"$n",%an .$n)ii a"a, m$n,na%an %i"$ia%i"$ia *an "$lah a)a/ P$n$"ah,an m$,pa%an )a.a )ai )'mian)'main .$lan1,"n*a/ 3a)i p$n$"ah,an a"a, %'ni"i( m$,pa%an )'main *an .ana" p$n"in ,n",% "$#$n",%n*a "in)a%an a"a, p$ila%, .$.$'an/
Fa%"'(a%"'
*an
m$mp$na,hi
"in%a"
p$n$"ah,an
.$.$'an
=N'"'a"m')1'-@::4> ?/
P$n)i)i%an P$n)i)i%an m$,pa%an .,a", ,.aha ,n",% m$n$m#an%an %$pi#a)ian )an
%$mamp,an )i)alam )an )il,a .$%'lah )an #$lan.,n .$,m, hi),p/ P$n)i)i%an m$mp$na,hi p'.$. #$la1a- .$ma%in "ini p$n)i)i%an .$.$'an ma%in m,)ah 'an "$.$#," m$n$ima in('ma.i/ D$nan p$n)i)i%an "ini ma%a .$.$'an 0$n),n ,n",% m$n)apa"%an in('ma.i- #ai% )ai 'an lain ma,p,n )ai m$)ia ma.a/ P$n$"ah,an .ana" $a" %ai"ann*a )$nan p$n)i)i%an- )$nan p$n)i)i%an "ini- )ihaap%an a%an .$ma%in l,a. p,la p$n$"ah,ann*a/ @/
In('ma.i In('ma.i *an )i)apa"%an #ai% )ai p$n)i)i%an ('mal )an in('mal )apa"
m$m#$i%an p$na,h 1an%a p$n)$% = +''ediate i'pact .$hina m$nha.il%an p$,#ahan a"a, p$nin%a"an p$n$"ah,an/ Ma1,n*a "$%n'l'i #$im#a. pa)a #an*a%n*a m$)ia ma.a *an )apa" m$mp$na,hi p$n$"ah,an ma.*aa%a" "$n"an in'va.i/ S$#aai .aana %'m,ni%a.i- #$#aai #$n",% m$)ia ma.a .$p$"i "$l$vi.ia)i'- .,a" %a#a- )an lainlain m$mp,n*ai p$na,h #$.a "$ha)ap p$m#$n",%an 'pini )an %$p$0a*aan 'an/ 4/ S'.ial #,)a*a )an $%'n'mi B,)a*a *an )ian," .$.$'an m$mp$na,hi p$n$"ah,an/ K$#ia.aan )an "a)i.i *an )ila%,%an 'an'an .$in%ali "anpa m$lal,i p$nalaan apa%ah *an )ila%,%an
#ai%
a"a,
#,,%/
D$nan
)$mi%ian
.$.$'an
a%an
#$"am#ah
p$n$"ah,ann*a 2ala,p,n "i)a% m$la%,%an/ S"a",. $%'n'mi .$.$'an 1,a a%an m$n$n",%an "$.$)ian*a .,a", (a.ili"a. *an )ip$la%,%an ,n",% %$ia"an "$"$n",.$hina ."a",. .'.ial $%'n'mi ini a%an m$mp$na,hi p$n$"ah,an .$.$'an/ /
Lin%,nan
Lin%,nan a)alah .$ala .$.,a", *an a)a )i.$%i"a in)ivi),- #ai% (i.i% #i'l'i.- ma,p,n .'.ial/ Lin%,nan #$p$na,h "$ha)ap p'.$. ma.,%n*a p$n$"ah,an %$)alam in)ivi), *an #$a)a )alam lin%,nan "$.$#,"/ Hal ini "$1a)i %a$na a)an*a in"$a%.i "im#al #ali% a"a,p,n "i)a% a%an )i$.p'n .$#aai p$n$"ah,an 'l$h .$"iap in)ivi),/ !/
P$nalaman P$nalaman
.$#aai
.,m#$
p$nalaman
a)alah
.,a",
0aa
,n",%
m$mp$'l$h %$#$naan p$n$"ah,an )$nan 0aa m$n,lan %$m#ali p$n$"ah,an *an )ip$'l$h )alam m$m$0ah%an ma.alah *an )iha)api )ima.a lal,/ P$nalaman )apa" )ip$'l$h )ai )ii .$n)ii ma,p,n 'an lain/ P$nalaman *an )apa" )ip$'l$h )apa" p$nin%a"an p$n$"ah,an .$.$'an/ P$nalaman .$inn*a an'"a %$l,aa )ia2a" m$n1a)i%an %$l,aa .$in m$n$ima in('ma.i .$hina )apa" m$nam#ah p$n$"ah,an m$$%a/ 6/
U.ia U.ia m$mp$na,hi "$ha)ap )a*a "an%ap )an p'la (i%i .$.$'an/ S$ma%in
#$"am#ah ,.ia a%an .$ma%in #$%$m#an p,la )a*a "an%ap )an p'la (i%in*a.$hina p$n$"ah,an *an )ip$'l$hn*a .$ma%in m$m#ai%/ S$ma%in #an*a% in('ma.i *an )i1,mpai )an .$ma%in #an*a% hal *an )i%$1a%an .$hina m$nam#ah p$n$"ah,ann*a/
2.2 ")nse$ "eluarga
K$l,aa )i)$(ini.i%an .$#aai ),a a"a, l$#ih )ai ),a in)ivi), *an "$a#,n %a$na h,#,nan )aah- h,#,nan p$%a2inan a"a, p$nan%a"an )an m$$%a hi),p )alam .,a", ,mah "ana- #$in"$a%.i .a", .ama lain- )an )ilam p$ann*a ma.inma.in m$n0ip"a%an )an m$mp$"ahan%an %$#,)a*aan =Bail'n Mala*a- ?5;8 )alam E(($n)*- @::;>/ K$l,aa )alam p$n$"ian lain a)alah
