Prevalensi resistan terhadap obat TB lini pertama rifampicin (RR-TB) di Dunia pada tahun 2017 sebesar 7,4 per 100.000 penduduk, dan dari angka tersebut 82% mengalami multidrug-resistant tuberculosis (MDR-TB). Indonesia termasuk 20 besar negara dengan MDR-TB terbanyak didunia, dengan prevalensi 8,8 per 100.000 penduduk. Pengobatan MDR-TB membutuhkan waktu yang lama, dan mempunyai efek samping secara biologis dan psikososial. Penelitian ini bertujuan mengetahui pengaruh tindakan keperawatan spesialis (ACT) terhadap ansietas, depresi, ide bunuh diri dan kepatuhan pada klien MDR-TB. Desain penelitian quasi eksperimental menggunakan pre-post test dengan total sampling dan dibagi menjadi 2 kelompok. Kelompok intervensi 1 dilakukan tindakan keperawatan ners (TKN) untuk diagnosa keperawatan ansietas, depresi, ketidakberdayaan, keputusasaan dan risiko bunuh diri, kelompok intervensi 2 dilakukan tindakan keperawatan ners dan keperawatan spesialis (ACT). Pengumpulan data menggunakan hammilton rating scale for anxiety (HAM-A), beck hopelesness scale (BHS), scale for suicide ideation (SSI), dan morisky medication adherence scale (MMAS). Hasil penelitian menunjukkan TKN menurunkan anisetas (p=0,008), TKS (ACT) menurunkan ansietas (p=0,006) dan TKS (ACT) menurunkan depresi (p=0,004), tidak ada perbedaan signifikan antara kelompok yang mendapatkan TKN dengankelompok yang mendapatkan TKN dan TKS (ACT), terdapat hubungan yang bermakna antara ansietas dan kepatuhan (p=0,006). Tindakan Keperawatan Ners (TKN) dan Tindakan Keperawatan Spesialis (ACT) direkomendasikan diterapkan pada klien MDRTB.

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Worldwide the prevalence of resistance to the first-line TB drug, rifampicin (RR-TB) in 2017 was 7,4 per 100.000 population, with 82% experienced multidrug-resistant tuberculosis (MDR-TB). Indonesia is the top 20 countries with MDR-TB burden, with a prevalence of 8.8 per 100,000 population. Multidrug resistant tuberculosis (MDR-TB) requires a long-time treatment, and has accompanying side effects both biological and psychosocial effects, but efforts to overcome the psychosocial impact have not been made. This study aims to determine the effect of specialist nursing actions (ACT) on anxiety, depression, suicidal ideas and adherence to MDR-TB clients. This research using quasi experimental design with total sampling and divided into 2 groups. Intervention group 1 gets general nursing action for nursing diagnosis anxiety, helplessness, hopelessness, and risk for suicide, intervention group 2 gets general nursing action and specialist nursing actions (ACT). Data collection uses hammilton rating scale for anxiety (HAM-A), Beck hopelesness scale (BHS), scale for suicide ideation (SSI), and morisky medication adherence scale (MMAS). The results showed that general nursing action reduced anxiety (p = 0,008), specialist nursing actions (ACT) reduced anxiety (p = 0,006) and specialist nursing actions (ACT) decreased depression (p = 0.004), there was no significant difference between both group, and there was a significant relationship between anxiety and adherence (p = 0,006). General nursing action and specialist nursing actions (ACT) are recommended to be applied to MDR-TB clients.