Damayanti 2012 also states the same
RESULTS
thing that self-efficacy
enhancing Patients withtype 2 diabetes mellitus
intervention program in DM patients,This program increase self-efficacy patient to
do self-care.
SEEIP is one the techniques of identification is Self Efficacy
Table1. Differences Self Efficacy type 2 diabetes patients are before and
after treatment to treatment group learning to improve self-efficacy
to and control group of Diabetes
patients who adopted the cognitive theory group in BPJS
branch Kediri, of social social cognitive theory, SCT
proposed by Bandura comes from four Kediri,District in
2015. April-May
main sources of influence, among other
Treatment Control
things: 1 performance accomplishments, 2 vicarious experience 3 verbal
persuasion, 4 somatic and emotional
Variabel n = 17
M p
SD n = 17
M P
SD
state Bandura, 1997. Meanwhile, to
Self Efficacy DMSES
support awareness of himself and others Pre
–Post 1 -21,706
,000 -,029
,868 we add model of caring by Jean Watson
12,572 ,717
with 10 caritasnya values of humanity, trust-hope,
sensitivity terdahapyourself and others, a relationship of trust and
Pre – Post 2
Post 1 – Post 2
-28,382 13,563
-6,676 ,000
,000 -,235
1,120 -,206
,399 ,130
mutual help, expression of positive and 4,334
,532 negative, systematic problem
solving
Self Efficacy PTES
methods, teaching and learning through Pre
– Post 1 -25,471
,000 ,294
,332 interpersonal relationships, support,
16,164 1,213
protection, mental, physical, social, Pre
– Post 2 -27,000
,000 ,118
,707 cultural and spiritual environment, human
15,996 1,269
needs and the strength of the existential Post 1
– Post 2 -1,529
,001 -,176
,548 phenomenological Alligood, 2014
1,463 1,185
METHODS
Table1. to refer in treatment groups show Design
research uses quasi-
that Self EfficacyDMSES PTES has a experimental, by the experimental group
were given intervention based SEEIP Caring, while control group received
routine maintenance carried out by doctors and nurses. Samples were some
participants Prolanis Chronic Disease Management Program amounted to 17
people chosen by simple random p value is 0.000, α0.05, its which means
that any significant changes before and after SEEIP based Caring. In contrast to
control group showed that Self Efficacy DMSES PTES has a p value greater
with α0.05, which means are not change before and after SEEIP based Caring.
sampling. SEEIP-based independent
variable is the dependent variable is Caring and Self - Efficacy Patient DM
Type 2. Data were collected using a questionnaire DMSES and PTES, then
analyzed using paired t-test, independent t- test, while confounding variables using
multiple linear regression.
526
Table2. Self Efficacy type 2 diabetes
Correlation characteristics Respondent
patients is identification in the
with Self Efficacy
treatment group and control group after to do SEEIP indiabetes
Table 3.Correlation variables are in
group in BPJS branch in Kediri, Kediri in April-May 2015.
research diabetic groups in the region of the branch BPJS Kediri
Treatment Control
in Kediri, in April-May 2015. Variabel
n=17 n=17
p
Post – 1 T2
Post – 2 T3
M SD M SD
Variabel T
Col. F
t Col.
F Self Efficacy DMSES
55,06 Pre
13,236 76,76
Post 1 5,483
83,44 Post 2
2,984
Self Efficacy PTES
55,06 13,236
55,09 13,579
55,29 13,815
1,000
,000 ,000
p vif
Self Efficacy DMSES
Group ,000 1,787 Age ,935 1,547
Gender ,068 1,431 Therapy ,842 1,376
Work ,066 1,895 Education ,031 4,709
Sick
,517 1,302
p
,000
a
p
,000 ,621
,161 ,972
,091 ,086
,285
vif
1,787 1,547
1,431 1,376
1,895 4,709
1,302
p
,000
a
Pre 66,59
16,086 73,00
17,288 ,271
Complication DMSES PRE
,609 ,000
1,069 3,230
,934 ,000
1,069 3,230
Post 1 Post 2
92,06 1,345
93,59 1,805
72,71 16,744
72,88 16,733
,000 ,000
Self Efficacy PTES
Group ,000 Age ,842
Gender ,922 Therapy ,325
1,597 1,633
1,430 1,339
,000
a
,000 ,943
,831 ,241
1,597 1,633
1,430 1,339
,000
a
The results analysis show that Self Efficacy DMSES PTES in pre do not
do SEEIP based Caring the difference was not significant, and after SEEIP
Work Education
Sick Complication
PTES PRE ,036
,147 ,243
,967 ,000
1,842 3,513
1,222 1,062
2,046 ,052
,183 ,191
,810 ,000
1,842 3,513
1,222 1,062
2,046
showed results that Self Efficacy DMSES PTES on post1 T2, post2 T3 has a
value p value = 0.000, α 0.05, which Test analysis results are f p value
0,000, α 0.05, which means together means that self-efficacy
were not variable group, age, gender, treatment,
significant differences between treatment and control groups. While seeing a change
employment, education, duration of illness, complications, pre dmses and
in the treatments group are mean number PTES significantly affects the self
self-efficacy show DMSES post 1
efficacy and the t test analysis on the 76.76 and post 2 83.66 in both
variable group, dmses and pre PTES p categories that were
previously pre value 0,000, α 0.05 which shows that the
55.06 in medium category and self efficacy PTES post 1 92.06 and post 2
93.59 in both categories that were previously pre 66.59 in the medium
category. This differs significantly from results of self-efficacy to control group are
lean to remain medium category.
