HUBUNGAN SKOR CEMAS UJIAN SEMESTER DENGAN JUMLAH DAN BESAR AGREGAT TROMBOSIT PADA SEDIAAN APUS DARAH TEPI (THE CORRELATION BETWEEN THE ANXIETY SCORE OF SEMESTER EXAMINATION AND THE COUNT AND SIZE OF PLATELET AGGREGATES IN PERIPHERIAL BLOOD SMEAR)

Abstract

ABSTRACT Background : Anxiety is a respons dealing with stressor. Semester examination is catagorized as an acute anxiety. During the anxiety various changes in the body such as platelet activation occurs. Platelet become easy to form aggregates due to the increased of adrenaline as a stress hormone. So far there has not been reported about how far the correlation between the count and size of platelet aggregates and the degree of anxiety. Objectives : The aim of this research was to prove if there was a correlation between the anxiety score of semester examination and the count and size of platelet aggregates in peripherial blood smear. Method : Fifty eigth subjects were fulfilled the inclusive criteria : not smoke, not consuming aspirin and caffeine, no exessive exercise, no symptoms, normal blood pressure, Hb, Ht, leucocytes and platelet count were in reference value limit, not in the menstruation period and have a normal menstruation period, the anxiety score before the exam was > 14. The blood samples were taken and checked 30 minutes before and 10 days after the semester examination period. Hb, Ht, leucocytes and platelet count were tested using an autoanalyzer. The peripherial blood samples were examined without additional anticoagulant. The aggregate size criterias were 10 — 50, 51 — 100 and > 100 of platelet. Result : The mean of the anxiety score before the exam was 24,0 ± 7,36 and after the exam was 16,03 ± 5,81. By using Spearman's non parametric test, it was showed that there was a significant weak positive correlation between the anxiety score and the count and size of platelet aggregates with the r and p values in sequence : 0,299 and 0,023 (the anxiety score with the total count of aggregates before the exam); 0,262 and 0,046 (the anxiety score with the size of aggregates 10 — 50 of platelet before the exam); 0,308 and 0,019 (the anxiety score with the size of aggregates 51 — 100 of platelet before the exam); 0,371 and 0,004 (the anxiety score with the size of aggregates > 100 of platelet before the exam); 0,262 and 0,047 (the anxiety score with the total count of aggregates after the exam); 0,313 and 0,017 (the anxiety score with the size of aggregates 51 — 100 of platelet after the exam); 0,397 and 0,002 (the anxiety score with the size of aggregates > 100 of platelet after the exam). However, the anxiety score with yhe size of aggregates of 10 — 50 of platelet showed a non significant weak positive correlation (r = 0,255 and p = 0,530). Conclusion : It was found that there was a significant weak positive correlation between the anxiety score and the count and size of platelet aggregates in peripherial blood smear either before or after examination. ABSTRAK Latar belakang : Comas merupakan respons untuk menghadapi stresor. Ujian semester tergolong cemas yang bersifat alas. Pada keadaan comas terjadi berbagai perubahan dalam tubuh diantaranya aktivasi trombosit. Trombosit menjadi mudah melekat membentuk agregat karena peningkatan adrenalin sebagai hormon stres. Belum pernah dikemukakan tentang seberapa jauh hubungan antara ukuran agregat trombosit dengan derajat comas. Tujuan : Penelitian ini bertujuan untuk membuktikan adanya hubungan skor comas ujian semester dengan jumlah dan besar agregat trombosit pada sediaan apus darah tepi. Bahan dan metoda : Sebanyak 58 subyek memenuhi kriteri inklusi • tidak merokok, tidak mengkonsumsi aspirin dan kafein, tidak melakukan aktivitas fisik berlebihan, tidak ada keluhan, tekanan darah normal, kadar Hb, Ht, junilah leukosit dan trombosit dalam batas nilai rujukan; tidak setlang haid dan lama haid normal, skor comas saat ujian > 14, diambil bahan darah dan diperiksa skor cemasnya 30 menit sebelum dan 10 hari setelah periode ujian semester. Dilakukan pemeriksaan kadar Hb, lit, jumlah leukosit dan trombosit menggunakan autoanalyzer dan pemeriksaan jumlah serta besar agregat trombosit dari sediaan apus darah tepi yang dibuat langsung tanpa penambahan antikoagulan. Kriteria besar agregat : 10 — 50, 51— 100 dan > 100 trombosit. Hash! : Didapatkan rerata skor comas sebelum ujian 24,02 ± 7,36 dan setelah ujian 16,03 ± 5,81. Flasil uji statistik non parametrik Spearman's didapatkan korelasi positif lemah yang signifikan antara skor cemas dengan jumlah dan besar agregat trombosit dengan nilai r dan p berturut — turut : 0,299 dan 0,023 (skor comas dengan jumlah total agregat sebelum ujian) ; 0,262 dan 0,046 (skor comas dengan besar agregat 10 — 50 sebelum ujian) ; 0,308 dan 0,019 (skor comas dengan besar agregat 51 — 100 sebelum ujian) ; 0,371 dan 0,004 (skor comas dengan besar agregat > 100 sebelum ujian) ; 0,262 dan 0,047 (skor comas dengan jumlah total agregat setelah ujian) ; 0,313 dan 0,017 (skor comas dengan besar agregat 51 — 100 setelah ujian) ; 0,397 dan 0,002 (skor cemas dengan besar agregat >100 setelah ujian). Sedangkan untuk skor cemas dengan besar agregat 10 — 50 setelah ujian didapatkan korelasi positif lemah yang tidak signifikan r = 0,255 dan p = 0,530. Kesimpulan : Terdapat hubungan lemah yang bermakna antara skor comas dengan jumlah dan besar agregat trombosit pada sediaan apus darah tepi baik sebelum maupun setelah ujian.