EFEKTIVITAS PENERAPAN STRATEGI KOPING SEEKING

SOCIAL SUPPORT TERHADAP PENURUNAN TINGKAT

STRESS PADA PERAWAT UGD DI RS. WAVA HUSADA

SKRIPSI

Oleh :

NIA HIDAYATI

201110420311012

PROGRAM STUDI ILMU KEPERAWATAN

FAKULTAS ILMU KESEHATAN

UNIVERSITAS MUHAMMADIYAH MALANG

2015

SURAT PERNYATAAN KEASLIAN TULISAN

Saya yang bertanda tangan di bawah ini:

Nama : Nia Hidayati

NIM : 201110420311012

Program Studi : Program Studi Ilmu Keperawatan FIKES UMM

Judul Skripsi : Efektivitas Penerapan Strategi Koping Seeking Social Support

Terhadap Penurunan Tingkat Stress Pada Perawat UGD Di RS. Wava

Husada

Menyatakan dengan sebenarnya bahwa Tugas Akhir yang saya tulis ini benar-benar

hasil karya saya sendiri, bukan merupakan pengambilalihan tulisan atau pikiran orang

lain yang saya akui sebagai tulisan atau pikiran saya sendiri.

Apabila dikemudian hari dapat dibuktikan bahwa Tugas Akhir ini adalah hasil

jiplakan, maka saya bersedia menerima sanksi atas perbuatan tersebut.

Malang, Mei 2015 Yang Membuat Pernyataan,

Nia Hidayati NIM. 201110420311012

KATA PENGANTAR

Puji dan syukur kehadirat Allah SWT, berkat rahmat dan bimbingan-Nya saya

dapat menyelesaikan skripsi dengan judul “Efektivitas Penerapan Strategi Koping

Seeking Social Support terhadap Penurunan Tingkat Stress Pada Perawat di RS.Wava

Husada”. Skripsi ini disusun sebagai salah satu syarat guna memperoleh gelar sarjana

keperawatan (S.Kep) pada Program Studi Ilmu Keperawatan Fakultas Ilmu

Kesehatan Universitas Muhammadiyah Malang.

Penulis menyadari bahwa tugas akhir ini dapat terselesaikan berkat bantuan,

arahan dan bimbingan dari berbagai pihak. Untuk itu tidak lupa penulis

menyampaikan terima kasih yang setulus-tulusnya kepada yang terhormat:

1. Yoyok Bekti Prasetyo, M.Kep., Sp.Kom, selaku Dekan Fakultas Ilmu

Kesehatan Universitas Muhammadiyah Malang dan sekaligus selaku Dosen

Pembimbing I yang telah memberikan bimbingan, arahan, dan motivasi

dalam penyusunan skripsi ini.

2. Nurul Aini, S.Kep., Ns., M.Kep., selaku Ketua Program Studi Ilmu

Keperawatan Fakultas Ilmu Kesehatan Universitas Muhammadiyah Malang.

3. Edi Purwanto, S.Kep., Ns., M.Ng., selaku Dosen Pembimbing II yang telah

memberikan bimbingan, arahan, dan motivasi dalam penyusunan skripsi ini.

4. Kedua orang tua dan keluarga yang selalu mendoakan dan memberikan

dukungan moril dan materil bagi terselesaikannya skripsi ini.

5. Direktur RS. Wava Husada, Kepanjen yang telah memberikan izin untuk

melakukan penelitian dan staff perawat UGD yang telah berpartisipasi dalam

penelitian ini.

6. Teman-teman PSIK 2011 dan semua pihak yang telah membantu

penyelesaian skripsi ini.

Penulis hanya mampu berdoa semoga amal kebaikannya mendapat imbalan

dan diterima sebagai ibadah oleh Allah SWT. Penulis menyadari masih banyak

kekurangan yang disebabkan oleh keterbatasan kemampuan dan pengetahuan yang

penulis miliki, oleh karena itu kritik dan saran yang bersifat membangun sangat

penulis harapkan. Semoga skripsi ini dapat bermanfaat bagi penulis dan para

pembaca.