527
variable group and self efficacy in pre influence on self-efficacy, but variables
age, sex, treatment, employment, education, duration of illness,
complications has a p value greater than
α, which means these variables individually have no effect on self-
efficacy. These results are also supported by the analysis of collinearity shows the
value of vif10 thus concluded variable group, age, gender, treatment,
employment, education, duration of
illness, complications, self-efficacy pre does not occur multikolinearitas or does
not happen a strong correlation with self efficacy.
DISCUSSION
The results show that significantly affect Caring based SEEIP Self Efficacy
patients with type 2 diabetes, is evidenced by the significant changes after treatment
with the value Self Efficacy DMSES PTES has a value of
value 0.000, α 0.05, which means that the significant
changes before and after SEEIP table 1 and supported the existence of differences
between treatment and control groups, namely Self Efficacy DMSES PTES
on post1 T2, post2 T3 has a value of
value = 0,000, α 0 , 05 which means that
similarity with the observers own self. The more people who are observed to have a
resemblance to him, the greater the potential for self-efficacy that will be
contributed by this factor. While helping individuals gain confidence in healing,
positive thinking. The more people have a strong belief and positive thinking, then
the self-efficacy would be optimal.
Verbal persuasion is persuasion that other people verbally or by yourself
self-talk that can be used effects how people act or behave. Individuals under the
influence or the suggestion that he was able to overcome the problems to be faced.
Someone who confidence always given and the drive to recover and be able to
control the disease, it will show behavior to try to recover and control, vice versa.
self-efficacy were no significant
This factor nature may come from outside differences between treatment and control
groups Table 2. This situation is caused by a
program-based Caring SEEIP given to patients with type 2 diabetes mellitus
or within the individual himself. The influence that can be given by the giver of
persuasion is a sense of trust to the grantor of persuasion and believed that he was
able to manage his illness. The same time
include Performance Accomplishments through verbal persuasion
helps to which recalls the accomplishments or
experience the best ever achieved by the patient in the past in controlling diabetes.
Good performance in the past experienced by the patient will make increase the
expectation of efficacy, while the experience of failure will decrease the
efficacy of the individual. At the same time it helps the individual to have a sense
of love, care, trust, hope, sensitive, positive thinking, creative problem-
solving, the best learning experience, and confidence to cure both to themselves and
to others.
Vicarious experience is the experience gained from others or emulate
their behavior to get what others get. Self- efficacy will increase if observing the
success that has been achieved by others, whereas the self-efficacy would decrease if
individuals observing someone who has the equivalent of his Traffic failure. Given
the influence of these factors on the self- efficacy is based on the observed
528
appreciate the power of existential- phenomenological namely appreciate and
realize that the life-death-suffering is a blessing from God and believe in the
possibility of the magic miracles of healing from God and recalling that the
individual is a creature cipataan Gods most perfect and continue loved by God.
Emotional arousal is generating positive emotions so that people have the
confidence to perform a particular action. Emotional condition mood also affect a
persons decision-making related to his self efficacy. Emotional state that accompanies
the individual when he was doing an activity will affect a persons self-efficacy.
Emotion is meant strong emotions such as fear, stress, anxiety and joy. These
emotions can increase or decrease ones self efficacy. At the same time dividing
issues with other individuals, which help the individual that he has friends and
relatives who always supported him.
