Efektivitas Terapi Guided Imagery Dan Terapi Orientasi Realita Terhadap Gangguan Proses Berpikir (Waham) Pada Pasien Skizofrenia

Vallentina Reza Aulia; Siti Sholikhah; Moh. Saifudin

doi:10.30651/jkm.v10i3.27025

Authors

Vallentina Reza Aulia Universitas Muhammadiyah Lamongan
Siti Sholikhah Departemen Keperawatan, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Lamongan, Indonesia
Moh. Saifudin Departemen Keperawatan, Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Lamongan, Indonesia

DOI:

https://doi.org/10.30651/jkm.v10i3.27025

Keywords:

Schizophrenia, Delusions, Guided Imagery, Reality Orientation Therapy, Psychiatric Nursing

Abstract

Schizophrenia is a chronic mental disorder characterized by disturbances in thought processes, one of which is delusion. Delusions are fixed false beliefs that deviate from reality and are difficult to correct, thereby impairing patients’ cognitive and social functioning. Managing delusions requires not only pharmacological treatment but also non-pharmacological approaches, such as guided imagery therapy and reality orientation therapy. This study aims to evaluate the effectiveness of both therapies in reducing delusional levels among schizophrenic patients at the Griya Cinta Kasih Foundation in Jombang Regency. The research employed a pre-experimental design using a two-group pretest– posttest approach, the sampling method used was purposive sampling. Involving 34 patients divided into two intervention groups of 17 participants each. The first group received guided imagery therapy, while the second group received reality orientation therapy. The Positive and Negative Syndrome Scale (PANSS) was used as the assessment instrument, and data were analyzed using the Mann–Whitney test.

The results showed that both therapies were effective in lowering delusional scores, with a decrease from 132.94 to 105.88 in the guided imagery group, and from 135.29 to 98.65 in the reality orientation group. A p-value of 0.039 indicated a statistically significant difference, with reality orientation therapy proving to be more effective than guided imagery.

In conclusion, reality orientation therapy can be considered a superior non- pharmacological intervention for reducing delusions in schizophrenic patients and may be routinely implemented in mental health nursing practice.

References

American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). American Psychiatric Publishing.

Brown, J. W., Lee, S. M., & Zhang, X. (2021). Effectiveness of Reality Orientation Therapy on Cognitive and Psychotic Symptoms: A Meta-Review. Journal of Psychiatric Nursing, 12(2), 78–85. https://doi.org/10.1016/j.pjn.2021.04.003

Chiang, Y. C., Lu, C. Y., Lin, Y. C., & Chen, W. T. (2020). Effectiveness of guided imagery in reducing stress and anxiety among psychiatric patients: A meta-analysis. Journal of Psychiatric Research, 130, 76–85. https://doi.org/10.1016/j.jpsychires.2020.07.012

Glasser, W. (2017). Choice Theory: A New Psychology of Personal Freedom. HarperCollins.

Gogtay, N., Vyas, N. S., Testa, R., Wood, S. J., & Pantelis, C. (2021). Age of onset of schizophrenia: perspectives from structural neuroimaging studies. Schizophrenia Bulletin, 47(3), 515–530. https://doi.org/10.1093/schbul/sbaa184

Hawari, D. (2018), Pendekatan Holistik Bio-Psiko-Sosial- Spiritual (Skizofrenia), edisi 3, Fakultas Kedokteran Universitas Indonesia, Jakarta.

Keliat, B. A., & Prawiroyono. (2015). Keperawatan jiwa Terapi Aktivitas Kelompok. Jakarta: EGC.

Lestari, D., & Rahayu, F. (2022). Terapi Orientasi Realita dan Penurunan Gejala Waham pada Skizofrenia. Jurnal Ilmu Keperawatan Jiwa, 5(1), 15–22.

Pratiwi, A., Aditama, D., Suryati, T., Studi, P., Keperawatan, I., Ners, P., & Madani, Y. (2021). (n.d). Efektivitas Terapi Guided Imagery Terhadap Pasien Skizofrenia Dengan Gangguan Proses Pikir: Waham. https://journal-mandiracendikia.com/index.php/ojs3

Pratiwi, A., Wibowo, H., & Sari, M. (2021). Efektivitas Orientasi Realita terhadap Waham Skizofrenia. Jurnal Kesehatan Jiwa, 9(2), 109–116.

Riegel, B., et al. (2021). Cognitive and Behavioral Strategies in Psychiatric Care. Journal of Psychiatric Practice, 27(2), 85–94.

Sheila L. Videbeck. (2020). Psychiatric-Mental Health NURSING Eighth Edition.

Stuart, Gail Wisscarz. (2016). “Prinsip Dan Praktik Keperawatan Kesehatan Jiwa 1.” in 1, edited by B. A. Keliat. Elsevier : Singapura, 2016.

Stuart, G. W. (2016). Prinsip dan Praktik Keperawatan Kesehatan Jiwa (Buku 2), Elsevier.

Townsend, M. C., & Morgan, K. I. (2018). Psychiatric mental health nursing: Concepts of care in evidence-based practice.

WHO. (2018). Schizophrenia. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/schizophrenia

Wykes, T., Joyce, E., Velikonja, T., Watson, A., Aarons, G., Birchwood, M., et al. (2018). The CIRCuiTS study (implementation of cognitive remediation in early intervention services): Protocol for a randomised controlled trial. Trials, 19(1), 183.

Zhao, Y., Chen, F., & Wang, L. (2023). Non-Pharmacological Interventions for Schizophrenia: Systematic Review of Reality-Based Therapies. Asian Journal of Psychiatry, 83, 103574. https://doi.org/10.1016/j.ajp.2023.103574 Hasil: TOR efektif mengurangi waham dan memperbaiki fungsi kognitif pasien skizofrenia.