LAPORAN SKRINING KESEHATAN JIWA ANAK SEKO

Strenghts and Difficults Questionnaire (SDQ)

Nama Puskesmas : Puskesmas Pagarsih

Nama Sekolah : MA PERSIS
Tanggal Pemeriksaan : 23 DAN 24 September 2019
DETEKSI DINI KESEHATAN JIWA ANA
JK
NO Nama Murid Usia SKOR
(L/P) Total Nilai
Pr H E C P Kesulitan Pr
1 2 3 4 5 6 7 8 9 10 11
Group a
1 al-daffa 17 L 6 3 5 1 4 13 NORMAL
2 dwiky nugraha 16 L 8 2 5 5 3 15 NORMAL
3 qorin karensi 16 P 9 6 7 3 1 17 NORMAL
4 Hilmi Dewani Fauziyah 16 P 8 6 3 1 5 15 NORMAL
6 Haya Syahla Arrumaisya 16 P 8 7 0 3 4 14 NORMAL
7 Nabilah Huwaidah 15 P 7 6 6 1 3 16 NORMAL
8 Najwa Raudhah Anshory 14 P 9 6 7 3 1 17 NORMAL
9 Dzhini Azka Sabila 15 P 7 4 0 2 3 9 NORMAL
10 Asti Angraeni 15 P 7 4 3 3 2 12 NORMAL
11 Anni Andriyani Fauziyah 16 P 9 5 7 3 1 16 NORMAL
12 raden Hani Al-Rajab 17 P 10 5 4 3 3 15 NORMAL
13 Reni Nuraeni 17 p 5 3 5 2 3 13 BORDERLINE
14 Idzni Azmiatunni'mah 16 P 5 7 5 4 5 21 BORDERLINE
15 Cut Tasya Nuraini 17 P 8 5 6 5 10 26 NORMAL
16 Zahra Alida Hanifiyah 16 P 9 4 8 7 6 25 NORMAL
17 Poeja Fadhilah 15 P 8 8 9 4 3 24 NORMAL
18 Amanda Moza Malika 15 P 5 1 1 2 0 4 BORDERLINE
19 zian Haura Rahmani 15 P 9 3 0 1 1 5 NORMAL
20 Destiya azzahra 16 P 7 4 0 3 3 10 NORMAL
21 Haifa Nur Auliya 16 P 10 1 3 1 5 10 NORMAL
22 Haya Kaustar 17 P 9 6 7 3 1 17 NORMAL
23 Yuke Kamilatun Nuha 15 P 10 4 4 3 5 16 NORMAL
24 Alya Kintara Maharani 16 P 9 2 4 3 3 12 NORMAL
25 Annisa Salsabila Yusup 15 P 9 7 7 1 3 18 NORMAL
26 widi Fachrunnisa 17 P 9 3 5 4 3 15 NORMAL
27 Najla Naila Putria A. 15 P 6 4 6 3 8 21 NORMAL
28 Yasmin Akhdinie 16 P 10 4 7 1 3 15 NORMAL
29 Adinda Mila Ardiana 16 P 7 5 2 2 2 11 NORMAL
30 Andini Widya Pangestika 16 P 9 6 7 6 1 20 NORMAL
31 Khalid Ghifari Kukuh Putra 16 L 10 4 7 3 7 21 NORMAL
32 Yassar Malik Arrasyid 16 L 9 6 7 3 1 17 NORMAL
33 Rizki Pratama Putra 16 L 8 8 9 4 5 26 NORMAL
34 Nafis Fajar Ramadhan 17 L 7 4 5 1 3 13 NORMAL
35 Deni Muhammad Rizal 16 L 6 7 6 1 5 19 NORMAL
36 Muhammad Fahreizy F. 16 L 9 3 4 2 2 11 NORMAL
37 Yumna Abdussalam Sadikin 16 L 8 3 5 1 6 15 NORMAL
38 Kikis Addilakiyans 17 L 8 5 5 3 4 17 NORMAL
39 Annur Rohmat 15 L 8 2 4 1 4 11 NORMAL
40 Jihad Fi Sobri 17 L 4 5 9 3 2 19 ABNORMAL