This is consistent with the results variables individually have no effect on
of the study conducted by Wu, et. Al self-efficacy. These results are also
2011 which states that the program SEEIP have an influence on self-efficacy.
Damayanti 2012 also states same thing that self-efficacy enhancing intervention
program in patients with DM, the program supported by the analysis concludes
variable collinearity group, age, gender, treatment, employment, education,
duration of illness, complications do not occur or do not occur multikolinearitas
enhances patient self-efficacy in
strong correlation with self efficacy. performing self-care.
Potter and Perry 2009 stated that confidence of the patients health can be a
powerful motivation to take actions that can reduce the disease or reduce the
severity. The role of nurses as educators took part in providing the knowledge and
motivation to patients.
Trento, et.al 2004 in Atak, Gurkan and Kose 2006 explained that the
health education group problem solving increase knowledge about diabetes and
improve the decision making lifestyle changes to manage the disease. Similarly,
Anderson, et al 1995 in Atak, Gurkan and Kose 2006 conducted a study on the
effects of health education about DM, with health education about disease
management obtained a change of psychosocial and skills where someone
with type 2 diabetes develops keyakinananya about coping psychology
DM called confidence DM.
Research nyut et al 2010, which conducts research on self-efficacy, self
care and control blood sugar result that the provision of education can improve self
efficacy 62 and 30 self-care behavior.
Self-efficacy is the belief in ones ability to organize and execute courses of
action required to manage a situation that will occur Bandura, 1994.
It is also supported by results of Table 3. on other factors that affect self-
efficacy, ie the t test analysis on the variable group, dmses and PTEs pre
indicates that the variable group and self efficacy in pre influence on self-efficacy,
but variables age , gender, treatment, employment, education, duration of
illness, complications has a p value Results were showed statistically
many female respondents, but there is no relationship between gender and self-
efficacy, means that men and women have the same ability in solving various
problems or to cope, and to behave as expected. Men and women possess the
same confidence in their ability to behave as expected to manage the disease.
Age of respondents average 47 years, the results not statistically significant
relationship of age with self-efficacy this is due to the older respondents have
complications or comorbidities that will further reduce the function of the physical
so that patients do not feel able to do the treatment himself with such good though
sport, whereas in the adult respondents were more likely to focus on perjaan and
household.
The average education level of respondents junior high school graduates,
according to the results of this study that education level was not associated with
self-efficacy can be interpreted that the higher the education level of respondents
do not guarantee good self efficacy. The level of education is high on the
respondents in this study is a formal education in general not describe specific
education about DM, but respondents with higher education should be easier to
understand and accept the information that helps in improving efficacy of himself.
Based on current experience researching, there are some respondents who are well
educated and know how to correct diabetes management, but is still difficult
melaksanakannnya a variety of reasons including the one about exercise and diet
DM.
greater than α, which means these
529
The average respondent has a job,
according to the results of this study that the job no association with self-efficacy, it
is because the working conditions can be a source of stressors that can reduce a
persons ability to solve problems. Stress conditions is one of the risk factors that
can aggravate the condition of patients with diabetes mellitus type 2, which will
have an impact on the decline in self- efficacy in the management of his
diabetes.
Long experience DM is mean of respondents two years, the results of this
study there was no significant relationship between old suffering from diabetes with
based Caring can improve Self Efficacy in patients with type 2 diabetes mellitus.
RECOMMENDATIONS
Application of Caring based SEEIP can be applied to health care institutions to
develop an integrated system of services and provides the means for the Center Self
Efficacy Restoration as an effort to increase confidence in type 2 diabetes
patients in the care of her. Caring based SEEIP program can be applied to cases of
other chronic diseases that require treatment eg patients with hypertension,
stroke, kidney failure, and in palliative
self-efficacy, due to the length of care.
experience DM will happen much damage to cells and body functions so more easily
appeared a variety of physical disorders
REFERENCES ADA, 2012. Diagnosis and Classification
and metabolic or in other words complications have occurred. someone
with komlikasi will experience a variety of of Diabetes Melitus.
Care
, II1, p.35. Alligood, Martha R., 2014.
Diabetes Nursing
disorders and limitations that can cause low self efficacy of patients.
The above results differ from test analysis f in Table 3. stating jointly
variables group, age, gender, treatment, employment, education, duration of
illness, complications, pre dmses and PTEs significant effect on self-efficacy.
