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Abstrak :
ABSTRAK
Permasalahan NAPZA secara global menjadi persoalan hampir di semua Negara. Pecandu Narkotika, dan Korban Penyalahgunaan Narkotika wajib menjalani Rehabilitasi Medis maupun Rehabilitasi Sosial. Perawatan Rehabilitasi Medis NAPZA memerlukan waktu lama dan biaya yang tinggi, perlu mengetahui faktorfaktor yang menjadi beban biaya. Penelitian ini menggunakan desainpotong lintang.. Dari 68 Pasien Rehabilitasi Medis NAPZA, 79,4 % mengalami komplikasi, rata-rata lama dirawat 180 hari, biaya rata-rata Rp.20.512.370,-, dan tidak terbukti ada hubungan antara karakteristik pasien dengan biaya rehabilitasi Medis NAPZA. Program Rehabilitasi di RSKO terdiri 3 tahap. Komponen biaya yang paling besar adalah tahap Rehabilitasi sebanyak 87,2%, tahap Detoksifikasi/EMP sebanyak 12,07 %, sedang tahap After Care 0.72 %. Komponen biaya terbesar pada tahap Rehabilitasi adalah Akomodasi, yang kedua adalah Obat. Pada tahap Detoksifikasi/EMP komponen biaya paling tinggi.adalah obat. Asuransi Kesehatan Sosial tidak menjamin biaya Rehabilitasi Medis NAPZA. Studi merekomendasikan sustainabilitas layanan Pasien Rehabilitasi Medis NAPZA.

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ABSTRACT
The drug abuse has become a problem globally. Addicts and the victims related to drugs abuse have to be admitted to the medical rehabilitation as well as social rehabilitation. Medical rehabilitation is expensive so that it?s important to know factors that affect the cost. This crossectional study was using quantitative method. The result showed that out off 68 rehabilitation patients, 79,8 % had complication, on average 180 treatment days, and average of cost was Rp.20.512.370,-,. There was no relationship between patients charactheristic and the cost. The rehabilitation program in RSKO consists of 3 stages, namely Rehabilitation (87,2 %), Detoxification (12,07 %), and After Care (0,72%). Accomodation, followed with the treatment cost are two largest cost component in rehabilitation stage. The highest cost of detoxification was for medication. The social health insurance do not cover any treatment for drug abuse rehabilitation. To sustain program in the future, advocacy to policy made is needed.

Abstrak :

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ABSTRACT
Objective of the study to identify Social and drug related factors associated with injecting drug use among drug users? in Jakarta.

Method the design of the study was cross sectional total respondents were 135 drug users (72 IDUs and 63 None-IDUs) personal, family Social factors, and drug related factors are included in the analysis.

Result Multivariate analysis showed that student are at low risk (AOR=0.09) of using injection than those who are working, also those whose family don?t know about his/her drug using habit are at low risk (AOR=0.07) of injection than those whose family member aware, and those who use tranquilizer as first drug are at higher risk (AOR=3.89) of using injection than who use marijuana.

Conclusion Primary prevention activities focusing on improving social conditions, controlling black market of tranquilizers and improving family knowledge and skills to detect drug use in family as early as possible would help drug users to prevent them from indulging in injecting drug use, according to this study job, family and type of drug should be considered in the designing and planning of addicts? treatment and harm reduction activities.

Abstrak :
Drug users in Indonesia are threatened by many health and social challenges of which HIV, HBV and HCV are dominant and hence the utilization of health services is vital for them. This study was aimed to determine the individual factors that influence the health service utilization among drug users in west Java (Bandung), Indonesia. We used secondary data from the National Drug Survey Indonesia 2008, with a sample size of 130 drug users. The individual determinant of health service utilization were studied in three categories, predisposing, enabling and need factors we found that living with parents, drug overdose, respiratory and miscellaneous symptoms were significantly associated with health service utilization. Those living with parents were more likely to use health services than those living with others. Those who had Digestive and Miscellaneous symptoms and did not experience drug overdose were also more likely to use health service utilization. We did not find any association among the predisposing factors and health service utilization among drug users.

