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"Tujuan: Klien yang dirawat di rumah sakit jiwa di Indonesia mempunyai rerata lama hari rawat yang tinggi yatu 54 hari, dan yang paling lama dirawat adalah klien dengan diagnosa skizofrenia. Data rumah sakit jiwa pusat Bogor 2001, menunjukkan rerata lama hari rawat adalah 115 hari dan untuk klien perilaku kekerasan 42 hari. Penelitian ini bertujuan mengurangi lama hari rawat klien skizofrenia dengan perilaku kekerasan dengan meningkatkan kemampuan klien mencegah perilaku kekerasan. Metoda: Metoda penelitian yang digunakan adalah kuasi eksperimen dengan disain multipel seri ganda. Penelitian dilakukan di RSJP Bogor, dengan 152 responden (75 orang kelompok intervensi dan 77 orang kelompok non intervensi). Pendidikan diberikan kepada kelompok intervensi tentang cara mencegah perilaku kekerasan. Hasil: Dari hasil penelitian ditemukan bahwa rerata lama hari rawat klien kelompok intervensi adalah 23 hari dan kelompok non intervensi 40 hari. Klien kelompok intervensi yang mempunyai kemampuan mandiri 86,6% dan kemampuan dengan bantuan 13,4% dalam mencegah perilaku kekerasan. Klien kelompok non intervensi semuanya tidak mempunyai kemampuan mengendalikan perilaku kekerasan. Klien dengan kemampuan mandiri dalam mencegah perilaku kekerasan mempunyai lama hari rawat yang lebih pendek secara bermakna dibandingkan dengan klien yang tidak mempunyai kemampuan (p-value 0.025). Kesimpulan: Disimpulkan, pendidikan kesehatan tentang cara mencegah perilaku kekerasan dapat meningkatkan kemampuan klien dan selanjutnya memperpendek lama hari rawat secara bermakna.

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AbstractAim: In average, the length of hospital stay in mental hospitals in Indonesia is 54 days, the longest of which occur on schizophrenic clients. In Bogor Mental Hospital, the average length of stay is 115 days. Those with schizophrenic and violence behavior have 42 days length of stay. The purpose of this study was to reduce length of stay for schizophrenic clients by enhancing their abilities to control violence behavior. Methods: This is a quasi experimental study with multiple series design. Study was conducted in Bogor Mental Hospital with 152 respondents (75 intervention and 77 non intervention). Training was given to the intervention group about the ways how to control violence behavior. Results: The results of this study showed that the average length of stay in the hospital for the clients in intervention group was 23 days and non intervention group was 40 days. There were 86.6% of clients in intervention group that independently (without assistance) could control their behavior, whereas 13.4 % still need assistant. All clients in non intervention group had no abilities to control their violence behavior. Clients who were independent in controlling violence behavior had significantly shorter length of stay compared to non independent clients (p < 0.05). Conclusion: Hence, the training control violence behavior can increase the abilities of the clients in controlling their violence behavior and resulting in shorter length of stay in hospital. "

"Insight buruk dimiliki 80% klien skizofrenia dan efikasi dirinya rendah. Insight buruk menurunkan efikasi diri. Penelitian bertujuan mengetahui pengaruh Terapi Penerimaan dan Komitmen (TPK) dan Program Edukasi Pasien (PEP) terhadap insight dan efikasi diri klien skizofrenia di RSJ Prof. Dr. Soeroyo Magelang. Desain quasi experimental pre-post test with control group. Sampel 147 diambil dengan teknik simple random sampling. Analisis data dengan Kruskall Wallis Test dan Regresi Linear Ganda. Hasil: Insight dan efikasi diri klien skizofrenia yang mendapatkan TPK-PEP meningkat secara bermakna dan lebih tinggi secara bermakna dari klien yang mendapatkan TPK. TPK-PEP meningkatkan insight sebesar 8,741 poin dan efikasi diri 11,522 poin. TPK-PEP direkomendasikan sebagai terapi keperawatan utama dalam merawat klien skizofrenia dengan insight buruk dan efikasi diri rendah.

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Impaired insight and low self-efficacy are common in schizophrenic clients. Bad insight exacerbates self stigma and lowers self-efficacy. This study aimed to determine effect of ACT-PEP on insight and self-efficacy of schizophrenic clients at Prof. Dr. Soeroyo Magelang Hospital. This was a quasiexperimental research, using pre-post test with control group. A number of 147 samples were recruited using simple random sampling technique, divided into 3 groups of ACT-PEP, ACT only and control. Data were analyzed using Kruskall Wallis Test and Linear Regression. Result: insight and self-efficacy of schizophrenia clients who get ACT-PEP was significantly increased and significantly higher than the clients were getting ACT. ACT-PEP increased insight by 8.741 points and increased self-efficacy by 11.522 points. ACT-PEP is recommended as primary therapy in nursing care for clients schizophrenia with poor insight and low self-efficacy."