This suggests that there are factors other than the four elements of self efficacy
which affect self-efficacy in individuals, although these factors do not stand alone
but affects together, are consistent with the theory Bandura 1977 states in addition to
the four sources of efficacy and process information can be also influenced by the
characteristics of the individual and the environment. Ideally, self-efficacy
strengthened through a variety of experiences related and will influence
subsequent behavior. Someone will decide to behave based on reflective thinking, the
use of knowledge in general, and the ability to perform an action.
CONCLUSIONS
Application of SEEIP Self Efficacy Enhancing Intervention Program
530 Theorist and Their Work
. 8th ed. United Satates of America:
Elsevier. Atak, N. Gurkan,T. Kose,K., 2006. The
effect of education on knowledge, self management behaviour and
self efficacy of patient with type 2 diabetes.
Australian journal of advanced nursing
, pp.66-74. Bandura, A., 1977.
Self-efficacy: Toward a unifying theory of behavioral
change
. New York: Psychological Review.
Bandura, A., 1994.
Self-efficacy
. 1st ed. New York: Academic Press.
Bandura, A., 1997.
Self-Efficacy: The exercise of kontrol
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sistem endokrin
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Perilaku
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2014. Depression, anxiety disorder, and
metabolic sydrome in a population at risk for type 2 Diabetes Melitus.
Brain and Behaviour
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Buku Ajar Fundamental Keperawatan
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Sandhi W.Nyut, Nopporn H, Nawarat S, Thiltipat R., 2010. self-efficacy,
self-care behaviour and glycemic kontrol among type-2 diabetes
patients attending two private clinic in yangon,myanmar.
Southeas Asian J Trop Med Public Health
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Shu-Fang V.W, Mei-chen L,Shu-Yuan L, Yu-Ying L, Tsae J.W, Heng H T.,
2011. Effectiveness of a self- efficacy program for persons with
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Nursing and Health Science
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Soegondo, S., Rudianto,P., Subekti, I., Pranoto, A., Arsana, P.M., et al..,
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. Jakarta: PB Perkeni.
531
EFFECT OF REMINISCENCE THERAPY OF OLDER PEOPLE AND SELF- ACCEPTANCE WITH GEROTRANSCENDENCE THEORY APPROACH IN
JOMBANG INSTITUTION AND GERIATRIC OF PUHJARAK COMMUNITY HEALTH CENTER KEDIRI
Nugrahaeni Firdausi
Akademi Keperawatan Pamenang Kediri Email: nug_fyahoo.co.id
Introduction: Aging process is a natural phenomenon. Aging process is change
to physical, social, psychological, moral and spiritual to older people. That change can to effect low self-acceptance. Older people of low self-acceptance will correlated with high
depression level. This research purpose was analyse effect of reminiscence therapy to self-acceptance older people with gerotranscendence theory approach in Jombang
Institution and Geriatric of Puhjarak Community Health Center Kediri. Method: This research used a quasy experiment two groups with non randomized pretest-posttest
control group design approach. This research sampling technique used purposive sampling, so 28 samples got to selected was based on inclusion and exclusion criteria.
This research independent variables was elderly self-acceptance and the dependent variable was the reminiscence therapy. The instrument used data collection of self-
acceptance questionnaire from modification psychological well-being questionnaire Ryff 1989. Data were analyzed using paired t test and t test independent. Result: The results
showed that treatment group in Jombang Institution, there was increasing acceptance older people with p= 0.001, whereas the control group was p= 0.021. Value pretest was
self-acceptance between treatment and control group showed p= 0.139, and the posttest value was p= 0.000. The treatment group was Puhjarak Community Health Center Kediri,
there was increase self-acceptance older people p= 0.001, whereas the control group was p= 1.000, between value were pretest self-acceptance treatment and control group to
show p= 0.226, and the posttest value was p= 0.000, differences between value were posttest self-acceptance treatment group in Jombang Institution and Geriatric of Puhjarak
Community Health Center Kediri p= 0.854, and the value control group was p= 0.017. Discussion: Reminiscence therapy can increase self-acceptance in the older people
through gerotrancendence theoretical approach, but older people acceptance effected age were too, stay nursing homes long time, history life, sadness, environmental, and social
support. Suggestion for next researcher expected can do qualitative research about self- acceptance older people and respondents are strict controls observing and environmental
research so to give maximum results.