Abstrak :

Adiksi Internet (AI) merupakan masalah kesehatan jiwa yang sering terjadi pada remaja yang dapat menimbulkan konsekuensi negatif berupa dampak fisik, psikologi, dan sosial. Diagnosis dan tata laksana yang tepat diperlukan untuk intervensi segera tetapi  kuesioner skrining AI bagi remaja di Indonesia sampai saat ini belum ada. Tujuan penelitian ini adalah mengembangkan kuesioner AI (KDAI) yang andal dan sahih bagi remaja Indonesia, memperoleh gambaran konektivitas fungsional otak pada remaja dengan AI, mendapatkan prevalensi AI, faktor risiko dan proteksi.

Domain dan butir pernyataan KDAI dikembangkan dari kepustakaan, focus group discussion (FGD) remaja, dan level of agreement para pakar melalui teknik Delphi. Uji reliabilitas dan validitas KDAI mengikutsertakan 643 subjek yang dipilih secara acak dari 4 SMP dan 5 SMA di Jakarta. Data diambil pada bulan Juli 2018–Juli 2019. Uji validitas konstruk KDAI menggunakan exploratory analysis factor (EFA) dan confirmatory analysis factor (CFA). Penentuan titik potong KDAI melalui metode receiver operating characteristics (ROC) yang dibandingkan dengan internet addiction test (IAT) versi Indonesia. Pemeriksaan rs-fMRI BOLD dilakukan pada 60 subjek untuk mendapatkan validitas prediktif KDAI dan gambaran konektivitas fungsional otak pada remaja dengan AI dan tidak AI. Faktor risiko dan proteksi AI dianalisis dengan uji regresi logistik multivariat.

Kuesioner diagnostik adiksi internet terdiri atas 7 domain dan 44 butir pernyataan dengan validitas isi dan konstruk yang baik. Nilai reliabilitas KDAI 0,942 dengan nilai titik potong 108 (sensitivitas 91,8% dan spesifisitas 77,8%). Terdapat korelasi positif antara skor KDAI dengan konektivitas fungsional lateral prefrontal cortex kiri dan lateral parietal kanan pada kelompok adiksi (p = 0,018; r = 0,437). Korelasi negatif juga didapatkan antara skor KDAI dengan konektivitas fungsional lateral prefrontal cortex kiri dan lateral parietal kanan pada kelompok adiksi (p = 0,049; r = -0,375). Diperoleh prevalensi AI 31,4% dengan faktor risiko berupa durasi penggunaan internet  >  20 jam / minggu (p <  0,001; OR = 2,889) dan masalah perilaku (p <  0,001; OR = 2,539). Faktor risiko lainnya adalah tujuan penggunaan internet untuk media sosial dan permainan daring (p = 0,005; OR = 1,826), masalah emosi (p = 0,001;
OR = 1,918), usia awitan penggunaan internet ≤ 8 tahun (p = 0,008; OR = 1,821), dan masalah perilaku prososial (p = 0,008; OR = 1,758). Faktor proteksi AI adalah pola asuh non-exposure (p = 0,012; OR = 0,518).

Reliabilitas dan validitas KDAI baik untuk digunakan sebagai alat skrining AI pada remaja di Indonesia. Skor KDAI dapat menggambarkan perbedaan konektivitas fungsional otak pada remaja AI dan tidak AI. Durasi penggunaan internet dan masalah perilaku menjadi faktor risiko utama, sedangkan pola asuh non-exposure menjadi faktor proteksi AI. Pencegahan AI dapat dilakukan dengan deteksi dini dan intervensi faktor risiko serta proteksi.

 

Kata kunci: adiksi internet, KDAI, remaja, konektivitas fungsional, faktor risiko

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Internet addiction (IA) is a common mental health problem in adolescents alongside the rapid rise of digital technology that results in negative physical, psychological, and social consequences. IA screening in adolescence is required to provide accurate diagnosis and treatment, however, to date an IA screening questionnaire for Indonesian adolescents does not exist. The purpose of this study is to develop a valid and reliable IA questionnaire for Indonesian adolescents titled Kuesioner Diagnosis Adiksi Internet – KDAI, evaluate brain functional connectivity in adolescents with IA, and find the prevalence of IA along with its risk and protective factors.

