PENGARUH TERAPI COGNITIVE REHABILITATION TERHADAP FUNGSI KOGNITIF PASIEN SKIZOFRENIA
Keywords:
cognitive rehabilitation, fungsi kognitif, skizofrenia, puzzle
Abstract
Schizophrenia is a severe mental disorder, organized into multiple dysfunctional domains including positive symptoms, negative symptoms, cognitive impairment, mood, carelessness, and aggression. Impaired cognitive function is an inability in attention, memory, consideration, problem solving, and the ability of executives such as planning, assessing, monitoring and evaluating. One of cognitive deficit therapy in schizophrenia is Cognitive Rehabilitation (CR) therapy. The purpose of this study is to determine whether there is an influence between cognitive therapy rehabilitation of cognitive function in schizophrenic patients. This research used Quasi Experiment with non-random pretest and posttest with control group design and method of data analysis used comparative test which is wilcoxon test and mann-whitney test. This research was done on schizophrenia patients in RSJD dr. Arif Zainudin Surakarta with 32 samples divided into control group (n = 15) and intervention group (n = 17). The cognitive function examination was assessed using the Montreal Cognitive Assessment (MoCA) version of Indonesia which has been validate. Interventions were done for during 6 sessions for 2 weeks and were done in groups. The cognitive function score in the control group, the pretest mean was 20.26 and the post-test mean was 21.60. For the function score in the intervention group, the average pretest score was 21.8, while the average post-test score was 25.6. The results of the research data analysis used the Wilcoxon test on the pretest and post-test of the control group with sig. 0.000 with a p-value <0.05; Wilcoxon test on pretest and post-test in the intervention group with sig. 0.000 with a p-value <0.05; Mann-Whitney test in the control-intervention group with sig. 000 with a p-value <0.05. This indicates that there is a significant difference in cognitive function abilities between the control group and the intervention group who underwent cognitive rehabilitation therapy for schizophrenia patients at RSJD Dr. Arif Zainudin Surakarta. This research shows a significant difference value between the control group and the intervention group. The result of the comparative test of both groups found that there was a significant effect on cognitive rehabilitation therapy on cognitive function in schizophrenic patients.
References
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[2] Agopian, T. N., & Abrams, G. Cognitive rehabilitation therapy. Encyclopedia of the Neurological Sciences, 824-826. 2014
[3] Al-Azizy. Ragam latihan khusus asah ketajaman otak anak plus melejitkan ingatannya. Jogyakarta: Diva Press. 2010
[4] American Psychiatric Assosiation. Diagnostic and statistic manual of mental disorder (5th ed.). Washington DC.2013
[5] AOTA. Schizophrenia. Retrieved from American Occupational Theraphy Association:
http://www.aota.org/conference-events/otmonth/what-is-ot.aspx.2017
[6] Averbuch, S., & Katz, N. Cognitive rehabilitation: A retraining model for clients with neurological disabilities. In N. Katz, Cognition and occupation across the life span: Cognitive models for intervention in occupational therapy. Bethesda MD: AOTA PRESS.2005
[7] Beer, J., & Ochsner, K. Social cognition: A multi level analysis. Brain Research(1079), 98-105.2006 [8] Bellack, A. S., Qold, J. M., & Buchanan, R. W. Cognitive rehabilitation for schizophrenia : Problems, prospects, and strategies. Schizophrenia Bulletin, 25, 257-274.1999
[8] Bennett, P. Abnormal and clinical psychology: An introduction textbook. New York: McGraw-Hill.2011 [9] Blanco, P., Martinez, C., Ortega, M., Gomez, R., & Schmucke, E. Cognitive rehabilitation therapy in patients with schizophrenia. European Psychiatry, 30, 1662.2015
[10] Bowie, C. R., Reichenberg, A., Petterson, T. L., Heaton, R. K., & Harvey, P. D. Determinants of real-world functional performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. American Journal Psychiatry, 3(163), 418-425.2006
[11] Brazo, P., Marie, R., Halbecq, I., Benali, K., Segard, L., & Delamillieure, P. Cognitive patterns in subtypes of schizophrenia. European Psychiatry, 155-162.2002
[12] Chattopadhyay, S., Patil, N. M., Nayak, R. B., & Chate, S. S. Cognitive deficits in scizophrenia. Journal of the Scientific Society, 39(2), 57-63.2012
