KETAHANAN MENTAL PADA SISWI REMAJA ANEMIA DAN NON ANEMIA (STUDI KASUS DI SLTP 14 KOTAMADIA SEMARANG)

Abstract

Background: Mental resistancy is one of the important factors to be growth as a "good quality" human being. Recent studies show the prevalence of mental-emotional disorders among female adolescence tends to increase. Also it has been reported the high prevalence of anemia among female junior high school students in Semarang city. Objective: To investigate the multi factors relationship in mental resistancy of female adolescent students. Design: Observational analytic study with cross-sectional design Setting: Junior High School 14 Semarang, Central Java Subjects: Female students of Junior High School 14 Semarang, age range 10-19 years. Main outcome measures: Mental resistant assessment, using modified Masrun Standard Mental Resistant Score (SMR Score). Explanatory variables were blood hemoglobin level, student's physical and social characteristics, parent characteristics and social economics status. Data analysis with SPSS ver 9 and Stata ver 6 for window, PC. Results: There were 420 female adolescent students participate in this study with age were 13.7 (SD=I .11) years. The subjects were divided to 2 categories by using cut-off point Hb=12 mg/d1. Explanatory variables in both groups were blood hemoglobin level, body mass index, student's physical and social characteristics, parent characteristics, social economics status, and we record menstrual status. The level of Hb in both groups is follow- anemia in 219 student's (mean Hb= 11.1 mg/dl; SD=0.6) with SMR Score 91.5 (SD-10.9) and non anemia in 201 student's (mean Hb = 13.0 mg/dl; SD= 0.7) with SMR Score 91.9 (SD-11.5). The results from regretion logistic method , the combination of hemoglobin and body mass index show anemic students have risk of 1.2 time higher than non-anemic students (95%CI= 1 to 1.5; p=0.05). In combination hemoglobin with age, body mass index and the number of the children in the family, anemia is also one of the risk factor to have low SMR score. It has been shown the students with anemia have 1.5 risk to get low SMR score (OR= 1.5; 95% CI = 0.9 to 2.0; p=0.09). The better nutritional status (body mass index) also has protective effect to get low SMR Score (OR=0.7; 95% CI= 0.5 to 1.0; p= 0.03). Another interesting finding here is the order of the children in the family also has an effect to the mental resistancy. The risk of elder children to get low SMR Score is lower than the younger children. (OR= 0.8; 95% CI=0.7 to 1.0; p= 0.01). Hemoglobin only has no significant correlation with SMR Score (correlation coefficient = - 0.014; 95% CI= -0.110 s/d 0.082; p= 0.8). It also has been found students with middle and high social economic classes, if anemia is present, have SMR score lower than the students from the same social economic classes but non-anemic. However, students with low social economic status, if anemia is present, have SMR score higher than the students from the same social economic class. Conclusion: these finding is that the multi factors concept of mental resistance in female adolescence Students. Combination of anemia with body mass index has a correlation with SMR Score. Social economic status has a corrrelation with SMR Score. Keywords: adolescent, mental resistant, anemia. Latar Belakang : Ketahanan mental merupakan salah satu faktor penting dalam kualitas tumbuh kembang remaja. Prevalensi gangguan mental emosional pada remaja putri akhirakhir ini dilaporkan meningkat. Demikian pula laporan peningkatan prevalensi anemia pada siswi SLTP di Semarang. Tujuan: Untuk mengetahui faktor yang berpengaruh terhadap ketahanan mental siswi remaja Metode penelitian: Penelitian analitik observasional dengan pendekatan belah lintang Ketahanan mental menggunakan tolak ukur skor ketahanan mental (SKM) modifikasi Masrun. Variabel yang diteliti meliputi kadar hemoglobin, karakteristik anak dan keluarga serta status sosial ekonomi. Analisis data dengan program komputer SPSS versi 9 dan Stata versi 6. Tempat: SLIP 14 Kotamadia Semarang„lawa Tengah Subjek: Siswi S1,TP dengan usia 10-19 tahun. Hasil penelitian 420 siswi remaja masuk dalam kriteria penelitian dengan usia 13.7 (SD=1.11) tahun dibagi dalam dua kelompok anemia dan non anemia (batas Hb 12 mg/di). Pada ke dua kelompok dilakukan pemeriksaan Hb, SKM, indeks masa tubuh (IMT), karakteristik fisik dan sosial anak, karakteristik orang tua status sosial ekonomi, dan dicatat status menstruasi. Didapat 219 ( 52.1%) siswi anemia (Hb 11.1; SD= 0.6 mg/dl) dengan SKM 91.5 (SD=10.9) dan 209 (47,9%) siswi non anemia (Hb 13.0; SD=0.7 mg/de dengan SKM 91.9 (SD=11.5). Dengan metode analisis regresi logistik, kombinasi Hb bersama 1MT menunjukkan siswi anemia mempunyai risiko 1,2 kali lebih tinggi mendapat skor ketahanan mental rendah dibanding siswi non anemia (95%0= 1 s/d 1.5; p=0.05). Kombinasi Hb, IMT, usia dan urutan anak dalam keluarga menunjukkan bahwa siswi anemia mempunyai risiko 1.5 lebih tinggi untuk rnendapat SKM rendah (OR= 1.5; 95% CI = 0.9 s/d 2.0; p=0.09). Status gizi (IMT) yang baik memberikan proteksi terhadap SKM rendah (OR=0.7; 95% CI= 0.5 s/d 1.0; p= 0.03). Tidak ditemukan korelasi antara kadar hemoglobin dengan SKM (koefisien korelasi: - 0.014; 95% Cl= -0.110 s/d 0.082; p= 0.8). Penelitian ini juga menunjukkan bahwa siswi dengan status sosial ekonomi menengah dan rendah, SKM kelompok anemia lebih rendah dibanding kelompok anemia Pada siswi dengan status sosial ekonomi rendah , ternyata SKM kelompok anemia lebih tinggi dibanding kelompok anemia. Kesimpulan: Ketahanan mental dipengaruhi multifaktor. Anemia dan indeks masa tubuh mempenganthi skor ketahanan mental siswi remaja. Status sosial ekonomi berpengaruh pada skor ketahanan mental. Kata kunci: remaja, ketahanan mental, anemia.,