The domains and items in KDAI were developed from literatures, adolescent focus group discussions (FGD), and level of agreements of experts through the Delphi technique. The reliability and validity testing of KDAI involved randomly selected adolescents from 9 schools (4 junior high schools and 5 high schools) in Jakarta. Data collection was done from July 2018–July2019. Exploratory analysis factor (EFA) and confirmatory analysis factor (CFA) was performed to find the construct validity. The cut-off for KDAI was determined through the receiver operating characteristic (ROC) method using the Indonesian version of the internet addiction test (IAT) as a comparison. Rs-fMRI examinations were performed on 60 subjects to attain predictive validity of KDAI and evaluate brain functional connectivity in adolescents with internet addiction. The risk and protective factors of IA were assessed using a multivariate logistic regression test.

The KDAI is comprised of 7 domains and 44 statement items with good content and construct validity. The reliability score of KDAI is 0.942. The cut-off for KDAI is 108 (sensitivity 91.8 and % specificity 77.8%). A positive correlation was found in non-addiction group (p = 0.018; r = 0.437). In contrast, a negative correlation between KDAI score with the functional connectivity of the left LPFC and right LP in the addiction group (p = 0.049; r = -0.375) was found. The prevalence of IA among adolescents in Jakarta is 31.4%. Risk factors associated with IA include duration of internet use > 20 hours/week (p < 0.001; OR = 2.889), conduct disorders (p < 0.001; OR = 2.539), purpose of internet use for social media and playing online games
(p = 0.005; OR = 1.826), emotional problems (p = 0.001; OR = 1.918), onset of internet use ≤ 8 years old (p = 0.008; OR = 1.821), and prosocial problems (p = 0.008; OR = 1.758). The protective factor of IA was found to be a non-exposure parenting style (p = 0.012; OR = 0.518).

The good reliability and validity properties of KDAI functions it as an IA screening tool for adolescents in Indonesia. KDAI scores were able to portray changes in brain functional connectivity in the IA group. The duration of internet use and conduct disorders are the main risk factors for IA and a non-exposure parenting style is a protective factor. Prevention programs for IA can be implemented by focusing on early detection and providing intervention to risk and protective factors.  

Keywords: Internet addiction, KDAI, adolescents, functional connectivity

 

Abstrak :

Adiksi Internet (AI) merupakan masalah kesehatan jiwa yang sering terjadi pada remaja yang dapat menimbulkan konsekuensi negatif berupa dampak fisik, psikologi, dan sosial. Diagnosis dan tata laksana yang tepat diperlukan untuk intervensi segera tetapi  kuesioner skrining AI bagi remaja di Indonesia sampai saat ini belum ada. Tujuan penelitian ini adalah mengembangkan kuesioner AI (KDAI) yang andal dan sahih bagi remaja Indonesia, memperoleh gambaran konektivitas fungsional otak pada remaja dengan AI, mendapatkan prevalensi AI, faktor risiko dan proteksi.

Domain dan butir pernyataan KDAI dikembangkan dari kepustakaan, focus group discussion (FGD) remaja, dan level of agreement para pakar melalui teknik Delphi. Uji reliabilitas dan validitas KDAI mengikutsertakan 643 subjek yang dipilih secara acak dari 4 SMP dan 5 SMA di Jakarta. Data diambil pada bulan Juli 2018–Juli 2019. Uji validitas konstruk KDAI menggunakan exploratory analysis factor (EFA) dan confirmatory analysis factor (CFA). Penentuan titik potong KDAI melalui metode receiver operating characteristics (ROC) yang dibandingkan dengan internet addiction test (IAT) versi Indonesia. Pemeriksaan rs-fMRI BOLD dilakukan pada 60 subjek untuk mendapatkan validitas prediktif KDAI dan gambaran konektivitas fungsional otak pada remaja dengan AI dan tidak AI. Faktor risiko dan proteksi AI dianalisis dengan uji regresi logistik multivariat.