[13] Cicerone, K. D., Dahlberg, C., Malec, J. F., Langenbahn, D. M., Felicetti, T., Kneipp, S., Catanese, J. Evidence-based cognitive rehabilitation: Updated Review of the Literature From 1998 Through 2002. Archives of Physical Medicine and Rehabilitation, 86(8), 1681-1692. Retrieved from
https://science/article/pii/S0003999305003308.2005
[14] Cohen, R. A. Psychiatric disturbance of attention. In R. A. Cohen, The neuropsychology of attention (2nd ed.). New York: Springer.2013
[15] Durand, V. M., & Barlow, D. H. Essential of abnormal psychology (5th ed.). Belmont: Wadsworth Cencage: Learning.2010
[16] Early, B. A. Physical Dysfunction Practice Skills for the Occupational Therapy Assistant (3rd ed.). New York: Elsevier Science Health Science.2012
[17] Emergency Care Research Institution. Cognitive rehabilitation for the treatment of traumatic brain injury. Plymouth Meeting: Emergency Care Research Institution.2009
[18] Erlina, Soewardi, & Pramono, D. Faktor-faktor yang berperan terhadap timbulnya skizofrenia pada pasien rawat jalan di rs jiwa prof. hb. saanin padang sumatra barat. Berita kedokteran masyarakat, 26(2), 71-80.2010
[19] Fioravanti, M., Carlone, O., Vitale, B., Cinti, M. E., & Clare, L. A meta-analysis of cognitive deficits in adults with a diagnosis of schizophrenia. Neuropsychology Review(15), 73-95.2005
[20] Folsom, D. P., Depp, C., Palmer, B. W., Mausbach, B. T., Golshan, S., Fellows, I., Cardenas, V., Petterson, T. L., Kreamer, H. C., Jeste, D. V. Physical and mental health-related quality of life among older people with schizophrenia. Schizophrenia Research, 207-2013.2009
[21] Gold, J., & Green, M. Schizophrenia : Cognition. In Kaplan, & Sadock, Comprehensive textbook of psychiatry (8th ed.). New York: Lippincott William & Walkins.2005
[21] Goldberg, S., & Gold, J. Neurocognitive function in schizophrenia. neuropsychopharmacology : The fifth generation of progress . Retrieved from www.neurppsycopharmacology.com.2000
[22] Green, M. New possibilities in cognition enhancement for schizophrenia. American Journal of Psychiatry(166), 749-752.2009
[23] Green, M., Kem, R., Braff, D., & Mint, J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the “right stuff ”? Schizophr. Bull (26), 119–136.2000
[24] Groff, P. R. Knowing how and knowing that, but knowing what? interference and transfer in the acquisution of problem solving skills. Toronto: University of Toronto.2001
[25] Hamalik, O. (1994). Media pendidikan. Bandung: Cita Aditya Bakti.
[26] Harvey, P., & Keefe, R. Studies of cognitive change in patients with schizophrenia following novel antipsychotic treatment. American Journal Psychiatry(158), 176-184.2001
[27] Hawari, D. Pendekatan holistik pada gangguan jiwa skizofrenia. Jakarta: Balai Penerbit FKUI.2009 [28] Heckers, S. Neuroimanging studies of hippocampus in schizofrenia. hippocampus(11), 520-528.2001
[29] Hurford, I. M., Kalkstein, S., & Hurford, M. O. cognitive rehabilitation in schizophrenia. Psychiatry Times(28), 1-9.2011
[30] Husein, N., Lumempouw, S. F., Ramli, Y., & Harqutanto. Uji Validitas dan Reliabilitas montreal cognitive assessment versi indonesia (MoCA-Ina) untuk skrining gangguan fungsi kognitif. Universitas Indonesia.2009
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[32] Kielhofner, G. Conceptual foundation of occupational theraphy practice (4th ed.). Philadephia: FA Davis Company.2009
[33] Krabbendam, L., & Aleman, A. Cognitive rehabilitation in schizophrenia: a qualitative analysis of controlled studies. Psychopharmacology, 169, 376-382.2003
[34] Kring, A. M., Johnson, S. L., Davinson, G., & Naele, J. Abnormal psychology (12th ed.). California: John Willey & Son.2012
[35] Kurtz, M. M. Cognitive remediation for schizophrenia: Current status, biological correlates and predictors of response. Cognitive remediation for schizophrenia review, 7(12), 813-821.2012
[36] Kusumawardhani, A. Buku ajar psikiatri. Jakarta: Badan Penerbit FK UI.2010
[37] Lajtha, A. Handbook of neuchemistry and molecular neurobiology schizophrenia. New York: Springer.2009
[38] Lewis, S., Escalona, P. R., & Keith, S. J. Phenomenology of schizophrenia. In B. Sadock, V. Sadock, & P. Ruiz, kaplanand sadock’s comprehensive textbook of psychiatry. Philadelphia: Lippincott Williams and Wilkins.2007
[39] Maslim, R. Buku saku diagnosis gangguan jiwa (PPDGJ) III. Jakarta: PT Nuh Jaya.2001
[40] McGurk, S. R., Mueser, K. T., Pascaris, A., Feldman, K., & Wolfe, R. Cognitive training and supported employment for persons with severe mental illness: one year results from a randomized controlled trial. Schizophrenia Bulletin, 31(4), 898–909.2007
