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KUESIONER 

FAKTOR-FAKTOR PENYEBAB GANGGUAN TIDUR PADA LANJUT USIA

DI UNIT PELAYANAN TERPADU

Tujuan Kuesioner:

1 Kuesioner ini !er"ujuan un"u# $en%e"a&ui 'a#"or-'a#"or %an%%uan "i(ur )a(a

*anju" usia +an% a(a (i UPT Pe*a+anan Sosia* Tuna Run%u ,iara (an Lanju"

Usia (i Ja*an Sisin%a$an%araja Pe$a"an%sian"ar. Pene*i"i $en%&ara)#an #erjasa$a res)on(en un"u# $enja/a! )er"an+aan

(en%an sejujur-jujurn+a $en(a)a"#an &asi* +an% !ai# (an se!enarn+a

Pe"unju#:

1 Pi*i&*a& sa*a& sa"u ja/a!an +an% "erse(ia (en%an $e$!eri#an "an(a 02 )a(a

#o*o$ +an% an(a rasa !enar. Ji#a in%in $e$)er!ai#i ja/a!an3 ore"*a& +an% sa*a& (en%an $e$!eri#an4 "an(a 0523 #e$u(ian !eri "an(a 02 )a(a ja/a!an an(a +an% !enar6 Se"ia) ja/a!an (ija$in #era&asiaann+a

Fa#"or No Per"an+aan Dia*a$iGan%%uan Ti(ur 

Ya012

Ti(a# 072

Fisio*o%is 1 Sa+a serin% su*i" "i(ur )a(a $a*a$ &ari#arena #a#i sa+a n+eri

86

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89

. Sa+a serin% !an%un "er*a*u e)a" (i )a%i &ari

#arena n+eri )a(a *a$!un%4 Pa(a $a*a$ &ari sa+a serin% "er!an%un#arena #ra$ a"au #e!as )a(a #a#i

6 Sa+a serin% "er!an%un )a(a $a*a$ &ari#arena su*i" !erna)as

9 Sa+a serin% "er!an%un )a(a $a*a$ &ari#arena rasa %a"a* (i !a(an

8 N+eri (a(a $e$!ua" sa+a serin% "er!an%un )a(a $a*a$ &ari

Sa+a serin% "er!an%un )a(a $a*a$ &ari

#arena &arus !uan% air #ei* 0BAK2; Ba"u# $e$!ua" sa+a serin% "er!an%un )a(a$a*a$ &ari

Psi#o*o%is < Sa+a $erasa #ese)ian (an i"u $e$!ua" sa+a

su*i" un"u# $e$u*ai "i(ur (i $a*a$ &ari17 =u!un%an #e#era!a"an (en%an #e*uar%a +an%

ren%%an% serin% $e$!ua" sa+a su*i" "i(ur

 )a(a $a*a$ &ari11 Ke"i#a $e$i*i#i $asa*a& sa+a serin% su*i"

un"u# $e$u*ai "i(ur1. Ke"i#a $e$i*i#i $asa*a& sa+a serin%

"er!an%un )a(a $a*a$ &ari14 Sa+a su*i" un"u# $e$u*ai "i(ur #arena serin%

$e$i#ir#an )asan%an &i(u) sa+a +an% "e*a&

"ia(a

Fa#"or No Gan%%uan Ti(ur Ya

012

Ti(a# 

072O!a"-

o!a"an

16 Sa+a $en(eri"a sa#i" (an &arus

$en%#onsu$si o!a" (ari (o#"er19 O!a" +an% sa+a $a#an $e$!ua" sa+a serin%

 !uan% air #ei* )a(a $a*a$ &ari18 O!a" +an% sa+a $a#an serin% $en+e!a!#an

$i$)i !uru# se&in%%a "er!a%un )a(a $a*a$

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88

&ari

1 O!a" +an% sa+a $a#an serin% $en+e!a!#an#an"u# !era" )a(a sian% &ari

1; Sa+a "i(a# sa#i"3 "e"a)i sa+a $e$inu$ o!a"

a%ar (a)a" "i(ur 0o!a" "i(ur2Ga+a &i(u) 1< Sa+a a(a*a& seoran% )ero#o# >ero#o#

se!e*u$ "i(ur $e$!ua" sa+a susa& "i(ur.7 Sa+a $inu$ "e& a"au #o)i se!e*u$ "i(ur3 i"u

$e$!ua" sa+a susa& "i(ur (i $a*a$ &ari.1 Sa+a $inu$ "e& a"au #o)i se!e*u$ "i(ur3 i"u

$e$!ua" sa+a serin% "er!an%un $a*a$ &ari.. A#"i?i"as (i sian% &ari serin% $e$!ua" sa+a

susa& "i(ur (i$a*a$ &ari.4 Sa+a serin% "i(a# (a)a" $e$u*ai "i(ur #arena

$erasa *a)ar.6 Ke#en+an%an serin% $e$!ua" sa+a susa&

un"u# $e$u*ai "i(ur )a(a $a*a$ &ari

Fa#"or No Gan%%uan Ti(ur Ya

012

Ti(a# 

072Lin%#un%a

n

.9 Sa+a serin% "i(a# (a)a" $e$u*ai "i(ur #arena

suara !isin% (ari *uar a"au (a*a$ #a$ar

.8 Sa+a serin% su*i" $e$u*ai "i(ur ji#a su&uruan%an )anas

. Sa+a serin% "i(a# (a)a" $e$u*ai "i(ur #arena

su&u ruan%an +an% (in%in.; Te$)a" "i(ur +an% #ei* $e$!ua" sa+a serin%

"er!an%un )a(a $a*a$ &ari.< Ruan%an +an% )en%a) serin% $e$!ua" sa+a

susa& "i(ur

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47 Se)rai +an% #o"or serin% $e$!ua" sa+a susa&

"i(ur41 N+a$u# serin% $e$!ua" sa+a serin%

"er!an%un (i $a*a$ &ari4. Sa+a serin% "i(a# (a)a" "i(ur #arena ruan%an

"eran%