.$%,mp,lan 'an )$nan i%a"an p$%a2inan- %$lahian a"a, a)'p.i *an #$",1,an ,n",% m$n0ip"a%an- m$mp$"ahan%an #,)a*a- )an m$nin%a"%an p$%$m#anan (i.i%m$n"al- .$"a $m'.i'nal )ai "iap %$l,aa/ S$0aa )inami. in)ivi), *an m$m#$n",% .$#,ah %$l,aa )apa" )iam#a%an .$#aai an'"a )ai %$l'mp'% ma.*aa%a" *an palin )a.a- "inal #$.ama- .alin #$in"$a%.i ,n",% m$m$n,hi %$#,",han an"a in)ivi), =D,val L'an- ?586 )alam Fi$)man- @:?:>/
2.2.1 /ungsi "eluarga
M$n,," Fi$)man- @:?:- "$)apa" lima (,n.i %$l,aa *an .alin #$%ai"an .a", .ama lain- *ai", =?> F,n.i a($%"i(- %$l,aa ha,. m$m$n,hi %$#,",han %a.ih .a*an )ai "iap an'"a %$l,aaJ =@> F,n.i .'.iali.a.i- (,n.i ini m$nan"a an'"a %$l,aa m$n1a)i an'"a ma.*aa%a" *an p'),%"i(J =4> F,n.i $p'),%"i(- ,n",% m$n1amin %'n",ini"a. an"a $n$a.i %$l,aa )an ma.*aa%a" *ai", m$n*$)ia%an an'"a #a, ,n",% ma.*aa%a" =L$.li$ K'man-@:?:>J => F,n.i $%'n'mim$lip,"i "$.$)ian*a .,m#$.,m#$ )ai %$l,aa .$0aa 0,%,p (inan.ial- ,an $a% )an ma"$i- )an p$nal'%a.ian .,m#$.,m#$ "$.$#," *an .$.,ai m$lal,i p'.$. p$nam#ilan %$p,",.an =Fi$)man-@:?:>J =!> F,n.i p$a2a"an %$.$ha"an- pa%"i% pa%"i% .$ha" *an m$mp$na,hi ."a",. %$.$ha"an an'"a %$l,aa .$0aa in)ivi),al m$,pa%an #aian *an palin $l$van )ai (,n.i %$l,aa #ai p$a2a"an %$l,aa/ K$l,aa m$,pa%an (a%"' *an .ana" p$n"in )alam p'.$. %$.$m#,han pa.i$n an,an 1i2a/ D$nan %$l,aa *an #$.i%ap "$ap$,"i% )an m$n),%,n pa.i$n- ma.a %$.$m#,han pa.i$n )apa" )ip$"ahan%an .$lama m,n%in/ S$#ali%n*a 1i%a %$l,aa %,an m$n),%,n- an%a %$%am#,han m$n1a)i 0$pa"/ B$)a.a%an p$n$li"ian- )i"$m,%an #ah2a an%a %am#,h pa)a pa.i$n an,an 1i2a "anpa "h$api
%$l,aa .$#$.a @!!:7- .$)an%an an%a %am#,h pa)a pa.i$n *an m$n)apa" "$api %$l,aa a)alah .$#$.a !?:! =K$lia"- @:?:>/ P$n)i)i%an
%$.$ha"an
%$l,aa )ihaapa%an
)apa"
m$n1a)i
.aana
p$#$)a*aan %$l,a- #ai% %$"i%a pa.i$n ma.ih )ia2a" )i,mah .a%i" ma,p,n .$"$lah p,lan %$,mah/ P$n)i)i%an %$.$ha"an in)ivi), %$l,aa a)alah p$n)i)i%ana %$.$ha"an *an )i#$i%an %$pa)a %$l,aa pa.i$n/ P$n)i)i%an %$.$ha"an %$l,aa 1$ni. ini m$,pa%an #aian )ai a.,han %$p$a2a"an pa.i$n =an'"a %$l,aa *an .$)an )ia2a">/ Ma"$i p$n)i)i%an ini a)alah 0aa m$na"a.i ma.alah %$p$a2a"an *an )ialami 'l$h pa.i$n *an )apa" )ila%,%an 'l$h %$l,aa- #ai% )i,mah .a%i" ma,p,n )i,mah/ M$n,," K$lia"- ?556 p$n"inn*a p$an .$"a %$l,aa )alam p$a2a"an an,an 1i2a .ana" #$.a ma%nan*a- %a$na a/ #/ 0/ )/ $/
K$l,aa a)alah "$mpa" %li$n #$la1a )an m$n$m#an%an #$#aai p$ila%,/ K$l,aa m$,pa%an lin%,nan *an )i%$nal %li$n/ K$l,aa m$,pa%an .i."$m p$n),%,n ,"ama *an m$a2a" %li$n/ P'am p$n)i)i%an %li$n )an %$l,aa m$n,ani an%a %$%am#,han/ P$a2a"an paip,na m$n*an%," pa.i$n )an .i.i"$m *an "$%ai" =%$l,aa )an ma.*aa%a">/ S$lain i", p$n$"ah,an m$n$nai pa.i$n *an ha,. )imili%i %$l,aa )alam
p$n'#a"an pa.i$n an,an 1i2a a)alah .$#aai #$i%," =Si$a-@::!> a/ T$api M,l"i O#a" Pa)a ,m,mn*a- ma%in #an*a% 1$ni. )an 1,mlah '#a" *an )i,na%an pa.i$n.$ma%in "ini $.i%' %$"i)a%pa",han/ Bah%an- apa#ila in",%.i )'.i. "$"$n", ,n",% '#a" "$lah )i#$i%an- ma.alah ma.ih )apa" "$1a)i/ K$.amaan p$nampilan mi.aln*a %$.amaan ,%,an- 2ana- )an #$n",% '#a"'#a" "$"$n", )apa" #$%'n"i#,.i pa)a %$#in,nan *an )apa" "$1a)i )alam p$n,naan m,l"i '#a"/ #/ F$%,$n.i P$m#$ian P$m#$ian '#a" pa)a 1an%a 2a%", *an .$in m$m#,a" %$"i)a% pa",han l$#ih m,n%in %a$na 1a)2al ,"in n'mal a"a, 1a)2al %$1a pa.i$n a%an "$an,