[41] Nasreddine, Z. Moca test full 8.1 (NEW). Retrieved from MoCA (Montreal cognitive assessment):
http://www.mocatest.org/wp-content/uploads/2017/05/MoCA-8.1-English-Instructions-2017- 061.pdf ).2017
[42] Nasreddine, Z. S., Phillips, N. A., Be dirian, V., Charbonneau, S., Whitehead, V., Collin, I., . . . Chertkow, H. The montreal Ccgnitive assessment, MoCA: A brief Ssreening tool for mild cognitive Iipairment . Journal of American Geriatrics Society, 53, 695-699.2005
[43] Notoatmojo. Metodologi penelitian kesehatan. Jakarta: Rineka Cipta.2010
[44] Perhimpunan Dokter Spesialis Saraf Indonesia. Modul neurobehavior. Jakarta: Kolegium Neuroligi Indonesia.2008
[45] Perry, A. G., & Potter, P. A. Fundamental keperawatan. Jakarta: Salemba Medika.2009
[46] Puri, B. K., & Treasaden, I. H. Textbook of psychiatry (3rd ed.). London: Crurchill Livingstone Elsevier.2011
[47] Rahmanelli. Efektivitas pemberian tugas media puzzle dalam pembelajaran geografi regional. Jurnal Pelangi Pendidikan, 2(1), 23-30.2007
[48] Rao, S., Subbakrishna, D., & Gopukumar, K. Neuropsychology battery-2004 manual. Bangalore: National Institute of Mental Health and Neurosciences (Deemed University).2004
[49] Reichberg. et al. Publication manual of the american psychological association. USA: Inc.2009 [50] RISKESDAS. Riset kesehatan dasar 2013. Kementerian Kesehatan RI, Departemen Kesehatan RI. Jakarta: Balai Pustaka Kementrian Kesehatan. Retrieved 10 21, 2017, from https://drive.google.com/file/d/0BxMqKGS9XxLqWHN3VFdPdEgtUmc/edit.2013
[51] Rokhmat, J. Pengembangan taman edukatif berbasis permainan untuk permainan di tk dan sd. Jurnal Dinamika Pendidikan, 2(1), 45-52.2006
[52] Schizophrenia. from Health Retrieved World Organization: http://www.who.int/mental_health/management/schizophrenia/en/2009
[53] Silverstein, S. M., & Wilkniss, S. M. At issue; The future of cognitive rehabilitation of schizophrenia. Schizophrenia Bulletin, 30(4), 679-692.2004
[54] Soderback, I., & Ekholm, J. Medical and social factors affecting behavior patterns in patients with acquired brain damage: A study of patients living at home three years after incident. Disability and Rehabilitation, 14(1), 30–35.1992
[55] Spaulding, W. D., Fleming, S. K., Reed, D., Sullivan, M., Storzbach, D., & Lam, M. Cognitive function in schizophrenia: Implications for Psychiatric rehabilitation. Schizophrenia Bulletin, 25(2), 257- 289.1999
[56] Strub, R., & Black, F. The mental status examination in neurology (4th ed.). Philadelphia: F.A. Davis
Company.2000
[57] Stuart, G. W. Buku saku keperawatan jiwa (5 ed.). Jakarta: EGC.2007
[58] Sugiyono. Metode penelitian kuantitatif dan R&D. Bandung: University Press.2011
[59] Supratiknya, A. Komunikasi antar pribadi tinjauan psikologi. Yogyakarta: Kanisius.2008
[60] Trivedi, J., & Murthy, D. R. Cognitive deficits in psychiatric disorders; Current status. Indian Journal Psychiatry(48), 10-20.2006
[61] Undang Undang No.18. Undang undang No.18 tahun 2014 tentang kesehatan jiwa. Balai Pustaka: Jakarta.2014
[62] Undang Undang No.36. undang undang No.36 tahun 2009 tentang kesehatan. Balai Pustaka: Jakarta.2009
[63] Utama, H. Buku ajar psikiatri. Jakarta: Badan Penerbit FK UI.2010
[64] Velligan, D., Diamond, P., & Maples, N. Comparing the efficacy of interventions that use environmental supports to improve outcomes in patients with schizophrenia. Schizophrenia Research(102), 3212–3319.2008
[65] Velligan, D., Mahurin, R., True, J., Lefton, R., & Flores, C. Preliminary evaluation of cognitive adaptation training to compensate for cognitive deficit in schizophrenia. American Psychiatric Association(47), 415-417.1996
[66] World Health Organization. chizophrenia. Retrieved from World Health Orgnization: http://www.who.int/mental_health/management/schizophrenia/en/’2017
[67] Wykes, T. Cognitive remediation therapy (CRT) for young early onset patients with schizophrenia: an exploratory randomized controlled trial. Schizophrenia Research, 94(1-3), 221–230.2007
[68] Wykes, T., Huddy, V., Cellard, C., McGurk, S. R., & Czobor, P. A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. American Journal Psychiatry, 168, 472–485.2011
[69] Wykes, T., & Van der Gaag M. Is it time to develop a new cognitive therapy for psychosis -cognitive remediation therapy (CRT)? Clinical Psychology Review(21), 1227-1256.2011
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2023-09-29
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