Kuesioner diagnostik adiksi internet terdiri atas 7 domain dan 44 butir pernyataan dengan validitas isi dan konstruk yang baik. Nilai reliabilitas KDAI 0,942 dengan nilai titik potong 108 (sensitivitas 91,8% dan spesifisitas 77,8%). Terdapat korelasi positif antara skor KDAI dengan konektivitas fungsional lateral prefrontal cortex kiri dan lateral parietal kanan pada kelompok adiksi (p = 0,018; r = 0,437). Korelasi negatif juga didapatkan antara skor KDAI dengan konektivitas fungsional lateral prefrontal cortex kiri dan lateral parietal kanan pada kelompok adiksi (p = 0,049; r = -0,375). Diperoleh prevalensi AI 31,4% dengan faktor risiko berupa durasi penggunaan internet  >  20 jam / minggu (p <  0,001; OR = 2,889) dan masalah perilaku (p <  0,001; OR = 2,539). Faktor risiko lainnya adalah tujuan penggunaan internet untuk media sosial dan permainan daring (p = 0,005; OR = 1,826), masalah emosi (p = 0,001;
OR = 1,918), usia awitan penggunaan internet ≤ 8 tahun (p = 0,008; OR = 1,821), dan masalah perilaku prososial (p = 0,008; OR = 1,758). Faktor proteksi AI adalah pola asuh non-exposure (p = 0,012; OR = 0,518).

Reliabilitas dan validitas KDAI baik untuk digunakan sebagai alat skrining AI pada remaja di Indonesia. Skor KDAI dapat menggambarkan perbedaan konektivitas fungsional otak pada remaja AI dan tidak AI. Durasi penggunaan internet dan masalah perilaku menjadi faktor risiko utama, sedangkan pola asuh non-exposure menjadi faktor proteksi AI. Pencegahan AI dapat dilakukan dengan deteksi dini dan intervensi faktor risiko serta proteksi.

 

Kata kunci: adiksi internet, KDAI, remaja, konektivitas fungsional, faktor risiko

 

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Internet addiction (IA) is a common mental health problem in adolescents alongside the rapid rise of digital technology that results in negative physical, psychological, and social consequences. IA screening in adolescence is required to provide accurate diagnosis and treatment, however, to date an IA screening questionnaire for Indonesian adolescents does not exist. The purpose of this study is to develop a valid and reliable IA questionnaire for Indonesian adolescents titled Kuesioner Diagnosis Adiksi Internet – KDAI, evaluate brain functional connectivity in adolescents with IA, and find the prevalence of IA along with its risk and protective factors.

The domains and items in KDAI were developed from literatures, adolescent focus group discussions (FGD), and level of agreements of experts through the Delphi technique. The reliability and validity testing of KDAI involved randomly selected adolescents from 9 schools (4 junior high schools and 5 high schools) in Jakarta. Data collection was done from July 2018–July2019. Exploratory analysis factor (EFA) and confirmatory analysis factor (CFA) was performed to find the construct validity. The cut-off for KDAI was determined through the receiver operating characteristic (ROC) method using the Indonesian version of the internet addiction test (IAT) as a comparison. Rs-fMRI examinations were performed on 60 subjects to attain predictive validity of KDAI and evaluate brain functional connectivity in adolescents with internet addiction. The risk and protective factors of IA were assessed using a multivariate logistic regression test.

The KDAI is comprised of 7 domains and 44 statement items with good content and construct validity. The reliability score of KDAI is 0.942. The cut-off for KDAI is 108 (sensitivity 91.8 and % specificity 77.8%). A positive correlation was found in non-addiction group (p = 0.018; r = 0.437). In contrast, a negative correlation between KDAI score with the functional connectivity of the left LPFC and right LP in the addiction group (p = 0.049; r = -0.375) was found. The prevalence of IA among adolescents in Jakarta is 31.4%. Risk factors associated with IA include duration of internet use > 20 hours/week (p < 0.001; OR = 2.889), conduct disorders (p < 0.001; OR = 2.539), purpose of internet use for social media and playing online games
(p = 0.005; OR = 1.826), emotional problems (p = 0.001; OR = 1.918), onset of internet use ≤ 8 years old (p = 0.008; OR = 1.821), and prosocial problems (p = 0.008; OR = 1.758). The protective factor of IA was found to be a non-exposure parenting style (p = 0.012; OR = 0.518).