,n",% p$nam#ilan .a", )'.i. '#a" )an )alam #an*a% %a.,. pa.i$n a%an l,pa- "i)a% inin .,.ah a"a, mal, #$#,a" )$mi%ian/ 0/ D,a.i )an T$api B$#aai .",)i m$n,n1,%an #ah2a "in%a" %$"i)a%pa",han m$n1a)i l$ #ih #$.aapa#ila p$i')$ p$n'#a"an lama/ S,a", $.i%' *an l$#ih #$.a )ai %$"i)a% pa",han p$l, )ian"i.ipa.i )alam pa.i$n *an m$mp,n*ai p$n*a%i" %'ni.- "$,"ama 1i%a p$nh$n"ian "$a(i m,n%in "i)a% #$h,#,nan )$nan "$1a)in*a %$m#ali .$$a a"a, m$m#,,%n*a %$.a%i"an/ K$"aa"an pa)a p$n'#a"an 1an%a pan1an l$#ih .,li" )i0apai/ ala,p,n "i)a% a)a in"$v$n.i ",nal *an #$,na ,n",% m$nin%a"%an %$"aa"an- %'m#ina.i in",%.i *an 1$la.- p$man"a,an .$n)ii 'l$h pa.i$n- ),%,nann .'.ial- p$",n1,% #ila m$n,ana%an '#a"- )an )i.%,.i %$l'mp'%/ )/ E($% m$,i%an P$%$m#anan )ai $($% .,a", '#a" "i)a% m$n*$nan%an- m$m,n%in%an m$nhin)a )ai %$pa",han- 2ala,p,n #$#aai .",)i m$n*aan%an #ah2a hal ini "i)a% m$,pa%an (a%"' p$n"in .$#aaimana )ihaap%an/ Dalam #$#$apa .i",a.i a)alah m,n%in m$n,#ah )'.i. a"a, m$n,na%an '#a" al"$na"i( )apa" )i"ia)a%an )an man(aa" *an )ihaap%an )ai "$a(i ha,. )ip$"im#an%an "$ha)ap $.i%'/ P$n,,nan m,", %$hi),pan *an )ia%i#a"%an $($%- .$p$"i m,al )an m,n"ah *an h$#a"- m,n%in #$i", p$n"in #ai #$#$apa in)ivi), .$hina m$$%a "i)a% pa",h )$nan .,a", $im$n/ 2.2.2 enis Dukungan "eluarga Kaplan )alam Fi$)man-@::4 m$n1$la.%an #ah2a- "$)apa" $mpa" 1$ni. ),%,nan
*a%niJ a/ D,%,nan In('ma.i'nal D,%,nan in('ma.i'nal m$,pa%an ),%,nan *an #$(,n.i .$#aai p$n,mp,l in('ma.i "$n"an .$ala .$.,a", *an )i,na%an ,n",% m$n,n%apa%an .,a", ma.alah/ 3$ni. ),%,nan ini .ana" #$man(aa" )alam m$n$%an m,n0,ln*a .,a", ."$..' %a$na in('ma.i *an )i#$i%an )apa" m$n*,m#an%an a%.i .,$."i
*an %h,.,. pa)a in)ivi),/ S$0aa ai. #$.a "$)ii )ai a.p$% na.$ha"- ,.,lan p$",n1,%- )an p$m#$ian in('ma.i/ #/ D,%,nan P$nilaian/ M$n$%an%an pa)a %$l,aa .$#aai ,mpan #ali%-
m$m#im#in- )an
m$nanani ma.alah- .$"a .$#aai .,m#$ )an vali)a"' i)$n"i"a. an'"a =Fi$)man@::4>/ D,%,nan p$nilaian )apa" )ila%,%an )ian"aan*a )$nan m$m#$i%an support p$na%,an- p$nhaaan- )an p$ha"ian pa)a an'"a %$l,aa/ 0/ D,%,nan In.",m$n"al D,%,nan *an m$m('%,.%an %$l,aa .$#aai .$#,ah .,m#$ p$"'l'nan pa%"i. )an %'n%i" #$,pa #an",an lan.,n )ai 'an *an )ian)al%an .$p$"i ma"$i- "$naa- )an .aana =Fi$)man-@::4>/ Man(aa" )ai ),%,nan ini a)alah m$n$m#ali%an $n$i a"a, ."amina )an .$mana" *an m$n,,n )an m$m#$i%an a.a p$ha"ian .$"a %$p$),lian pa)a .$.$'an *an m$nalami %$.,.ahan a"a, p$n)$i"aan/ )/ D,%,nan Em'.i'nal D,%,nan *an m$n$mpa"%an %$l,aa .$#aai "$mpa" aman )an )amai ,n",% i."iaha" .$"a )apa" m$m#an", p$n,a.aan "$ha)ap $m'.i =Fi$)man- @::4>/ 2.2. Man*aat !ukungan keluarga M$n,," 3'hn.'n 3'hn.'n- ?55?- a)a $mpa" man(aa" ),%,nan .'.ial