"ABSTRAKPenelitian ini membahas hubungan antara beban pramurawat pasien skizofrenia dan ekspresi emosi yang muncul pada mereka serta faktor-faktor yang mempengaruhi munculnya beban perawatan dan ekspresi emosi. Penelitian ini berbentuk studi potong lintang dengan jumlah subyek sebanyak 118, yang merupakan pramurawat pasien skizofrenia yang menjalani rawat jalan di RS Jiwa Islam Klender pada bulan Oktober 2012 – November 2012. Seluruh subyek penelitian diminta untuk mengisi lembar keusioner, instrument BAS untuk mengukur beban perawatan dan instrument FQ untuk mengukur ekspresi emosi, kemudian dilakukan analisis terhadap data yang sudah terkumpul. Hasil penelitian didapatkan sebanyak 67,8% merasakan adanya beban perawatan, 49,2% memiliki ekspresi emosi tinggi dan 50,8% memiliki emosi rendah. Beban perawatan memiliki hubungan yang bermakna terhadap ekspresi emosi (OR 5,093; CI 95% 2,128 -12,190; p=0,000). Ditemukan adanya faktor perancu terhadap penilaian beban perawatan dan ekspresi emosi.

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ABSTRACTThis study examine the relation between schizophrenia patient's caregiver's burden and expression emotion that appear on them and the factors that affect the appearance of the burden and emotional expression. This research is a cross- sectional study with a number of subjects as many as 118 caregiver of schizophrenia patient who underwent outpatient at Klender Islamic Mental Hospital in October 2012 - November 2012. The entire study subjects were asked to fill out quesioner BAS instrument to measure the burden and FQ instrument to measure the expression emotion. The results are, as much as 67.8% caregiver feel the burden, 49.2% have a high emotional expression and 50.8% had low emotions. The burden has a significant association with the expression emotion (OR 5.093; 95% CI -12.190 2.128, p = 0.000). There is a confounding factor in assessment of the burden and emotional expression."

"Latar Belakang: Skizofrenia adalah salah satu gangguan jiwa berat, Skizofrenia diderita oleh 21 juta orang di dunia. Anggota Rumah Tangga (ART) di Indonesia yang menderita Skizofrenia/ psikosis 6,7 per mil pada 2018. Cakupan pengobatan penderita Skizofrenia atau psikosis yang berobat ke RS Jiwa/fasilitas layanan kesehatan/Tenaga Kesehatan adalah pernah/seumur hidup (85%) dan yang minum obat rutin 1 bulan terakhir (48,9%). Sekalipun prevalensinyaya kecil namun dampaknya sangat besar biaya finansial Skizofrenia di Amerika Serikat diperkirakan melampaui biaya semua kanker bila digabungkan, karena Skizofrenia bermula pada awal kehidupan, menyebabkan hendaya/ketidakmampuan yang signifikan dan bertahan lama, membuat tuntutan perawatan rumah sakit yang berat, membutuhkan perawatan rawat jalan, rehabilitasi, dan layanan dukungan terus-menerus. Tujuan dari penelitian ini adalah diketahuinya determinan kepatuhan minum obat pada penderita Skizofrenia di Poli Rawat Jalan RSJ Daerah Propinsi Lampung tahun 2019.Metode: Penelitian Kuantitatif dengan desain Cross Sectional, sampel 192 responden diolah dengan chi square dan regresi logistik.Hasil: Sebagian dari penderita yang menjadi responden patuh minum obat (51,0%), berumur dewasa >30 tahun (70,3%), berpenghasilan dibawah UMP Lampung (82,3%), tingkat pendidikan dasar (46,9%), akses ke RSJ terjangkau (73,4%), persepsi dukungan keluarga sangat kuat (50,5%), wawasan terkait penyakit luas (94,3%), persepsi keparahan penyakit sedang (61,5%), persepsi tidak ada efek samping obat (54,7%), persepsi peran Dokter baik (35,9%) dan peran Apoteker sangat baik (80,2%). Kepatuhan berasosiasi secara positif dengan penghasilan (OR= 4,73), tingkat pendidikan, akses ke RSJ (OR=5), persepsi dukungan keluarga (OR=2,2), wawasan terkait penyakit (OR=5), persepsi keparahan penyakit, persepsi efek samping obat (OR=2,6), peran Dokter dan peran Apoteker (OR=2,7). Variabel yang paling dominan yang berhubungan dengan kepatuhan minum obat adalah akses dengan OR = 6,6.Rekomendasi: Meningkatkan akses pada penderita melalui optimalisasi pelayanan kesehatan mental rujukan berjenjang di PPK I, II, disertai sumber daya manusia (Dokter, Apoteker) serta obat-obatan terkait, mengaktifkan Website RSJ serta melakukan edukasi melalui video edukasi, leaflet, poster, banner terkait kepatuhan minum obat penderita Skizofrenia.