41 Huzaini Ramadhan 16 L 9 6 7 3 1 17 NORMAL
42 Sehabudin 16 L 5 1 2 0 5 8 BORDERLINE
43 Muhammad Ghiyats 16 L 8 7 4 0 1 12 NORMAL
44 farhan jamaludin hakim 16 L 7 2 6 2 5 15 NORMAL
45 Rijal Dzikri Awaula 17 L 9 5 4 2 2 13 NORMAL
46 Royyan L 15 L 10 2 6 1 1 10 NORMAL
47 Raihan Haikal F. A 15 L 8 3 5 4 3 15 NORMAL
48 Ruslan Ramdhan 16 L 9 3 3 1 4 11 NORMAL
49 rizky robbani 15 L 8 7 9 4 4 24 NORMAL
50 Muhammad Hanif Rahman 16 L 5 1 7 3 3 14 BORDERLINE
51 Alif Yusuf S 16 L 7 5 3 4 2 14 NORMAL
52 Jidan Abdurahman Aufan 15 L 9 4 5 2 2 13 NORMAL
53 Dyaaz Muhammad Fathier 15 L 9 6 7 3 1 17 NORMAL
54 Rizal Ihza Muhaimin 15 L 10 5 1 0 2 8 NORMAL
55 Richard Thariq Hussain 16 L 10 2 5 3 5 15 NORMAL
56 Jasmine Shiffany 16 P 8 6 6 1 2 15 NORMAL
57 Tazka Wihdatu Rahma 16 P 5 6 5 2 2 15 BORDERLINE
58 zidinannur Mahda Lana 15 P 8 6 6 1 2 15 NORMAL
59 Nadea Nisa Syifalani 17 P 10 3 4 1 2 10 NORMAL
Group B
1 Sevana Jauharunnisa 17 P 10 5 4 2 2 13 NORMAL
2 Azhar Fikriyah 16 L 10 1 3 2 1 7 NORMAL
3 Nisrina Arefa 15 P 8 8 7 4 3 22 NORMAL
4 Najma Khaira 16 P 9 6 9 3 5 23 NORMAL
5 Salsabila Dea N 16 P 8 7 8 1 3 19 NORMAL
6 Amelia Nurlestari 17 P 9 1 3 3 1 8 NORMAL
7 Maura Eariyana Pratiwi 16 P 8 4 5 4 5 18 NORMAL
8 Azmi Rahmi Rauziah 16 P 10 1 3 2 3 9 NORMAL
9 Shabrina Salsabila 15 P 10 5 9 2 3 19 NORMAL
10 reyza Cndrawati Shada 15 P 8 2 1 1 2 6 NORMAL
11 Adinda Naima M 16 P 8 2 2 1 2 7 NORMAL
12 Fauziah Rahmah 16 P 7 7 10 2 1 20 NORMAL
13 Felda Putri Pebriani 15 P 9 7 7 6 4 24 NORMAL
14 Nazwa Airfa Abdurahman 15 P 8 7 8 4 3 22 NORMAL
15 Faja Miftahul J 17 P 8 2 1 1 2 6 NORMAL
16 Reva Afrila Herawayi 15 P 8 4 3 4 2 13 NORMAL
17 Alifa Mustikaning Qolby 16 P 7 4 5 6 1 16 NORMAL
18 Nurul Abdulah 17 P 8 6 4 2 2 14 NORMAL
19 Nabila Julianti Rahman 16 P 7 4 5 6 1 16 NORMAL
20 Resvy Sahidah Umaroh 17 P 8 6 5 5 3 19 NORMAL
21 Silmi kaffah Atqiya 15 P 8 3 6 2 2 13 NORMAL
22 Rizaiana izza tunnisa 15 P 8 1 4 4 2 11 NORMAL
23 intan frima rachim 16 P 9 4 6 3 5 18 NORMAL
24 Muhammad Rais 17 L 8 1 4 4 2 11 NORMAL
25 izma saiman fadlel m isa 16 L 8 5 4 2 2 13 NORMAL
26 Theresia Michelle 16 P 10 7 6 6 6 25 NORMAL
27 Saskia Febrianti 16 P 10 4 5 2 1 12 NORMAL
