Electronic Theses and Dissertation

Pendekatan biopsikososial diperlukan untuk memahami hubungan antara faktor biologis, psikologis, dan sosial terhadap keparahan neuropati diabetik serta dampaknya terhadap gangguan psikologis. Penelitian ini bertujuan menganalisis pengaruh faktor biopsikososial dengan keparahan neuropati diabetik serta pengaruh keparahan neuropati diabetik dengan depresi dan ansietas pada pasien diabetes mellitus (DM) tipe 2. Penelitian ini menggunakan desain potong lintang dengan melibatkan 102 pasien DM tipe 2 yang menjalani perawatan di Rumah Sakit Umum dr. Zainoel Abidin Banda Aceh. Faktor biopsikososial dinilai melalui karakteristik biologis, psikologis, dan sosial. Keparahan neuropati diabetik diukur menggunakan Total Neuropathy Score (TNS), sedangkan tingkat depresi dan ansietas dinilai menggunakan Patient Health Questionnaire-9 (PHQ-9) dan Generalized Anxiety Disorder scale-7 (GAD-7). Analisis regresi menunjukkan bahwa durasi DM (B=0,986; p=0,008) dan indeks massa tubuh (IMT) (B=1,823; p=0,004) berpengaruh signifikan terhadap peningkatan keparahan neuropati diabetik. Keparahan neuropati diabetik berhubungan signifikan dengan depresi (B=0,230; p=0,013), namun tidak dengan ansietas (B=0,129; p=0,141). Tidak ditemukan pengaruh langsung faktor biopsikososial terhadap depresi (seluruh p>0,05), yang menunjukkan bahwa pengaruh durasi DM dan IMT terhadap depresi terjadi melalui keparahan neuropati diabetik sebagai mediator. Sebaliknya, tingkat pendidikan menunjukkan pengaruh signifikan terhadap ansietas dengan arah protektif (B=−0,651; p=0,018), tanpa melalui peran mediasi neuropati diabetik. Kesimpulan menunjukkan bahwa depresi pada pasien DM lebih dipengaruhi secara tidak langsung oleh faktor biologis melalui keparahan neuropati diabetik, sedangkan ansietas lebih dipengaruhi secara langsung oleh faktor sosial, khususnya tingkat pendidikan.

Kata kunci: neuropati diabetik, depresi, ansietas, faktor biopsikososial, diabetes mellitus tipe 2.

A biopsychosocial approach is required to understand the relationship between biological, psychological, and social factors and the severity of diabetic neuropathy, as well as its impact on psychological disorders. This study aimed to analyze the association between biopsychosocial factors and the severity of diabetic neuropathy, and to examine the relationship between diabetic neuropathy severity and depression and anxiety in patients with type 2 diabetes mellitus. A cross-sectional design was applied, involving 102 patients with type 2 diabetes mellitus receiving care at dr. Zainoel Abidin General Hospital, Banda Aceh. Biopsychosocial factors were assessed through biological, psychological, and social characteristics. Diabetic neuropathy severity was measured using the Total Neuropathy Score (TNS), while depression and anxiety levels were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Regression analysis demonstrated that diabetes mellitus (DM) duration (B=0.986; p=0.008) and body mass index (BMI) (B=1.823; p=0.004) were significantly associated with increased severity of diabetic neuropathy. The severity of diabetic neuropathy was significantly associated with depression (B=0.230; p=0.013), but not with anxiety (B=0.129; p=0.141). No direct effects of biopsychosocial factors on depression were observed (all p>0.05), indicating that the effects of DM duration and BMI on depression were mediated through the severity of diabetic neuropathy. In contrast, educational level showed a significant protective effect on anxiety (B=−0.651; p=0.018), independent of diabetic neuropathy as a mediating variable. These findings suggest that depression in patients with DM is predominantly influenced indirectly by biological factors through the severity of diabetic neuropathy, whereas anxiety is more directly influenced by social factors, particularly educational level. Keywords: diabetic neuropathy, depression, anxiety, biopsychosocial factors, type 2 diabetes mellitus.