The good reliability and validity properties of KDAI functions it as an IA screening tool for adolescents in Indonesia. KDAI scores were able to portray changes in brain functional connectivity in the IA group. The duration of internet use and conduct disorders are the main risk factors for IA and a non-exposure parenting style is a protective factor. Prevention programs for IA can be implemented by focusing on early detection and providing intervention to risk and protective factors.  

Keywords: Internet addiction, KDAI, adolescents, functional connectivity

Abstrak :
Masa remaja merupakan masa transisi, dimana pada periode ini remaja mengalami perubahan dan perkembangan fisik, otak, seksual, kognitif, sosial, emosional dan spiritual. Perilaku sehat dibentuk di masa remaja. Oleh karena itu remaja merupakan kelompok usia yang rentan terhadap terjadinya perubahan kearah positif maupun negatif. Dengan demikian diperlukan upaya pencegahan terjadinya perilaku tidak sehat seperti penyalahgunaan narkoba. Tujuan penelitian ini adalah mengujicobakan model intervensi kesadaran diri untuk meningkatkan kesadaran diri akan perilaku sehat mencegah risiko penyalahgunaan narkoba. Penelitian ini terdiri dari tiga tahap, yaitu identifikasi masalah dengan metode kualitatif dan kuantitatif, pengembangan model intervensi dan uji coba model intervensi menggunakan desain quasi eksperimen, kelompok intervensi dan kelompok kontrol, dengan sampel remaja awal usia 12-14 tahun. Kelompok intervensi mendapat perlakuan dengan program pendidikan dan pelatihan menggunakan modul. Hasil analisis sebelum dan sesudah perlakuan. didapatkan perbedaan signifikan kesadaran diri Sig (2 tailed) 0,011 dan perilaku sehat Sig (2 tailed) 0,000. Kesimpulan model intervensi kesadaran diri membuktikan dapat meningkatkan kesadaran diri dan perilaku sehat remaja. Model kesadaran diri diharapkan menjadi program Usaha Kesehatan Sekolah (UKS) yang terintegrasi dalam kegiatan pembinaan lingkungan sekolah sehat. ......Adolescence is a transition period in which humans experienced changes and development in the physical, brain, sexual, cognitive, social, emotional and spiritual. Healthy behavior is formed in adolescence. Therefore, adolescents are a vulnerable group of age to positive and negative behavior changes. Thus, it is necessary to prevent the occurrence of unhealthy behaviors such as drug abuse. The purpose of this study was to try out an intervention model of self-awareness to increase self-awareness of healthy behavior to prevent the risk of drug abuse. This study consisted of three stages, namely problem identification, intervention model development and intervention model trial using a quasi-experimental design, intervention group and control group, with samples of early adolescents aged 12 to 14 years. The intervention group received treatment with education and training programs using modules. Based on the results of the analysis before and after treatment, there was a significant difference in the healthy behavior of Sig (2-tailed) at 0.000 and self-awareness Sig (2-tailed) at 0.011. In conclusion, the Intervention model of self-awareness proves to be able to increase the healthy behavior and self-awareness of adolescents. The self-awareness model is expected to become an Integrated School Public Health (UKS) program in building a healthy school environment.