)ih,#,n%an )$nan p$%$1aan a%an m$ni%a" p'),%"ivi"a.n*a- m$nin%a"%an %$.$1ah"$aan p.i%'l'i. )an p$n*$.,aian )ii )$nan m$m#$i%an a.a m$mil%im$mp$1$la. i)$n"i"a. )ii- m$nam#ah haa )ii- )an m$n,ani ."$.- m$nin%a"%an )an m$m$lihaa %$.$ha"an (i.i%- .$"a p$n$l'laan "$ha)ap ."$. )an "$%anan/ M$n,," ill. )alam Fi$)man- @::4 m$n*a"a%an #ah2a ),%,nan %$l,aa )apa" m$nim#,l%an $($% p$n*ana- *ai", ),%,nan %$l,aa m$nahan $($%$($% n$a"i( )ai ."$. "$ha)ap %$.$ha"an )an $($% ,"ama- *ai", ),%,nan %$l,aa .$0aa lan.,n m$mp$na,hi p$nin%a"an %$.$ha"an/ S$0aa l$#ih .p$.i(i%- %$#$a)aan ),%,nan .'.ial %$l,aa *an a)$%,a" "$#,%"i #$h,#,nan
)$nan m$n,,nn*a m'"ali"a.- l$#ih m,)ah .$m#,h )ai .a%i" )an )i%alanan lan.ia )apa" m$n1aa (,n.i %'ni"i(- (i.i%- )an %$.$ha"an $m'.i'nal/ 2.2.4 'u%ber Dukungan "eluarga M$n,," R''% )an D''l$* )alam K,n0''- @::@- a)a ),a .,m#$
),%,nan %$l,aa *ai", .,m#$ na",al )an .,m#$ a"i(i.ial/ D,%,nan %$l,aa *an na",al )i"$ima .$.$'an m$lal,i in"$a%.i .'.ial )alam %$hi),pann*a .$0aa .p'n"an )$nan 'an'an *an #$a)a )i.$%i"an*a- mi.aln*a an'"a %$l,aa =ana%- i."i- .,ami- )an %$a#a"> "$man )$%a" a"a, $la.i/ D,%,nan %$l,aa ini #$.i(a" n'n('mal/ S$m$n"aa i", ),%,nan a"i(i.ial a)alah ),%,nan .'.ial *an )ian0an %$)alam %$#,",han pim$ .$.$'an/ Mi.aln*a ),%,nan %$l,aa a%i#a" #$n0ana alam m$lal,i #$#aai .,m#$ .,m#anan .'.ial/ D$nan )$mi%ian- .,m#$ ),%,nan %$l,aa na",al m$mili%i #$#aai p$#$)aan 1i%a )i#an)in%an )$nan ),%,nan %$l,aa a"i(i.ial/ P$#$)aan "$.$#," "$l$"a% pa)a %$#$a)aan .,m#$ ),%,nan %$l,aa na",al #$.i(a" apa a)an*a "anpa )i#,a"#,a" .$hina l$#ih m,)ah )ip$'l$h )an #$.i(a" .p'n"an/ S,m#$ ),%,nan %$l,aa *an na",al m$mili%i %$.$.,aian )$nan nama *an #$la%, "$n"an %apan .$.,a", ha,. )i#$i%an )an #$a%a )ai h,#,nan *an "$lah #$a%a lama/ 2.2.5 /akt)r*akt)r ang %e%$engarui !ukungan keluarga M$n,," P,na2an )alam Raha*,- @::8- p$m#$ian ),%,nan 'l$h
%$l,aa )ip$na,hi 'l$h (a%"' in"$nal )an (a%"' $%."$nal *an %$),an*a .alin #$h,#,nan/ a/ Fa%"' in"$nal B$a.al )ai in)ivi), i", .$n)ii *an m$lip,"i Fa%"' "ahap p$%$m#anan • P$mahaman )an $.p'n "$ha)ap p$,#ahan %$.$ha"an *an #$#$)a#$)a •
•
pa)a .$"iap $n"an ,.ia =#a*i .ampai lan.ia>/ Fa%"' p$n)i)i%an a"a, "in%a" p$n$"ah,an/
•
Dalam hal ini %$mamp,an %'ni"i( *an m$m#$n",% 0aa #$(i%i .$.$'an "$ma.,% %$mamp,an ,n",% m$mahami (a%"'(a%"' *an #$h,#,nan
• •
)$nan p$n*a%i" )alam m$n1aa %$.$ha"an )iin*a Fa%"' $m'.i Fa%"' $m'.i *an m$mp$na,hi %$*a%inan "$ha)ap a)an*a ),%,nan )an 0aa m$la%,%an .$.,a",/ R$.p'n $m'.i *an #ai% a%an m$m#$i%an an"i.ipa.i p$nananan *an #ai% "$ha)ap #$#aai "an)a .a%i"- nam,n 1i%a $.p'n $m'.in*a #,,% %$m,n%inan #$.a a%an "$1a)i p$n*an%alan "$ha)ap $1ala
p$n*a%i" *an a)a/ #/ Fa%"' $%."$nal B$a.al )ai l,a in)ivi), i", .$n)ii )an "$)ii )ai "ia hal- *ai", Pa%"i% %$l,aa • aa %$l,aa m$m#$i%an ),%,nan *an m$mp$na,hi p$n)$i"a )alam m$la%.ana%an %$.$ha"ann*a .$0aa 'p"imal/ Ti)a%an )apa" #$,pa p$n0$ahan *an )i0'n"'h%an %$l,aa %$pa)a an'"a %$l,aa/ Fa%"' .'.i'$%'n'mi • aia#$l (a%"' .'.ial )apa" m$nin%a"%an $.i%' "$1a)in*a p$n*a%i"m$mp$na,hi
0aa
.$.$'an
m$n)$(ini.i%an
.$"a
#$$a%.i
"$ha)ap
