Pendekatan Cognitive Behavioral Therapy (CBT) terhadap Kepatuhan dan Self awareness Pasien Tuberkulosis (TB), “Loss to follow-up” (LTFU)
DOI:
https://doi.org/10.33006/ji-kes.v9i1.927Abstract
Abstrak
Tuberkulosis (TB) masih menjadi masalah kesehatan global dengan sekitar 8,2 juta kasus baru setiap tahun. Strategi End TB WHO menargetkan penghentian epidemi TB pada 2035 dengan tingkat keberhasilan pengobatan ≥90%. Kabupaten Probolinggo menempati urutan kedua kasus TB tertinggi di Jawa Timur. Hingga 18 Maret 2025, dari target 16.466 terduga, ditemukan 3.532 kasus dengan 713 pasien positif (21%). Namun, hanya 638 (89%) yang terdaftar memulai terapi, dan capaian pengobatan tetap 21%. Penelitian ini bertujuan menganalisis pengaruh cognitive behavioral therapy (CBT) terhadap kepatuhan dan kesadaran diri pasien TB kategori “loss to follow-up” (LTFU). Desain yang digunakan adalah metode campuran (sequential exploratory). Tahap pertama berupa penelitian kualitatif fenomenologi untuk menggali fenomena perilaku pasien TB yang tidak berobat melalui FGD dan wawancara yang dianalisis tematis. Tahap kedua merupakan pra-eksperimen dengan desain one-group pre-post test pada 40 pasien LTFU dari populasi 45 orang, dipilih secara purposive sampling. Intervensi berupa konseling oleh pakar keperawatan jiwa selama 4 minggu (1 kali/minggu, 6 sesi, 30–40 menit). Hasil menunjukkan pemahaman dan pengalaman dalam pengobatan TB, pasien merasa malu dan khawatir terhadap lamanya pengobatan. CBT terbukti meningkatkan kepatuhan dan kesadaran diri, sehingga direkomendasikan diterapkan pada pasien maupun keluarga.
Kata kunci: Cognitive Behavioral Therapy; Kepatuhan; Kesadaran Diri; Tuberkulosis; loss to follow up
Abstract
Tuberculosis (TB) remains a critical global health challenge, with an estimated 8.2 million new cases reported annually. The WHO End TB Strategy aims to eliminate the epidemic by 2035, with a recommended treatment success rate of ≥90%. Probolinggo Regency ranks second in East Java for TB incidence. As of March 18, 2025, 3,532 suspected cases were identified from a target of 16,466, with 713 confirmed cases (21%). However, only 638 (89%) initiated treatment, resulting in an overall treatment success of 21%. This study examined the effectiveness of cognitive behavioral therapy (CBT) in improving adherence and self-awareness among TB patients categorized as “loss to follow-up” (LTFU). A mixed-method sequential exploratory design was employed. The qualitative phase used a phenomenological approach through focus group discussions and interviews, analyzed thematically. The quantitative phase applied a pre-experimental one-group pre-post test involving 40 purposively selected LTFU patients. Counseling sessions were delivered by psychiatric nursing experts over four weeks (once weekly, six sessions, 30–40 minutes). Results revealed that CBT interventions enhanced understanding, reduced anxiety, and significantly improved adherence and self-awareness, suggesting its applicability for both patients and families.
Keywords: Cognitive Behavioral Therapy; Adherence; Self-Awareness; Tuberculosis; Loss to Follow-up
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