Malang, Mei 2015

Penulis

DAFTAR ISI Halaman Judul .................................................................................................................. i Lembar Persetujuan .......................................................................................................... ii Keaslian Penulisan ............................................................................................................. iii Kata Pengantar ................................................................................................................. iv Abstrak ................................................................................................................................ vi Daftar Isi ............................................................................................................................. viii Daftar Tabel ...................................................................................................................... xi Daftar Gambar ................................................................................................................. xii Daftar Lampiran ............................................................................................................... xiii Daftar Grafik ..................................................................................................................... xiv BAB I PENDAHULUAN ....................................................................................... 1

1.1. Latar Belakang ........................................................................................ 1 1.2. Rumusan Masalah .................................................................................. 6 1.3. Tujuan ..................................................................................................... 6

1.3.1 Tujuan Umum ........................................................................... 6 1.3.2 Tujuan Khusus ......................................................................... 6

1.4. Manfaat Penelitian ................................................................................. 7 1.4.1 Manfaat bagi Akademis ........................................................... 7 1.4.2 Manfaat bagi Profesi Keperawatan ....................................... 7 1.4.3 Manfaat bagi Peneliti ............................................................... 7 1.4.4 Manfaat bagi Perawat .............................................................. 8 1.4.5 Manfaat bagi Pihak Pengelola RS.Wava Husada ................. 8

1.5. Keaslian Penelitian ................................................................................ 8 BAB II TINJAUAN PUSTAKA ................................................................................ 11

2.1. Konsep Strategi Koping Seeking Social Support ................................... 11 2.1.1 Pengertian Social Support ........................................................... 11 2.1.2 Tipe Social Support ...................................................................... 12 2.1.3 Metode Seeking Social Support .................................................... 14 2.1.4 Pengertian Strategi Koping ...................................................... 16 2.1.5 Social Support sebagai Strategi Koping ..................................... 17

2.2 Konsep Stress pada Perawat ................................................................ 20 2.2.1 Pengertian Stress ...................................................................... 20 2.2.2 Stress Kerja ............................................................................... 21 2.2.3 Stress Pekerjaan pada Perawat ............................................... 23 2.2.4 Stress Perawat berdasarkan Karakteristik .............................. 24

2.3 Hubungan Stress dan Strategi Koping ............................................... 26 2.3.1 Faktor Pemicu Stress ............................................................... 27 2.3.2 Appraisal .................................................................................... 28 2.3.3 Respon Stress ............................................................................ 30 2.3.4 Koping ....................................................................................... 31 2.3.5 Adaptasi ..................................................................................... 32

BAB III KERANGKA KONSEP DAN HIPOTESIS ........................................ 34

3.1. Kerangka Konsep ................................................................................... 34 3.2 Hipotesis Penelitian ............................................................................... 35

BAB IV METODOLOGI PENELITIAN .............................................................. 36 4.1 Rancangan Penelitian ............................................................................. 36

4.1.1 Desain Penelitian ....................................................................... 36 4.1.2 Pendekatan Penelitian ............................................................. 36

4.2 Identifikasi Masalah ................................................................................ 38 4.3 Populasi dan Sampel .............................................................................. 38

4.3.1 Populasi ...................................................................................... 38 4.3.2 Sampel......................................................................................... 38 4.3.3 Sampling ..................................................................................... 39

4.4 Variabel Penelitian .................................................................................. 39 4.4.1 Variabel Independen................................................................. 39 4.4.2 Variabel Dependen ................................................................... 39 4.4.3 Variabel Confounding .............................................................. 40

4.5 Definisi Operasional .............................................................................. 40 4.6 Tempat Penelitian ................................................................................... 41 4.7 Waktu Penelitian ..................................................................................... 41 4.8 Instrumen Penelitian .............................................................................. 42 4.9 Prosedur Pengumpulan Data ................................................................ 43 4.10 Analisis Data ........................................................................................... 46

4.10.1 Analisis Univariat ........................................................................ 46 4.10.2 Analisis Bivariat ........................................................................... 46

4.11 Etika Penelitian ....................................................................................... 47 4.11.1 Lembar Persetujuan (Informed Consent) ..................................... 47 4.11.2 Tanpa Nama (Anonimity) ............................................................ 47 4.11.3 Kerahasiaan (Confidentality) ......................................................... 47

BAB V HASIL PENELITIAN DAN ANALISA DATA .................................... 48 5.1. Karakteristik Responden ....................................................................... 48 5.2. Tingkat Stress Perawat UGD Sebelum Menerapkan

Strategi Koping Seeking Social Support ................................................... 50 5.3. Tingkat Stress Perawat UGD Setelah Menerapkan

Strategi Koping Seeking Social Support ................................................... 50 5.4. Efektivitas Penerapan Strategi Koping Seeking Social Support

terhadap Penurunan Tingkat Stress pada Perawat UGD ................. 51 BAB VI PEMBAHASAN ............................................................................................. 54