p$n*a%i"n*a/ S$m$n"aa (a%"' $%'n'mi m$n1$la.%an #ah2a .$ma%in"ini $%'n'mi .$.$'an #ia.an*a )ia a%an l$#ih 0$pa" "anap "$ha)ap $1ala p$n*a%i" *an )ia.a%an .$hina ia a%an .$$a m$n0ai p$"'l'nan %$"i%a m$a.a a)an*a an,an %$.$ha"an/ La"a #$la%an #,)a*a • Fa%"' ini a%an #an*a% m$mp$na,hi %$*a%inan- nilai- )an %$#ia.aan in)ivi), )alam m$m#$i%an ),%,nan "$ma.,% 0aa p$la%.anaan %$.$ha"an pi#a)i/
2. ")nse$ "e$atuan
K$pa",han co'plience- 1,a )i%$nal .$#aai %$"aa"an adherence a)alah )$a1a" )imana pa.i$n m$ni%,"i an1,an %lini. )ai )'%"$ *an m$n'#a"in*a/
'n"'h )ai %$pa",han a)alah m$ma",hi p$1an1ian- m$ma",hi )an m$n*$l$.ai%an p'am p$n'#a"an- m$n,na%an m$)i%a.i .$0aa "$pa"- )an m$ni%,"i an1,an p$,#ahan p$ila%, a"a, )i$"/p$ila%, %$pa",han "$an" pa)a .i",a.i %lini. "$"$n",.i(a" p$n*a%i" )an p'am p$n'#a"an =Kaplan Sa)'0%-@:?:> Sa0%$"" )alam Niv$n =@::@> m$n)$(ini.i%an %$pa",han pa.i$n .$#aai .$1a,hmana p$ila%, pa.i$n .$.,ai )$nan %$"$n",an *an )i#$i%an 'l$h p'($..i'nal %$.$ha"an/ B$i%," ini (a%"' *an m$n),%,n %$pa",ah pa.i$n=F$,$."$in $" al-?586 )alam Niv$n @::@> 1,a mn$*ampai%an .,a", p'am "in)a%an *an "$)ii )ai lima $l$m$n
?/ P$n)i)i%an P$n)i)i%an )apa" m$nin%a"%an %$pa",han- .$pan1an #ah2a p$n)i)i%an "$.$#," m$,pa%an p$n)i)i%an *an a%"i( .$p$"i p$n,naan #,%,#,%, )an %a.$" 'l$h pa.i$n .$0aa man)ii/ @/ A%'m')a.i S,a", ,.aha ha,. )ila%,%an ,n",% m$mahami 0ii %$pi#a)ian pa.i$n *an )apa" m$mp$na,hi %$pa",han/ 4/ M')i(i%a.i (a%"' lin%,nan )an .'.ial Hal ini #$a"i m$m#an,n ),%,nan .'.ial )ai %$l,aa )an "$man"$man/ K$l'mp'%%$l'mp'% p$n),%,n )apa" )i#$n",% ,n",% m$m#an", %$pa",han "$ha)ap p'amp'am p$n'#a"an/ / P$,#ahan m')$l "$api P'amp'am p$n'#a"an )apa" )i#,a" .$)$hana m,n%in- )an pa.i$n "$li#a" a%"i( )alam p$m#,a"an p'am "$.$#,"/ D$nan 0aa ini %'mp'n$n%'mp'n$n *an l$#ih %'mpl$%./ !/ M$nin%a"%an in"$a%.i p'($..i'nal %$.$ha"an )$nan pa.i$n/ M$,pa%.,a", hal p$n"in ,n",% m$m#$i%an ,mpan #ali% pa)a pa.i$n .$"$lah m$mp$'l$h in('ma.i "$n"an )ian'.i./ Pa.i$n m$m#,",h%an p$n1$la.an "$n"an %'n)i.in*a .aa" ini- apa p$n*$#a# )an apa *an )apa" m$$%a la%,%an )$nan %'n)i.i .$p$"i ini/
K$pa",han "$1a)i #ila a",an pa%ai '#a" *an )i$.$p%an .$"a p$m#$iann*a )ii%,"i )$man #$na/ 3i%a "$a(i ini a%an )ilan1,"%an .$"$lah pa.i$n p,lan- p$n"in aa pa.i$n m$n$"i )an )apa" m$n$,.%an "$a(i i", )$nan #$na )an "anpa p$na2a.an/ Ini "$,"ama p$n"in ,n",% p$n*a%i"p$n*a%i" m$nah,n/ M$n,," Tam#a*'n-@::@ "$)apa" lima (a%"' %$"i)a% pa",han "$ha)ap p$n'#a"an *ai", %,an pahamn*a pa.i$n "$n"an ",1,an p$n'#a"an "$.$#,"- "i)a% m$n$"in*a "$n"an p$n"inn*a m$ni%,"i a",an p$n'#a"an *an )i"$"ap%an .$h,#,nan )$nan p'n'.i.n*a- .,%an*a m$mp$'l$h '#a" l,a ,mah .a%i"- mahaln*a haa '#a"- )an %,ann*a p$ha"ian )an %$p$),lian %$l,aa *an m,n%in #$"an,n 1a2a# a"a. p$m#$lian a"a, p$m#$ian '#a" i", %$pa)a pa.i$n/ M$n,," Si$a-@::6 *an )ima%.,)
)$nan
%$pa",han
)alam
p$n'#a"an a)alah m$n%'n.,m.i '#a"'#a"an *an )i$.$p%an pa)a 2a%", )an )'.i. *an "$pa"/ K$pa",han )apa" )i)$(ini.i%an .$#aai "in%a" %$"$pa"an p$ila%, .$'an in)ivi), )$nan na.iha" m$)ia a"a, %$.$ha"an- pa.i$n *an #$p$n$"ah,an "$n"an '#a"n*a m$n,n1,%an %$"aa"an *an m$nin%a" "$ha)ap $im$n '#a" *an )i",li. .$hina m$nha.il%an ha.il "$api *an m$nin%a"/ T$)apa" 1$ni. %$pa",han- a%i#a" )ai %$"i)a%pa",han )an p$nin%a"an %$pa",han pa)a p$n,naan '#a"- an"aa lain 2. 1 enis keti!ak$atuan P$n'#a"an a%an $($%"i( apa#ila m$ma",hi a",an )alam $n'#a"an- m$n,," Si$a