28 Haula Rahma 15 P 8 7 10 4 6 27 NORMAL
26 Savira Hamira 15 P 9 7 10 2 2 21 NORMAL
27 seli aulia yulianti 15 P 10 3 3 2 1 9 NORMAL
28 sheila sabilatul 15 P 10 6 4 1 1 12 NORMAL
29 salsabila gita salwa malihah 15 P 10 4 2 2 1 9 NORMAL
30 shalsabila putri 17 P 8 8 8 5 4 25 NORMAL
31 siti arofatul m 15 P 10 4 6 4 2 16 NORMAL
32 salimah 15 P 8 6 8 6 4 24 NORMAL
33 nuri puzizakiah 16 P 5 6 9 3 3 21 BORDERLINE
34 naavilah az-zahra 16 P 8 3 5 2 4 14 NORMAL
35 nada fatharani 15 P 10 5 9 3 1 18 NORMAL
36 khoirinah nur ajijah 16 P 10 8 8 5 4 25 NORMAL
37 firda fitria 17 P 9 4 6 4 2 16 NORMAL
38 denisa S. A 15 P 10 6 8 6 4 24 NORMAL
39 dwi sabrina itsar 16 P 9 6 9 3 3 21 NORMAL
40 elsa nur hafifah 17 P 6 3 5 2 4 14 NORMAL
41 alifah intan n 15 P 8 5 9 3 1 18 NORMAL
42 andina zanatul 16 P 9 4 8 3 4 19 NORMAL
43 kamilia nabila 16 P 7 4 4 2 2 12 NORMAL
44 isnaina fathira 16 P 9 7 7 2 3 19 NORMAL
45 riva anggara setiawan 16 L 10 6 4 4 2 16 NORMAL
46 M. Ikhsan ridho 15 L 9 3 5 2 5 15 NORMAL
47 indra ardian 16 L 8 8 4 2 2 16 NORMAL
48 sadam husein 16 L 10 4 6 4 3 17 NORMAL
49 muhammad rafie 17 L 9 3 5 2 5 15 NORMAL
50 muhammad fauzi al aziz 15 L 10 7 6 2 2 17 NORMAL
51 Muhammad Affan rahman 15 L 9 6 6 1 4 17 NORMAL
52 M. Alawi Hanafi 16 L 10 7 7 2 1 17 NORMAL
53 ilham Al-mardiansyah 16 L 9 3 5 2 5 15 NORMAL
54 Fiqri Naufal Herdian 16 L 10 7 6 2 2 17 NORMAL
55 Muhammad Thoriq Ramadhan 16 L 10 6 6 1 4 17 NORMAL
56 Raja Muhammad Akmal 15 L 10 7 7 2 1 17 NORMAL
57 Fauzan Fedriansyah Sudrajat 15 L 10 5 1 0 2 8 NORMAL
58 erick zachary 15 L 10 2 5 3 5 15 NORMAL
59 fauzan M Ismail 16 L 8 2 1 1 2 6 NORMAL
60 Bintang M. Rafi 15 L 8 2 2 1 2 7 NORMAL
61 alief fauay rizky rabbani 15 L 8 7 0 3 4 14 NORMAL
62 breymena 16 L 7 6 6 1 3 16 NORMAL
63 Arhen azra al biruni 16 L 9 6 7 3 1 17 NORMAL
64 Muhammad ridwan 17 L 7 4 0 2 3 9 NORMAL
65 fathul umam 16 L 7 4 3 3 2 12 NORMAL
66 abduah 17 L 9 5 7 3 1 16 NORMAL
67 rizal anugrah 15 L 10 5 4 3 3 15 NORMAL
68 muhammad hasbi qodarurrahman 16 L 5 3 5 2 3 13 BORDERLINE
69 aleh hidayat 17 L 5 7 5 4 5 21 BORDERLINE
70 nur m al ghifari 18 L 8 5 6 5 10 26 NORMAL
71 hamdhan raihan 17 L 9 4 8 7 6 25 NORMAL