6.1. Interpretasi dan Diskusi Hasil Penelitian ............................................ 54 6.1.1 Identifikasi Karakteristik Responden ..................................... 54 6.1.2 Tingkat Stress Perawat UGD Sebelum Menerapkan Strategi Koping Seeking Social Support...................................... 61 6.1.3 Tingkat Stress Perawat UGD Setelah Menerapkan Strategi Koping Seeking Social Support...................................... 64 6.1.4 Efektivitas Penerapan Strategi Koping Seeking

Social Support terhadap Penurunan Tingkat Stress pada Perawat UGD ............................................................................ 67

6.2. Keterbatasan Penelitian ......................................................................... 72 6.3. Implikasi Untuk Keperawatan .............................................................. 73

BAB VII PENUTUP ..................................................................................................... 74 7.1. Kesimpulan .............................................................................................. 74 7.2. Saran ......................................................................................................... 74

7.1.1 Bagi Tenaga Kesehatan ............................................................ 74 7.1.2 Bagi Institusi Pendidikan ......................................................... 75 7.1.3 Bagi Pihak Pengelola RS. Wava Husada ................................ 75 7.1.4 Bagi Peneliti Selanjutnya .......................................................... 76

Daftar Pustaka .................................................................................................................. 77 Lampiran ............................................................................................................................ 81

DAFTAR TABEL

Tabel 4.1 Definisi Operasional ........................................................................................ 40 Tabel 4.2 Sistem Penilaian Kuesioner The Workplace Stress Scale ................................. 43 Tabel 4.3 Interpretasi Kuesioner The Workplace Stress Scale ......................................... 43 Tabel 4.4 Jadwal Kegiatan Intervensi .............................................................................. 45 Tabel 5.1 Hasil Penelitian Berdasarkan Karakteristik Perawat UGD ......................... 49 Tabel 5.2 Tingkat Stress Perawat UGD Sebelum Menerapkan Strategi Koping Seeking Social Support .......................................................................................... 50 Tabel 5.3 Tingkat Stress Perawat UGD Setelah Menerapkan Strategi Koping Seeking Social Support .......................................................................................... 51 Tabel 5.4 Efektivitas Penerapan Strategi Koping Seeking Social Support terhadap Penurunan Tingkat Stress Perawat UGD ..................................... 52

DAFTAR GAMBAR

Gambar 2.1 Biopsychosocial Adaptation ............................................................................. 33 Gambar 3.1 Kerangka Konseptual ................................................................................ 34 Gambar 4.1 Kerangka Penelitian ................................................................................... 37

DAFTAR LAMPIRAN

Lampiran 1 Permohonan Menjadi Responden .............................................................. 81 Lampiran 2 Informed Consent ............................................................................................... 82 Lampiran 3 Kuesioner The Workplace Stress Scale ............................................................ 83 Lampiran 4 Standar Operasional Prosedur Strategi Koping Seeking Social Support ... 84 Lampiran 5 Form A. Social Network in Adult Life ........................................................... 89 Lampiran 6 Form B. Fungsi Jaringan Sosial ................................................................... 90 Lampiran 7 Form C. Peningkatan Jaringan .................................................................... 91 Lampiran 8 The Workplace Stress Scale Original Questionnaire ........................................... 92 Lampiran 9 Jadwal Kegiatan Penelitian ............................................................................ 94 Lampiran 10 Lembar Konsultasi Bimbingan Skripsi ...................................................... 95 Lampiran 11 Hasil Analisa Data .......................................................................................... 101 Lampiran 12 Hasil dokumentasi Penelitian ....................................................................... 102 Lampiran 13 Surat Izin Studi Pendahuluan dan Penelitian ............................................. 104 Lampiran 14 Surat Telah Melaksanakan Penelitian .......................................................... 105 Lampiran 15 Tabulasi Data Responden ............................................................................. 106

DAFTAR GRAFIK Grafik 5.4 Perbandingan Efektivitas Penerapan Strategi Koping Seeking Social

Support terhadap penurunan Tingkat Stress Perawat UGD ................... 52

DAFTAR PUSTAKA

Adriaenssens, J.M.L. (2014). Surviving Chaos : Predictors Of Occupational Stress

And Well-Being In Emergency Nurses. Leiden University Repository, 1-139

Aiska, S. (2014). Analisis Faktor-Faktor Yang Berpengaruh Pada Tingkat Stres Kerja Perawat Di Rumah Sakit Jiwa Grhasia Yogyakarta.