=@::6> a)ap,n #$#apa 1$ni. %$"i)a% pa",han *an "$1a)i a)alah )i.$#a#%an 'l$h .$#aai #$i%," a/ K$"i)a%pa",han pa)a min,m '#a"- m$n0a%,p %$aalan m$n$#,. $.$pm$lalai%an )'.i.- %$.alahan )'.i.- %$.alahan )alam 2a%", p$m#$ian %'n.,m.i '#a")an p$nh$n"ian '#a" .$#$l,m 2a%",n*a/
#/
Ti)a% m$n$#,. $.$p '#a"n*a- *ai", %a$na pa.i$n%$l,aa pa.i$n "i)a% m$a.a
m$m$l,%an '#a" a"a, "i)a% m$nh$n)a%i m$nam#iln*a/ A)a 1,a pa.i$n *an "i)a% m$n$#,. $.$pn*a %a$na "i)a% mamp, m$m#$lin*a/ 0/ K$.alahan pa)a 2a%", %'n.,m.i '#a"- *ai", )apa" m$n0a%,p .i",a.i *an '#a"n*a )i%'n.,m.i "i)a% "$pa" )i%ai"%an )$nan 2a%", ma%an/ '"'hn*a ? 1am .$#$l,m ma%an )an @ 1am .$.,)ah ma%an/ )/ P$nh$n"ian p$m#$ian '#a" .$#$l,m 2a%",n*a- pa.i$n ha,. )i#$i"ah, p$n"inn*a p$n,naan '#a" an"i#i'"i% *an )i%'n.,m.i .ampai ha#i. .$lama "$api/ $/ P$m#$ian '#a" %,an )ai )'.i. *an "$",li. )an p$nh$n"ian '#a" .$#$l,m 2a%",n*a- (a%"' lain *ai", %$"i)a% pa",han m$n0a%,p p$n$"i%$"an *an "i)a% #$na )an p$n,naan.$n)'% "$h *an m$mp,*ai #$#aai v'l,m$ *an #$#$)a/ (/ Pa.i$n a2a" 1alan *an "i)a% pa",h %a$na "i)a% m$n$"i in",%.i p$n,naan )$nan #$na )an a)a *an .alah m$nin"$p$"a.i%an- .$lain i", %$m,%inan %$"i)a% pa",han pa.i$n a2a" 1alan %a$na %,ann*a p$na2a.an "$a(i/ @/ A%i#a" %$"i)a%pa",han K$"i)a% pa",han a%an m$na%i#a"%an p$n,naan .,a", '#a" *an %,an/ D$nan 0aa )$mi%ian- pa.i$n %$hilanan man(aa" "$a(i *an )ian"i.ipa.i )an %$m,n%inan mana%i#a"%an %'n)i.i *an )i'#a"i .$0aa #$"ahap m$n1a)i #,,%/ S$'an pa.i$n m$nh$n"i%an p$n,naan an"i#i'"i% ,n",% p$n'#a"an .,a", in($%.i apa#ila $1ala "$lah m$$)a- )an %a$nan*a "i)a% m$n,na%an .$m,a '#a" *an )i",li.- hal ini m$n*$#a#%an %$m#ali %$%am#,han- p$n*a%i" %am#,h lai %a$na )ia%i#a"%an 'l$h %$"i)a% pa",han )ai pa)a )i.$#a#%an "im#,ln*a $.i."$n "$ha)ap '#a"/ 4/ P$nin%a"an %$pa",han Dalam m$nin%a"%an %$pa",han %'m,ni%a.i m$,pa%an 0aa an"aa "im m$)i. )an pa.i$n )alam #$#i0aa m$n$nai '#a" *an )i",li./ K$$($%"i(an %'m,ni%a.i a%an "$1a)i p$n$n", ,"ama %$pa",han pa.i$n/ Di#a2ah ini m$,pa%an p$anan )alam m$nha)api ma.alah %$"i)a% pa",han *ai", a/
M$ni)$n"i(i%a.i (a%"' $.i%' *ai", m$n$nai in)ivi), *an m,n%in "i)a% pa",h.$#aai mana )i),a 'l$h .,a", p$"im#anan #$#aai $.i%' *an p$l,
)ip$hi",n%an )alam m$$n0ana%an "$a(i pa.i$n- aa $im$n .$1a,h m,n%in %'mpa"i#$l )$nan %$ia"an n'mal pa.i$n/ #/ P$n$m#anan $n0ana p$n'#a"an ha,. )i)a.a%an pa)a %$#,",han pa.i$napa#ila m,n%in pa.i$n ha,. m$n1a)i pa"i.ipan )alam %$pa",han p$m#$ian $im$n "$a(i/ Un",% m$m#an", %$"i)a% n*amanan )an %$lalaian- $im$n ha,. )i.$.,ai%an aa )'.i. *an )i#$i%an pa)a 2a%", *an .$.,ai )$nan 1a)2al pa.i$n/ 0/ Ala" #an", %$pa",han *an m$lip,"i p$m#$ian la#$l )an %al$n)$ p$n'#a"an )an %a", p$nina" '#a" .$hina pa.i$n m$n$"i "$n"an p$n,naan )alam m$m#an", pa.i$n m$n$"i '#a" *an )i,na%an- %apan )i,na%an- )an m$n$nai )'.i. '#a" *an )i,na%an/
.