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Introduction: Skizophrenia is a severe mental disorder, it affects 21 Million people in the word. Household membersin Indonesia who suffer from schizophrenia/psychosis 6,7 per mile in 2018. Treatment coverage for schizophrenia/ psychosis patients who go to mental health/health care facilities/ health workers is ever/ for lifetime (85%) and who take routine medication for last month (48.9%). Even though the prevalence is small but the impact is enormous, financial costs of schizophrenia in the United States are estimated to exceed the costs of all cancers when combined, because schizophrenia starts early in life, causes significant and long-lasting health/disability, makes demands for severe hospital treatment, requires outpatient care, rehabilitation, and continuous support services. The purpose of this study was to determine the determinants of medication adherence in patients with paranoid schizophrenia in outpatient polyclinic in Lampung Province Regional Hospital in 2019

Method: a quantitative research with cross sectional design, 192 sample respondents, using chi square and logistic regression analysis.

Result: Some of the patients who became respondents obeyed taking medication (51.0%), having adult age > 30 years (70.3%), earning under the UMP Lampung (82.3%), basic education level (46.9%), access to RSJ affordable (73.4%), perception of family support was very strong (50.5%), good insight into illness (94.3%), perception of disease severity moderate (61.5%), perception of drug: no side effects (54.7%), perceptions of the role of the doctor good (35.9%) and the role of the Pharmacist is very good (80.2%). Compliance was positively associated with income (OR = 4.73), education level, access to RSJ (OR = 5), perceptions of family support (OR = 2.2), insight into illness (OR = 5), perception of disease severity, perception of drug side effects (OR = 2.6), the role of the doctor and the role of the pharmacist (OR = 2.7). The most dominant variable that is related to medication adherence is access with OR = 6.6

Recommendation: Increase access to patients through optimization of tiered referral mental health services in PPK I, II, along with human resources (Doctors, Pharmacists) and related medicines, activate the RSJ Website and conduct education through educational videos, leaflets, posters, related banners compliance with taking medication for patients with schizophrenia."

"Latar belakang: Skizofrenia merupakan sindrom pada perilaku maupun kognitif yang berhubungan dengan gangguan perkembangan otak seseorang. Halusinasi merupakan salah satu gejala positif yang paling umum pada skizofrenia yaitu dialami oleh 60% - 80% penderita skizofrenia. Kasus: Ny. P (33 tahun) diantar oleh keluarga ke rumah sakit karena merasa takut dan mendengar suara bisikan – bisikan tanpa ada wujudnya. Selain itu, menunjukkan sikap curiga, marah – marah, sulit tertidur, dan keluyuran. Diskusi: Asuhan keperawatan dimulai dari pengkajian, analisa data, perencanaan, implementasi, hingga evaluasi. Proses asuhan keperawatan dilakukan pada tanggal 4 April 2023 hingga 18 April 2023 di Ruangan Utari Rumah Sakit Jiwa Dr. Marzoeki Mahdi Bogor. Intervensi yang diberikan kepada Ny. P sesuai dengan standar asuhan keperawatan generalis dan terapi modifikasi yang digunakan adalah kombinasi mendengarkan murottal dengan teknik relaksasi napas dalam sebagai distraksi atau pengalihan pasien pada halusinasinya. Kesimpulan: Penerapan intervensi keperawatan generalis dan terapi modifikasi kombinasi mendengarkan murottal dengan teknik relaksasi napas dalam pada masalah keperawatan halusinasi dapat mengurangi tanda dan gejala halusinasi, dan meningkatkan kemampuan pasien dalam mengontrol halusinasi.

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Background: Schizophrenia is a behavioral and cognitive syndrome associated with the development of a person's brain disorder. Hallucinations are one of the most common positive symptoms in schizophrenia, which is experienced by 60% - 80% of people with schizophrenia.