Bidlan, J.S. (2013). Occupational Stress Among Healthcare Professional. Indian Journal of Health and Wellbeing, 4(8), 1558-1562

Boyd, M.A. (2008). Psychiatric Nursing: Contemporary Practice 4th Edition. Philadelpia: Wolters Kluwer Health, Lippincott Williams & Wilkins

Chao, R.C.L. (2010). Managing Stress And Maintaining Well-Being : Social Support, Problem-Focused Coping, And Avoidant Coping. Journal Of Counseling And Development, 89(3)338-248

Circenis, K. & Millere, I. (2012). Stress Related Work Environment Factors: Nurses Survey Result. International Journal of Collaborative Research on Internal Medicine & Public Health, 4(6), 1150-1157

Erickson, R.J., Grove, W.J.C. (2008). Why Emotions Matter: Age, Agitation, And Burnout Among Registered Nurses. American Nurse Association. 13(1)

Folkman, S. (2010). Stress, Coping, And Hope. Psycho-Oncology, 19: 901–908

Format referensi elektronik direkomendasi oleh American Holistic Nurse Association, 2014, http://www.ahna.org/Resources/Stress-Management, diperoleh 03 Desember, 2014).

Friedman, H.S. (2011). The Oxford Handbook Of Health Phschology. Oxford University Press, Inc : New York

Gatot, D.B., & Adisasmito, W. (2005). Hubungan Karakteristik Perawat, Isi Pekerjaan Dan Lingkungan Pekerjaan Terhadap Kepuasan Kerja Perawat Di Instalasi Rawat Inap Rsud Gunung Jati Cirebon. Makara Kesehatan, 9(1), 1-8

Ghiyasvandian, S., Gebra, A.A. (2014). Coping Work Strategies And Job Satisfaction Among Iranian Nurses. Iran Red Crescent Med J., 16(6), 1-8

Gholamzadeh, S., Sharif, F., Rad, F.D. (2011). Surces Of Occupational Stress And Coping Strategies Among Nurses Who Are Working In Admission And Emergency Departemnt In Hospitals Affiliated To Shiraz University Of Medical Sciences. Irian Journal of Nursing and Midwifery, 16(1), 42-47

Haryanti., Aini, F., Purwaningsih, P. (2013). Hubungan Antara Beban Kerja dengan Stress Kerja Perawat di Instalasi Gawat Darurat RSUD Kabupaten Semarang. Jurnal Managemen Keperawatan, 1(1), 48-56.

Healy, S., Tyrrell, M. (2011). Stress In Emergency Departments: Experiences Of Nurses And Doctors. Emergency Nursing, 19(4), 31-37

Heaney, A.C., Price,H.R., Rafferty, J. (2011). Increasing Coping Resources at Work: A Field Experiment to Increase Social Support, Improve Work Team Functioning, and Enhance Employee Mental Health. Journal Of Organizational Behavior, 16(4), 334-352

Hidayat, A.A. (2007). Riset Keperawatan Dan Teknik Penulisan Ilmiah. Jakarta: Salemba Medika

Hidayat, R. (2012). Hubungan Faktor Stres Kerja Dengan Kinerja Perawat Di Instalasi Gawat Darurat Rumah Sakit Premier Surabaya, 1-12

Insel, P.M., Roth, W.T. (2007). Core Consepts In Health. New York: McGraw_Hill

Jahromi, K.M, Hojat, M. (2014). The Etiology Of Burnout Syndrome And The Levels Of Stress Among Nurses. Journal Of Jahrom University Of Medical Sciences, 12(1), 49-57

Jehangir, M., Kareem, N., Khan, A. & Jan, M.T. (2011). Effects of Job Satisfaction. Interdisciplinary Journal of Contemporary Research in Vusiness, 3(7), 453-465

Kato, T. (2014). Coping With Interpersonal Stress And Psychological Distress At Work: Comparison Of Hospital Nursing Staff And Salespeople. Department Of Social Psychology, 7, 31-36

Laal, M., Aliramaie, N. (2010). Nursing And Coping With Stress. International Journal Of Collaborative Research On Internal Medicine & Public Health, 2(5),168-181

Lane,R.S. (2004). The Influence Of Work Stress and Work Support on Burnout in Public Hospital Nurse

Lehouillier, I.S., Bjorvatn, B., Hetland, H., Sandal, G.M., Moen, B.E, Magerøy, Akerstedt, T., Pallesen, S. (2012). Individual, Situational And Lifestyle Factors Related To Shift Work Tolerance Among Nurses Who Are New To And Experienced In Night Work. Journal Of Advanced Nursing, 1-11

Li Li., Hu, H., Zhou, H., He, C., Gan, L., Liu, X., Zhang, Z. Li, H., Sun, T. (2014). Work Stress, Work Motivation And Their Effects On Job Satisfaction In Community Health Workers: A Cross-Sectional Survey In China. BMJ Journal, 4, 1-9

