B. Discussion
3. Result
Traditional medical systems are in fact still alive, not obliterated by the practice of biomedical medicine which is increasingly developing. This fact shows that health
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care and services are complex socio-cultural phenomena. Efforts to cure the disease by patients' families are not only done in health centers, hospitals, general practitioners and specialists, but can also be done traditionally (Kasniyah, 1985:
71). Connor added that for most Balinese people or people have a tendency to utilize the modern health service system when sick. However, it is undeniable that relatively many people also come to traditional medical practitioners (prametra) in a case of a particular disease or health problems that cannot be overcome through the modern health service system (Connor, 1982: 3). Agreeing with Connor, Nala stated that in the life of the Balinese people generally to find solutions to health problems and efforts in the health care system (health care system), the traditional treatment system is still a very important choice besides modern medicine (Nala, 1997: 6 --10). Decision making in choosing a source of treatment is used as a guide in public health behavior. It is known that traditional treatment behaviors (which are used as treatment options by families of sufferers) are divided into two health care options, namely household remedies and folk care options. Both of these treatment systems in the implementation of treatment or care for the sick meet the indicators of the implementation of traditional treatments / treatments. The indicators referred to include healing by massaging or massaging limbs, concocting various special ingredients, medicines made from plants, the use of spells and amulets, as well as various obstacles / taboos. Forms of implementation of treatment or care in the traditional care behavior system is certainly not found in the modern / professional (medical) health care behavior system.
In the Balinese who are Hindus, seek treatment at Battra (traditional medicine known as Balian, Tapakan or Jero Dasaran, still a choice that cannot be ruled out for granted. Convincing is not only a biological phenomenon, but has another dimension which is social and cultural That is why it is not enough to cure a disease just to look at its biological problems, but it must also be tackled with socio-cultural problems. Often to seek treatment from doctors or health centers, in fact more treatment is addressed to biological problems, and forget or not have time to deal with social problems Moreover, if they are hospitalized, they will be reluctant because of this socio-cultural problem Doctors and nurses, even though Balinese, are considered foreigners, due to the way of thinking, acting, working are different from the habits of the Balinese people in general. nurses think, talk as well as be the act of using a foreign culture, which focuses more on rational and scientific problems, is difficult to talk about irrational and traditional problems. That is why there are some people who are less satisfied with modern medical services, they will feel more satisfied to go to Battra, a traditional healer. In traditional healers, social and cultural issues are handled well and satisfactorily.
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In Bali, according to Hindu religious beliefs, illness occurs when there is no balance of 3 elements, namely aluana buana, great buana and Sanghyang Widhi Wasa as scales or noetic factors that can cause disturbance in humans (Suryani, 2000). So according to these beliefs and beliefs that disease can be caused by two causes / causes, namely causa scale (natural, natural) and causal niskala (supernatural, personalistic). Causes are a natural cause of pain that is visible, tangible, tangible, such as temperature changes / colds, physical impact / injury due to knives, broken bones due to fall. While noetic causes are subtle forms, such as spirits, ghosts and black magical powers are causes of pain that are not visible, unreal and without a definite form. Both of these elements enter the body or remain outside the body and cause imbalance of the alit where Tri's existence -dosha consisting of Vayu, Pita, Kapha or in the form of air, heat, liquid. In the western world the term for this disease is known as disease and illness. Disease as a disease includes a concept of pathology which is limited to medical and organobiological disorders while illness is a cultural concept that is a problem or disorder experienced that interferes with daily life. day. It is this belief that causes the sufferer or family to visit the dukun or balian for guidance or treatment. Likewise, after the patient is discharged from the hospital, most sufferers go to the doctor and balian and some go to balian only or to the doctor alone. And if they relapse then most of them come to balian. which is declared balian (Putro, 2004).
ODGJ actually creates a heavy burden on families and people close to patients.
Management that involves the family early in the treatment process can reduce relapse and reduce stress and disorder in the family (Power, 2015). Patients who in their care almost always need medication usually do not succeed optimally if they do not get service and support to overcome the disease in the face of fear, isolation and humiliation that often accompanies it. The bio-psycho-socio-cultural approach is the assumption that schizophrenic mental disorders are caused by three factors above one with the other interconnected. From the biological point of view Schizophrenia is a brain disease, psychologically influenced by personality and in terms of sociocultural influence influenced by culture, environment and family sufferers (Schulze & Rosler, 2005).
Until now, mental disorders are still considered an embarrassing disease, a disgrace for the sufferer and his family. Families tend to try to cover up if there are family members who suffer from mental disorders. The stigma created by the community towards people with mental disorders also indirectly causes families of people with mental disorders to be reluctant to provide fast and appropriate treatment. Stigma that occurs can not be separated from the background of myths circulating in the community about mental disorders. First, there is an assumption that people with mental disorders only occur in people who are weak soul; Second, the assumption
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that people with mental disorders are attached to their lives with criminal behavior;
Third, the assumption that people with mental disorders must be ostracized and exiled in social life; Fourth, the assumption that mental disorders cannot be cured;
Fifth, the assumption that people with mental disorders must be due to poor parental care.
On that basis, the alternative to seeking mental health treatment services is inseparable from the beliefs of ODGJ families. As Kleinman (1985: 65) states that the belief in deciding to choose health services can be influenced by various factors, including: 1) etiology and condition, 2) the time and type of symptoms that attack, 3) the treatment process, 4) the severity disease, and 5) appropriate treatment for the condition.
These factors are an important element of a decision in the selection of the health care sectors to be used. Said to be important because it is a concept or cognitive maps that are always referenced and used by individuals (community members or medical practitioners) to explain the causality of illness, diagnosis, and treatment.
On this basis also individuals in the community classify the types of diseases that can or should be treated by doctors or hospitals and the types of diseases that must be brought to the dukun (traditional healers) who know and are able to treat it. The explanation given is partly on consciousness and partly outside consciousness. The characteristics of the model explain the point of view of these individuals