Case: Mrs. P (33 years) was taken by his family to the hospital because he was afraid and heard whispering voices without his form. In addition, showing a suspicious attitude, angry, difficulty falling asleep, and wandering.

Discussion: Preparation care starts from assessment, data analysis, planning, implementation, to evaluation. The nursing care process was carried out from 4 to 18 April 2023 in the Utari Room of the Dr. Marzoeki Mahdi Bogor. The intervention given to Mrs. P according to general care service standards and the modified therapy used is a combination of murottal listening with deep breathing relaxation techniques as a distraction for her hallucinations.

Conclusion: The application of generalist interventions and modification therapy in combination with murottal listening and breathing relaxation techniques in hallucinatory disorder problems can reduce the signs and symptoms of hallucinations, and improve the patient's ability to control hallucinations."

"Kekambuhan pada klien skizofrenia perlu mendapat perhatian khusus karena menunjukkan angka yang tinggi serta memberikan dampak yang buruk terhadap klien dan keluarga. Tujuan penelitian untuk mengetahui pengaruh tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga terhadap pencegahan faktor risiko kekambuhan klien perilaku kekerasan dan halusinasi di rumah sakit jiwa. Desain yang digunakan dalam penelitian ini adalah quasi experimental pre-post test with control group. Pengambilan sampel menggunakan teknik purposive sampling dengan jumlah sampel 61 klien dan keluarga yang dibagi menjadi 2 kelompok. Kelompok intervensi 1 berjumlah 31 klien dan keluarga diberikan tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga, sedangkan kelompok intervensi 2 berjumlah 30 klien dan dikeluarga diberikan tindakan keperawatan ners. Pengumpulan data menggunakan kuesioner dan lembar observasi kemudian dianalisis secara univariat dan bivariat. Analisis univariat menggunakan distribusi frekuensi dan tendensi sentral. Analisis bivariat menggunakan uji dependent t-test, independent t-test, dan korelasi pearson untuk data yang berdistribusi normal sedangkan untuk data yang berdistribusi tidak normal menggunakan uji wilcoxon, mann-whitney test, dan korelasi rank spearman. Hasil penelitian menunjukkan peningkatan kemampuan klien dan keluarga mencegah kekambuhan serta penurunan tanda dan gejala perilaku kekerasan dan halusinasi pada kelompok yang mendapatkan tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga lebih besar secara bermakna dibandingkan kelompok yang mendapatkan tindakan keperawatan ners saja (p value < 0,05). Tindakan keperawatan ners direkomendasikan dilakukan oleh perawat generalis serta cognitive behaviour therapy dan psikoedukasi keluarga direkomendasikan dilakukan oleh perawat spesialis jiwa di rumah sakit jawa dalam mencegah faktor risiko kekambuhan klien skizofrenia dengan diagnosis keperawatan perilaku kekerasan dan halusinasi.

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Relapse in schizophrenia clients needs to get special attention, because it shows high numbers and has a negative impact on clients and their families. The purpose of research was to determine the effects of standard nursing intervention, cognitive behavioural therapy, and family psychoeducation on preventing the risk factors of relapse among client with violent behaviour and hallucinations in mental health hospital. The design used in this study was a quasi experimental pre-post test with control group. Sampling used purposive sampling technique with 61 clients and their families divided into 2 groups. The intervention group 1 consisted of 31 clients and their families were given standard nursing intervention, cognitive behavioural therapy, and family psychoeducation, while the intervention group 2 consisted of 30 clients and their families were given standard nursing intervention. Data were collected using questionnaires observation sheets then analyzed by univariate and bivariate. Univariate analysis used frequency distribution and tendency central. Bivariate analysis used dependent t-test, independent t-test, and pearson correlation for normally distributed data, while for data that was not normally distributed using wilcoxon, mann-whitney test, dan rank spearman correlation. The results showed that an increased in ability of clients and their families to prevent relapses, and the decreased in signs and symptoms of violent behaviour and hallucinations in the group that received standard nursing intervention, cognitive behavioural therapy, and family psychoeducation was significantly greater than the group that only received general nursing intervention (p value < 0,05). Standard nursing intervention are recommended performed by generalist nurses, while cognitive behavioural therapy and family psychoeducation performed by mental nurses specialist in mental health hospital to prevent relapses risk factors of schizophrenic clients with nursing diagnosis of violent behaviour and hallucinations."