Lubis., Lumongga. N., (2011). Dampak intervensi kelompok cognitive behavioral therapy dan kelompok dukungan sosial dan sikap mnghargai diri sendiri. Makara Seri Kesehatan, 15(2), 65-72

Mattson’s Health (2011). Linking Health Communication With Social Support. Kendal Hunt, 182-218

Moksnes, U.K., Moljord, I.E.O., Espnes, G.A., Byrne D.G. (2010). The Association Between Stress And Emotional States In Adolescents:The Role Of Gender And Self-Esteem. Personality And Individual Differences. 1-6

Nasir, A., & Muhith, A. (2011). Dasar-Dasar Keperawatan Jiwa : Pengantar Dan Teori. Jakarta: Salemba Medika

Nguyen, L.K., Spitzberg, B.H., Lee, C.M. (2012). Coping With Obsessive Relational Intrusion And Stalking: The Role Of Social Support And Coping Strategies. Violence And Victims, 27(3), 414-433

Notoatmodjo, S. (2012). Metodologi Penelitian Kesehatan. Jakarta: Rineka Cipta

Notoatmodjo, S. (2007). Promosi Kesehatan dan Ilmu Perilaku. Jakarta : Rineka Cipta

Nursalam.(2013). Metodologi Penelitian Ilmu Keperawatan Edisi 3. Jakarta: Salemba Medika

Nursing Times. (2011). Are Newly Qualified Nurses Prepared For Practice?. American Nurse Association, 107(19/20), 20-23

Pan, F.F.C. (2014). Using Analytic Hierarchy Process To Identify The Nurses With High Stress-Coping Capability: Model And Application. Iranian J Publ Health, 43(3), 273-281

Potter, P.A., Perry, A.G. (2010). Fundamental Keperawatan, Edisi 7. Buku 2. Salemba Medika : Jakarta

Potter, P.A., Perry, A.G. (2010). Fundamental Keperawatan, Edisi 7. Buku 2. Salemba Medika : Jakarta

Prayascitta, P. (2010). Hubungan Antara Coping Stress Dan Dukungan Sosial Dengan Motivasi Belajar Remaja Yang Orangtuanya Bercerai

Rai, S., Singh, A. (2013). Stress And Coping Strategies Among Nursing Students. Indian Journal Of Positive Psychology, 4(2), 329-332

Rante, D.I (2013). Pemilihan Strategi Penyelesaian Masalah dalam Menghadapi Kelelahan Emosional pada Perawat Bagian Instalasi Gawat Darurat (IGD) Rumah Sakit Umum Daerah AW. Syahranie Samarinda ditinjau dari Jenis Kelamin. eJournal Psikologi, 1(2), 230-240

Robbins, G., Powers, D., Burgess, S. (2009). A Welness Way Of Life. Library Of Congress Cataloging-In-Publication Data : New York

Rosmawar. (2009). Identifikasi Stress Kerja dan Strategi Koping Perawat di Ruang Instalasi Gawat Darurat Rumah Sakit Kota Langsa.

Salilih, S.Z., Abajobir, A.A. (2014). Work-Related Stress And Associated Factors Among Nurses Working In Public Hospitals Of Addis Ababa, Ethiopia: A

Cross-Sectional Study. Health Sciences College, Debremarkos University, 62(8), 326-332

Shivaprasad, A.H. (2013). Work Related Stress of Nurse. Journal of Psychiatric Nursing, 2(2), 33-72

Singh, G.P. (2013). Job Stress Among Emergency Nursing Staff : A Preliminary Study. Indian J Psychiatry, 55(4), 407-408

Torres, P.R., Padilla, R.A.A., Simo, M.J.M. (2013). Job Stress Across Gender: The Importance Of Emotional And Intellectual Demands And Social Support In Women. Int. J. Environ. Res. Public Health, 10, 375-389

Urbanetto, J.S., Silva, P.C, Hoffmeister, E., Negri, B.S., Costa, B.E.P, Figueiredo, C.E.P. (2011). Workplace Stress In Nursing Workers From An Emergency Hospital: Job Stress Scale Analysis. Rev. Latino-Am. Enfermagem, 19(5):1122-1131

Wu, H., Ge, C.X., Sun, W., Wang, J.N., Wang, Lie. (2011). Depressive Symptoms And Occupational Stress Among Chinese Female Nurses: The Mediating Effects Of Social Support And Rational Coping. Nursing And Health, 34(5), 401-407

Yosep, I. (2010). Keperawatan Jiwa (Edisi Revisi). Bandung: Refika Aditama