Abstrak :
Pada statistik penyalahguna narkoba dengan status drug relapse di Indonesia mencapai 70% pada tahun 2019 (BNN, 2019). Kondisi ini menggambarkan bahwa mekanisme rehabilitasi sosial bagi drug relapse di Indonesia masih berpeluang hadir tanpa shaming. Oleh karena itu, penelitian ini berusaha melihat signifikansi lifestyle-related shaming sebagai bagian penting dari mekanisme penerapan shaming bagi, khususnya para drug relapse di Indonesia. Penelitian ini dilakukan berdasarkan analisis teori John Braithwaite tentang reintegrative shaming yang menyatakan bahwa respon masyarakat terhadap pelaku terbagi menjadi 2 (dua) yaitu reintegrative shaming yang berarti penerimaan kembali dan stigmatisasi. Shameless berpeluang memberikan stigma negatif secara permanen. Metode yang digunakan dalam penelitian ini adalah studi dokumentasi, wawancara delphi, FGD, survei dan wawancara mendalam. Selain itu, peneliti memanfaatkan dan mencoba mengembangkan konstrukti teoretis (grounded theory) dengan menghadirkan konsep (variabel) sesuai dengan keterjangkauan data penelitian sehingga menghasilkan temuan baru mengenai pentingnya lifestyle-related shaming dalam drug relapse. Lifestyle-related shaming adalah bagian dari kombinasi teori reintegrative shaming, teori desistensi dan teori aktivitas rutin. Diharapkan nantinya, kajian ini mampu memberikan pemahaman yang luas kepada pemerintah untuk menyiapkan program terbaik untuk mengatasi fenomena shameless, khususnya penyalahgunaan narkoba di Indonesia. Selain itu juga bermanfaat dalam ilmu pengetahuan sebagai dasar penerapan shaming di Indonesia. ......In statistical calculations, drug abusers with the status of drug relapse in Indonesia reached 70% in 2019 (National Narcotics Agency: 2019). This condition illustrates that the social rehabilitation mechanism for drug abusers in Indonesia still has the opportunity to present shameless. Therefore, this study seeks to see the significance of Lifestyle-related shaming as an important part of the mechanism for implementing shaming for the shameless, especially drug relapse offenders in urban areas. This study was conducted based on the analysis of John Braithwaite's shaming theory which states that the public's response to perpetrators is divided into 2 (two) namely reintegrative shaming which means re-acceptance of the shameless by giving shame to them and stigmatization which means treating the shameless by giving a negative stigma permanently. The method used here was literature review, deplhi, FGD, survey and in-depth interview by utilizing and trying to develop existing theories (grounded theory) by presenting concepts (variables) in accordance with the affordability of study data so as to produce new findings regarding the significance of Lifestyle-related shaming in its role for drug relapse offenders. Lifestyle-Related Shaming is part of a combination of reintegrative shaming theory, desistance theory and routine activity theory. In the literature study conducted, the combination of (3) three macro theories produces Lifestyle-related shaming which is closely related to urban lifestyle. It is expected that later, this study will be able to provide a broad understanding to the government to prepare the best program for solving shameless phenomenon, especially drug abuse in Indonesia. Furthermore, it is also useful in science as a basis for the application of shaming in Indonesia.

Abstrak :
Kadar testosteron pada penyalahguna narkotika lebih kecil 43 dari padalaki-laki yang bukan penyalahguna narkotika, kadar testosteron yang rendahberpotensi menimbulkan masalah fisik, psikis dan sosial. Tujuan penelitian untuk mengetahui perubahan kadar hormon testosteronpada program rehabilitasi medis penyalahguna narkotika di Balai BesarRehabilitasi Badan Narkotika Nasional Indonesia, Lido-Bogor. Desain penelitianini adalah longitudinal dengan analisis GLM-RM Generalized Linear ModelsRepeated Measure. Hasil penelitian adalah program rehabilitasi medis pada penyalahgunanarkotika meningkatkan kadar hormon testosteron tidak dapat dibuktikan. Saranpenelitian ini adalah masih perlu penelitian lanjut dengan membutuhkan waktuyang lebih lama, bukan dilakukan pada awal rehabilitasi dan tidak setiap minggutetapi setiap bulan. Program yang dilakukan lebih bertumpu pada aktifitas fisikyang disesuaikan dengan perilaku agresif dan menyenangkan.

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Testosterone levels in narcotics abusers are 43 smaller than males whoare not narcotics abusers, low testosterone levels potentially cause physical,psychological and social problems. The purpose of this research is to know the changing of testosterone levelin medical rehabilitation program of narcotics abuser in Central RehabilitationAgency of National Narcotics Board of Indonesia, Lido-Bogor. The design of thisstudy is longitudinal with GLM-RM Generalized Linear Models RepeatedMeasure analysis. The results of study for medical rehabilitation programs on narcoticsabusers raise the testosterone levels was not proven. This study result is suggestfor the future research needed more longer time, not start from the beginning ofrehabilitation and also not every week examination but every month. The programis based on more physical activity suitable to aggressive behavior and more fun.