"Skizofrenia merupakan salah satu contoh gangguan jiwa berat dan merupakan bentuk psikosis fungsional paling berat dan menimbulkan disorganisasi personalitas terbesar yang tidak mempunyai kontak dengan realita.Penelitian ini bertujuan untuk mengetahui peran daerah tempat tinggal terhadap kejadian penyakit skizofrenia pada penderita gangguan jiwa yang dirawat inap di RS.Dr.Ernaldi Bahar Provinsi Sumatera Selatan tahun 2007.Hasil penelitian menemukan bahwa responden yang tinggal di perkotaan yang menderita penyakit skizofrenia sebanyak 155 orang (82.4%). Berdasarkan hasil analisis multivariat menunjukan bahwa penderita yang tinggal di perkotaan mempunyai resiko 3,22 kali untuk mengalami penyakit skizofrenia dibandingkan dengan yang tinggal di pedesaan, setelah dikontrol dengan tingkat pendidikan, yaitu dengan OR= 3,22 (CI; 1,99 - 5,46 ).

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Schizophrenia is one of example of serious mental disorder and the most serious functional psychosis form and cause severest disorganization of personality which does not have any contact to reality.

This study aim to find out the role of residence area for schizophrenia disease to inpatient of mental disorder treated in Dr.Ernaldi Bahar Hospital South Sumatera Province year 2007.

Study result founds that respondent who live in the city area suffering schizophrenia as much as 155 people (82.4%). Based on multivariate analysis, it showed that sufferers who lived in city area have 3,22 times of risks to suffer schizophrenia disease compared with their counterparts in the village, after controlled by education level, with OR = 3,22 (CI; 1,99 - 5,46)."

"Risiko perilaku kekerasan merupakan keadaan yang berisiko membahayakan melakukan sebuah aksi terhadap suatu perasaan terancam dimana individu mewujudkannya dengan cara melakukan tindakan mengancam, mencederai orang lain, baik secara verbal, secara fisik, emosi, seksual maupun psikologis pada diri sendiri, orang lain serta lingkungan. Tanda dan gejala risiko perilaku kekerasan membutuhkan penatalaksanaan yang sesuai. Tujuan penulisan karya ilmiah akhir ini adalah untuk memberikan gambaran penerapan Penerapan Acceptance Commitment Therapy (ACT) dan Assertiveness Training (AT) pada klien risiko perilaku kekerasan dengan menggunakan pendekatan teori Interpersonal Peplau. Sampel dalam penulisan laporan kasus ini melibatkan 5 klien dengan klien risiko perilaku kekerasan. Klien tersebut diberikan tindakan keperawatan ners oleh perawat generalis dan tindakan keperawatan spesialis berupa tindakan Acceptance Commitment Therapy CT) dan Assertiveness Training (AT) kemudian pengumpulan data menggunakan instrumen tanda gejala dan kemampuan. Hasil karya ilmiah ini menunjukkan dari setiap pertemuan terjadi penurunan tanda dan gejala serta peningkatan kemampuan klien risiko perilaku kekerasan. Berdasarkan hasil diatas Penerapan Acceptance Commitment Therapy (ACT) dan Assertiveness Training (AT) dapat direkomendasikan dilakukan di rumah sakit jiwa untuk digunakan menurunkan tanda gejala serta meningkatkan kemampuan klien risiko perilaku kekerasan dalam mengatasi masalah yang dihadapi.

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The risk of violent behavior is a situation that is at risk of endangering taking action against a feeling of being threatened where individuals manifest it by threatening actions, injuring others, either verbally, physically, emotionally, sexually or psychologically to themselves, other people and the environment. Signs and symptoms of risk of violent behavior require appropriate management. The purpose of writing this final scientific work is to provide an overview of the application of Acceptance Commitment Therapy (ACT) and Assertiveness Training (AT) to clients at risk of violent behavior using Peplau's Interpersonal theory approach. The sample in writing this case report involved 5 clients with clients at risk of violent behavior. The client is given nursing actions by generalist nurses and specialist nursing actions in the form of Acceptance Commitment Therapy (CT) and Assertiveness Training (AT) then data collection uses symptoms and abilities instruments. The results of this scientific work show that from each meeting there is a decrease in signs and symptoms and an increase in the client's ability to risk violent behavior. Based on the results above, the application of Acceptance Commitment Therapy (ACT) and Assertiveness Training (AT) can be recommended to be carried out in a mental hospital to be used to reduce symptoms and increase the ability of clients at risk of violent behavior in overcoming the problems they face"