PENGARUH KONSELING GENETIK PADA TINGKAT KECEMASAN DAN DEPRESI TERHADAP PENENTUAN GENDER AMBIGUS GENITALIA THE EFFECT OF GENETICS COUNSELING ON DEPRESSION AND ANXIETY LEVEL IN GENDER ASSIGNMENT FOR AMBIGUOUS GENITALIA

Abstract

Latar Belakang. Ambigus genitalia merupakan ketidaksesuaian karakteristik yang menentukan jenis kelamin seseorang, secara umum tingkat kejadiannya untuk mendapatkan penyakit ini adalah 1: 2000. Orang tua merupakan bagian yang paling terpenting dalam penentuan identitas gender dan juga penentuan seks dari anak dengan kelainan ambigus genitalia sehingga dapat menyebabkan orang tua dapat mengalami mengalami depresi dan kecemasan. Tujuan. Penelitian ini bertujuan mengetahui pengaruh konseling genetik orang tua terhadap tingkat kecemasan dan depresi pada penentuan gender ambigus genitalia. Metode. Penelitian ini merupakan studi analitik dengan metode prospektif dengan menggunakan pre-post test group design. Data dianalisis secara deskriptif dengan menggunakan tabel silang dan analitik menggunakan T-test dengan SPSS versi 15.00. Hasil. Penelitian ini didapatkan 20 subyek penelitian. Tujuh pasien dengan gender perempuan didapatkan 4(57%) dengan 46,XX dan 3(42%) dengan 46,XY, sedangkan dari 13 pasien dengan gender laki-laki didapatkan 10(76%) dengan 46,XY, 2(15%) dengan mosaik 45,X/46,XY dan 1(7%) dengan 46,XX. Pemeriksaan skala depresi Hamilton pada pretes didapatkan hasil 10(50%) depresi ringan, 7(35%) depresi sedang dan 3(15%) depresi berat, pada postes 7(35%) tidak ada depresi, 13(65%) depresi ringan, sedangkan untuk pemeriksaan tingkat kecemasan didapatkan 14(70%) anxietas ringan, 4(20%) anxietas ringan-sedang, 2(10%) anxietas sedang-berat, pada postes semua ibu penderita mengalami anxietas ringan. Uji Statistik dengan T-test menunjukkan hubungan yang signifikan antara pre dan post test dari tingkat depresi dan kecemasan setelah konseling genetik dengan nilai p<0.05. Back ground. Ambiguous genitalia is a phrase used to describe a person whose sex chromosomes, genitalia, and/or secondary sex characteristics cannot be determined as exclusively male or female. In general, it is estimated that the risk to catch this disease is 1: 2000. Parents take an important role in making decision for children with ambiguous genitalia concerning their gender identity and sex rearing, therefore may cause parents trap in depression and anxiety. Purpose. This research aimed to study the effect of genetics counseling session towards parents on their depression and anxiety level in rearing the gender of ambiguous genitalia.. Methods. This research was an analytic study with prospective approach and applying pre-post test group design. Data was analyzed descriptively by cross tabulation table, and analytically by T- test with SPSS for window version 15.00. Results Of the 20 subjects collected in this research, seven patients with female gender were consisted of 4 (57%) with karyotipe 46,XX and 3 (42%) with 46,XY. While from 13 patients with male gender, 10 (76%) has karyotipe 46,XY; 2 (15%) has mosaic 45,X/46,XY; and 1 (7%) has 46,XX. Hamilton depression scale which performed in pretest showed 10 (50%) respondents were in mild level, 7 (35%) were moderate, and 3 (15%) were severe, while anxiety level measurements showed 14 (70%) were in mild level, 4 (20%) were in mild-moderate and 2 (10%) were in moderate-severe. Meanwhile, the posttest showed 7 (35%) respondents were having no depression, 13 (65%) were in mild level, whilst for anxiety level all of respondents were mild. T- test showed that there was a significant relation between pre and posttest regarding depression and anxiety level after genetic counseling session with p<0,05. Conclusion. genetic counseling session has an impact in rearing the gender of children suffering from ambiguous genitalia.