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Gan,an 1i2a a)alah .,a", p$n*a%i" *an m$mp$naa,hi '"a% )an m$n*$#a#%an "im#,ln*a pi%ian- p$.$p.i- $m'.i- $a%an )an p$ila%, *an an$h )an "$an, =i)$#$0%-@::8>/ S%i&'($nia m$,pa%an #$n",% an,an p.i%'"i% =p$n*a%i" m$n"al #$a"> *an $la"i( .$in/ P$val$n.i .$,m, hi),p hampi m$n0apai ?7- in.i)$n "iap "ah,nn*a .$%i"a ?:?! p$ ?::/::: )an .%i&'($nia m$,pa%an .in)'m )$nan #$#aai p$.$n"a.i )an .a", vaia#$l- p$1alanan p$n*a%i" ,m,mn*a 1an%a pan1an.$"a .$in m$nalami %$%am#,han =Davi$.- @::5>/ M$n,," orld health organitation =HO> p$val$n.i ma.alah %$.$ha"an 1i2a .aa" ini 0,%,p "ini @!7 )ai p$n),),% ),nia p$nah m$n)$i"a ma.lah %$.$ha"an 1i2a- ?7 )ian"aan*a a)alah an,an 1i2a #$a"- p'"$n.i .$.$'an m,)ah "$.$an an,an 1i2a m$man "ini- .aa( ma,p,n p$ila%,/ Sim,n) ($,) #$p$n)apa" #ah2a p.i%'l'i .$#$nan*a a)alah "i)a% 0,%,p )$nan m$n*$li)i%i %$.a)aan .a1a- .$#a# *an l$#ih p$n"in )an #$p$na,h #$.a )alam %$hi),pan 1i2a man,.ia a)alah %$"i)a%.a)aan/ %$.a)aan m$man p$l, 1,a
)i.$li)i%i a%an "$"api %$"i)a%.a)aan *an m$n$m,)i%an %$hi),pan man,.ia .$hai hai/ S",%", 1i2a m$n,," al G,."av 3,n #ah2a 1i2a "$)ii )ai a"a. ),a lapanan *an #$ha)apan )an .alin m$l$n%api *ai", %$.a)aan )an %$"i)a%.a)aan/ K$.a)aan #$(,n.i m$n*$.,ai%an )ii )$nan lin%,nan- %$"i)a%.a)aan #$(,n.i m$n*$.,ai%an )ii )$nan ),nia )alam =P,2an"'-@:?@>/ M$n,," Un)anUn)an "$n"an K$.$ha"an n'm' 46 "ah,n @::5 pa.al ? a*a" ? m$n1$la.%an )$(ini.i %$.$ha"an *ai", %$.$1ah"$aan )ai #a)an- 1i2a )an .'.ial *an m$m,n%in%an .$"iap 'an p'),%"i( .$0aa .'.ial)an $%'n'mi/ T$"api )alam )$%a)$ *an lal, .$ma%in #an*a% p$n$li"ian "$lah m$li#a"%an p$anan pa"'(i.i'l'i. ,n",% )a$ah "$"$n", )i '"a%- "$ma.,% .i."$m lim#i0- %'"$%. p'n"al- )an anlia #a.ali./ K$"ia )a$ah "$.$#," .alain #$h,#,nan .$hina )i.(,n.i pa)a .alah .a", )a$ah m,n%in m$li#a"%an pa"'l'i pim$ lainn*a =Kaplan Sa)'0%-@:?:>/ Ki"$ia ,m,m ,n",% m$n)ian'.a an,an 1i2a m$lip,"i %$"i)a%p,a.an )$nan %aa%"$i."i%- %$mamp,an )an p$."a.i )iiJ h,#,nan *an "i)a% $($%"i( a"a, "i)a% m$m,a.%anJ "i)a% p,a. hi),p )i),niaJ a"a, %'pin *an "i)a% $($%"i( "$ha)ap p$i."i2a %$hi),pan )an "i)a% "$1a)i p$",m#,han p$.'nal/ S$lain i", p$li%a, in)ivi), *an "i)a% )ihaap%an a"a, )i%$na%an .an.i .$0aa #,)a*a #,%an p$ila%, *an m$n*impan- *an m$n1a)i in)i%a.i .,a", an,an 1i2a =DSMI-?55 )alam i)$#$0%-@:?:>/ Fa%"' *an m$n*$#a#%an an,an 1i2a 1,a )apa" )ipan)an )alam "ia %a"$'i/ Fa%"' in)ivi),al m$lip,"i .",%", #i'l'i.- an.i$"a.- %$%ha2a"ian )an %$"a%,"an%$"i)a% ham'ni.an )alam hi),p )an %$hilanan a"i hi),p =S$a2$)- ?55;>/ Fa%"' in"$p$.'nal m$lip,"i %'m,ni%a.i *an "i)a% $($%"i(- %$"$an",nan *an #$l$#ihan a"a, m$nai% )ii h,#,nan )an %$hilanan %'n"'l $m'.i'nal/ Fa%"' #,)a*a )an .'.ial m$lip,"i "i)a% a)a p$nha.ilan- %$%$a.an- "i)a% m$mili%i "$mpa" "inal
=",na2i.ma>- %$mi.%inan )an )i.%imina.i .$p$"i p$m#$)aan a.- 'l'nan- ,.ia )an 1$ni. %$lamin- =i)$#$0%-@::8>/ B$n",% an,an p'.$. #$(i%i a)alah p$n*impanan )ai pi%ian a.i'nal- l'i. )an #$",1,an/ Pi%ian a,."i% )i",1,%an 'l$h a)an*a (an"a.i(an"a.i )i#a2ah alam .a)a *an #$h,#,nan )$nan p$nai%an )ii p$nai%an )ii .$0aa .'.ial/ Ti)a% )apa" )i%'$%.i #$)a.a%an $ali"a .$p$"i haln*a pi%ian n'mal/ Pi%ian *an "$halan "$liha" pa)a p'.$. p$m#i0aaan *an "i#a"i#a "$h$n"i/ Gan,an a.'.ia.i *an m$naah pa)a "i)a% a)an*a %$.inam#,nan a,. p$m#i0aaan/ P$m#i0aaan *an m$nin%a" )an .,%a )ip'"'n/ I)$ *an m$l'mpa"l'mpa" .ana" 0$pa"- m$l'mpa" )ai .a", .,#*$% %$ .,#*$% lainn*a *an l'na i%a"ann*a .$"a m$n*impan )alam $.p'n "$ha)ap an.anan lin%,nan/ P$m#i0aaan *an m$l'mpa"l'mpa" .$p$"i pa)a )$p$.i- m,n%in m$,pa%an #aian )ai am#aan ,m,m $"a)a.i p.i%'m'"'/ M$n'la% p$m#i0aaan #ai% %a$na ala.an *an )i.a)ai ma,p,n "i)a% )i.a)ai =P,2an"'- @:?@>/ S%i&'($nia a)alah .,a", p$n*a%i" *an m$mp$na,hi '"a% )an m$n*$#a#%an "im#,ln*a pi%ian - p$.