Mengetahui,
Kepala UPT Puskesmas Pagarsih

dr.Trisiana Irawati
NIP. 19740303 200212 2 004
ATAN JIWA ANAK SEKOLAH
s Questionnaire (SDQ)

NI KESEHATAN JIWA ANAK SEKOLAH Tindak Lanjut

Interpretasi
Tidak Ada Konsultasi Rujuk
H E C P Guru
12 13 14 15 16 17 18

NORMAL NORMAL NORMAL BORDERLINE √

NORMAL NORMAL ABNORMAL NORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
BORDERLINE NORMAL NORMAL BORDERLINE √
ABNORMAL NORMAL NORMAL BORDERLINE √
BORDERLINE BORDERLINE NORMAL NORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL NORMAL BORDERLINE BORDERLINE √
NORMAL BORDERLINE ABNORMAL ABNORMAL √
NORMAL ABNORMAL ABNORMAL ABNORMAL √
ABNORMAL ABNORMAL BORDERLINE NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL BORDERLINE NORMAL ABNORMAL √
NORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
BORDERLINE ABNORMAL ABNORMAL NORMAL √
NORMAL ABNORMAL NORMAL ABNORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL BORDERLINE BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL BORDERLINE NORMAL BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL ABNORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL ABNORMAL NORMAL NORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
ABNORMAL NORMAL NORMAL NORMAL √
NORMAL BORDERLINE NORMAL BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
NORMAL BORDERLINE NORMAL NORMAL √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
ABNORMAL ABNORMAL BORDERLINE BORDERLINE √
NORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL NORMAL NORMAL NORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
BORDERLINE BORDERLINE NORMAL NORMAL √
BORDERLINE NORMAL NORMAL NORMAL √
BORDERLINE BORDERLINE NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √

NORMAL NORMAL NORMAL NORMAL √

NORMAL NORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL BORDERLINE NORMAL √
BORDERLINE ABNORMAL NORMAL BORDERLINE √
ABNORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL BORDERLINE BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
NORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL ABNORMAL BORDERLINE √
ABNORMAL ABNORMAL BORDERLINE NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL NORMAL ABNORMAL NORMAL √
BORDERLINE NORMAL NORMAL NORMAL √
NORMAL NORMAL ABNORMAL NORMAL √
BORDERLINE NORMAL ABNORMAL NORMAL √
NORMAL BORDERLINE NORMAL NORMAL √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL BORDERLINE NORMAL BORDERLINE √
NORMAL NORMAL BORDERLINE NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL BORDERLINE ABNORMAL ABNORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL BORDERLINE ABNORMAL √
ABNORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
BORDERLINE NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL ABNORMAL BORDERLINE √
NORMAL BORDERLINE BORDERLINE NORMAL √
BORDERLINE ABNORMAL ABNORMAL BORDERLINE √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL ABNORMAL NORMAL NORMAL √
ABNORMAL ABNORMAL ABNORMAL BORDERLINE √
NORMAL BORDERLINE BORDERLINE NORMAL √
BORDERLINE ABNORMAL ABNORMAL BORDERLINE √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL ABNORMAL NORMAL NORMAL v
NORMAL ABNORMAL NORMAL BORDERLINE v
NORMAL NORMAL NORMAL NORMAL v
ABNORMAL ABNORMAL NORMAL NORMAL v
BORDERLINE NORMAL BORDERLINE NORMAL v
NORMAL NORMAL NORMAL BORDERLINE v
ABNORMAL NORMAL NORMAL NORMAL v
NORMAL BORDERLINE BORDERLINE NORMAL v
NORMAL NORMAL NORMAL BORDERLINE v
ABNORMAL BORDERLINE NORMAL NORMAL v
BORDERLINE BORDERLINE NORMAL BORDERLINE v
ABNORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
ABNORMAL BORDERLINE NORMAL NORMAL √
BORDERLINE BORDERLINE NORMAL BORDERLINE √
ABNORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL BORDERLINE √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL NORMAL NORMAL BORDERLINE √
BORDERLINE BORDERLINE NORMAL NORMAL √
BORDERLINE ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL ABNORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
NORMAL NORMAL NORMAL NORMAL √
ABNORMAL NORMAL BORDERLINE BORDERLINE √
NORMAL BORDERLINE ABNORMAL ABNORMAL √
NORMAL ABNORMAL ABNORMAL ABNORMAL √

Pengelola Program Kesehatan Jiwa

Fisyal Hidatulloh.,S.Kep,Ners
NIPK. 2017.05.03.074