$p.i- $m'.i- $a%an- )an p$ila%, *an an$h )an "$an,/ S%i&'($nia "i)a% )apa" )i)$(ini.i%an .$#ai p$n*a%i" "$.$n)ii- m$lain%an .,a", .in)'m a"a, .,a", p'.$. p$n*a%i" *an m$n0a%,p #an*a% 1$ni. )$nan #$#aai $1ala .$p$"i 1$ni. %an%$/ S$lam #$p,l,hp,l,h "ah,n- .%i&'($nia .$in )i.alah a"i%an 'l$h ma.*aa%a"/ P$n*a%i" ini )i"a%,"i .$#aai an,an 1i2a *an #$#aha*a )an "i)a% )apa" "$%'n"'l- )an m$$%a *an "$)ian'.a p$n*a%i" ini )iam#a%an .$#aai in)ivi), *an "i)a% m$nalami ma.alah $m'.i'nal a"a, p.i%'l'i. *an "$%$n)ali )an m$mp$liha"%an p$ila%, *an an$h )an amaah/ K$#an*a%an in)ivi), *a%in #ah2a .%i&'($nia p$l, )ia.in%an )an )i%iim %$ in."i",.i/ Han*a #a,#a, ini .a1a- %'m,ni%a.i %$.$ha"an 1i2a m$n*a)ai ,n",% #$la1a )an m$m#$i%an
p$n*,l,han %$pa)a ma.*aa%a" .%i&'($nia a)alah an,an 1i2a *an m$mili%i #$#aai "an)a )an $1ala )an .%i&'($nia m$,pa%an p$n*a%i" *an )apa" )i%$n)ali%an )i%$n)ali%an )$nan '#a"/ G$1ala .%i&'($nia )i#ai )alam ),a %a"a'i ,"ama $1ala p'.i"i( a"a, $1ala ,"ama*an m$n0a%,p 2aham- hal,.ina.i- )an )i.'ani.a.i pi%ian- #i0aa- )an pila, *an "i)a% "$a",- .$"a $1ala n$a"i( a"a, $1ala .ama- .$p$"i a($% )a"a- "i)a% m$mili%i %$ma,an- )an m$nai% )ii )ai ma.*aa%a" a"a, a.a "i)a% n*aman/ G$1ala p'.i"i( )apa" )apa" "$%'n"'l )$nan p$n'#a"an- "$"api $1ala n$a"i( .$in%ali m$n$"ap .$pan1an 2a%", )an m$n1a)i p$nham#a" ,"ama p$m,lihan )an p$#ai%an (,n.i )alam %$hi),pan .$haihai %li$n- =i)$#$0%-@::8>/ 1. #an!a !an ge+ala B$i%," "an)a "ip$ .%i&'p$nia )ai DSMITR @:::/ Dian'.a )i"$a%%an #$)a.a%an $1ala *an )'minan a/ T*p$ paan'i) Di"an)ai )$nan 2aham %$1a =a.a m$n1a)i %'#an a"a, )ima"ma"ai> a"a, 2aham %$#$.aan- hal,.ina.i- )an %a)an%a)an %$aamaan *an #$l$#ihan =('%,. 2aham aama>- a"a, p$ila%, a$.i( )an #$m,.,han/ #/
T*p$ "i)a% "$'ani.i Di"an)ai )$nan a($% )a"a a"a, a($% *an "i)a% .$.,ai .$0aa n*a"a- in%'h$$n.i-
a.'.ia.i l'na- )an )i.'ani.a.i p$ila%, *an $%."i m/ 0/ T*p$ %a"a"'ni% Di"an)ai )$nan an,an p.i%'m'"' *an n*a"a- #ai% )alam #$n",% "anpa $a%an a"a, a%"i(i"a. m'"'i% *an #$l$#ihan- n$a"ivi.m$ *an $%."im- m,"i.m$- $a%an v'l,n"$ *an an$h- $%'lalia a"a, $%'pa%.ia/ Im'#ili"a. m'"'i% )apa" "$liha" #$,pa %a"al$p.i =(l$i#ili"a. 0$$a> a"a, .",p'/ A%"i(i"a. m'"'i% *a #$l$#ihan "$liha" "anpa ",1,an )an "i)a% )ip$na,hi 'l$h ."im,l,. $%"$nal/ )/ T*p$ "i)a% )apa" )i#$)a%an Di"an)ai )$nan- $1ala$1ala .%i&'($nia 0amp,an ="*p$ lain> )i.$"ai an,an pi%ian- a($%- )an p$ila%,/ $/ T*p$ $.i),al
Di"an)ai )$nan .$"i)a%n*a .a", $pi.')$ .%i&'($nia .$#$l,mn*a- "$"api .aa" ini "i)a% p.i%'"i%- m$nai% )ii )ai ma.*aa%a"- a($% )a"a- .$"a .'.ia.i l'na-=i)$#$0%@::8>/ M$n,," T'2n.$n)- @:?: Sin)'m *an #$%ai"an )$nan .%i&'($nia )an an,an p.i%'"i% lain m$n,n1,%an p$,#ahan )alam i.i )an 'ani.a.i pi%ian- p$.$p.i inp," .$n.'i- a($% a"a, iama $m'.i- a.a i)$n"i"a.- %$ma,an- p$ila%, p.i%'m'"'- )an %$mamp,an m$m#ina h,#,nan in"$p$.'nal *an m$m,a.%an/ T'2n.$n) 1,a m$n%a"a'i%an #$#$apa 1$ni. an,an p.i%'"i% lain- *ai", a/
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2.
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P$n$li"ian ilmiah "$#a, m,lai m$n,n1,%an #ah2a .%i&'($nia a)alah .,a", "*p$ )i.(,n.i '"a%/ Pa)a "ah,n ?5;:an- p$n$li"i m,lai #$('%,. pa)a .$#a#.$#a# n$,'%imia *an m,n%in- )an hal ini ma.ih m$n1a)i ('%,. ,"ama p$n$li"ian )an "$'i .aa" ini/ T$'i n$,'%imian$,'l'i. )i),%,n 'l$h $($% an"ip.i%'"i% *an m$m#an", m$n'n"'l $1ala p.i%'"i% )an ala" p$n0i"aan .aa( .$p$"i co'puted to'ograph) =T> *an m$n,n1,%an #ah2a .",%", )an (,n.i '"a% in)ivi), *an m$nalami .%i&'($nia #$#$)a =G, G,-@::: )alam- i)$#$0%-@::8> T$'i #i'l'i .%i&'($nia #$('%,. $n$"i%- (a%"' n$,'ana"'mi )an n$,%imia =.",%", )an (,n.i '"a%>- .$"a im'n'vi'l'i =$.p'n ",#,h "$ha)ap p$1anan .,a", vi",.>
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