Keywords: self-acceptance older people, reminiscence therapy,
gerotranscendence theory
INTRODUCTION
Increasing degree of health and well-being of the population at this time
will have an effect on the increase in life Number of older people in the province
with the highest percentage of three contained in Yogyakarta 13.04, East
expectancy in Indonesia Kemenkes RI, Java 10.40, and Central Java
2013. The Central Statistics Agency BPS reported that life expectancy in
2010 was 69.43 with the percentage of the elderly population is 7.56 and in
2011 to 69.65 years with the percentage of the elderly population is 7.58.
10.34. Changes in physical, social, psychological, moral and spiritual occur
in the older people can lead to negative self-acceptance Mariana, 2014.
The research of Tika Saifuddin 2013 showed that of 54
532
older people, found 31 59.6 older people have enough self-acceptance, and
3 5.8 older people have less self- acceptance, while the data collection
showed that two out of three people 66.67 in the Jombang institution had
a lack of self-acceptance, and one 33.33 had self-acceptance well, the
same data was also obtained on Geriatric of Puhjarak Community Health Center
Kediri, from three older people, single the influence of the reminiscence
therapy to improve self-acceptance has not been done. The using of
reminiscence therapy by motivating the older people to remember the ability he
has, whether biological, psychological, social, spiritual, and cognitive, so the
limitations due to the aging process can be minimized Syarniah, 2010. Elderly
will become more focused on the needs of others, and obsession with body
people 33.33 of older people had switch with self-acceptance
which enough self-acceptance, one person
results in life satisfaction Tornstam, 33.33 had less self-acceptance, and
2011. This research purpose was
one person 33.33 had good self- analyse effect of reminiscence therapy to
acceptance. self-acceptance
older people with Gerotransenden theory is a
theory explaining the aging process, in this process the thought patterns of the
older people will become more extensive and cosmic Jonson
Magnusson, 2001. Thorstam in Thorsen 1998 mentions that gerotransenden is a
universal phenomenon that occurs in any process of aging. The research of
Tornstam 1994, 1997a, b, 1999, 2003, gerotranscendence theory approach in
Jombang Institution and Geriatric of Puhjarak Community Health Center
Kediri.
METHOD
This research used a quasy experiment two groups with non
quantitatively demonstrate that the randomized pretest-posttest
control gerotransenden theory positively
correlated with age, but in fact, only about 20 of the population. achieving
a high degree of gerotranscendence without difficulty Tornstam, 2011.
Johnson Magnusson 2001 mentions that changes to the natural
aging process is described by the gerotransenden theory an awareness in
old age toward wisdom. Gerotransenden sign is divided into three levels, the
cosmic level, the level of self, and the level of the individual and social
relations Tornstam in Jonson, 2001. At the level of self, gerotransenden theory
outlines the developments associated with the aging process Wadensten,
2005. Older people who do not have self-acceptance will view themselves as
group design approach, with research time was 4 weeks in Jombang Institution
and Geriatric of Puhjarak Community Health Center Kediri.
This research sampling technique used purposive sampling, so
28 samples got to selected was based on inclusion and exclusion criteria. Twenty-
eight samples were in Jombang Institution divided into two groups, 14
samples were treatment group, and 14 samples were control group. Puhjarak
Community Health Center was divided into two, each 14 samples were
treatment group, and 14 samples were control group. This research independent
variables was elderly self-acceptance and the dependent variable was the
reminiscence therapy. The instrument
depressed, too boast of his past, or use a used
data collection pretest and
self-defense mechanism to deal with posttest
of self-acceptance change associated with increasing age
itself Sari Nuryoto, 2002. questionnaire from modification
psychological well-being questionnaire Reminiscence therapies
Ryff 1989, which contains 14
currently used as a therapy for treatment of depression in the older people, while
533 questions. Format attitude scale
questionnaire self-acceptance is a Likert
scale. In the questionnaire of self- acceptance, there are four possible
answers, Strongly Agree, Agree, Disagree and Strongly Disagree. This
measure are items favorable item number 1, 2, 5, 6, 8, 12, and 13 and
items unfavorable item number 3, 4, 7, 9, 10, 11, and 14. Score 4 for Strongly
Agree, 3 to Agree to Disagree 2, and 1 for Strongly Disagree, while for item
unfavorable scoring is the opposite. Assessment questionnaire is indicated
by a score of acceptance of yourself, better when the score 43-56, acceptance
of self-sufficient when the score 29-42, and the acceptance of self-less when the
reminiscing childhood with 2 meetings, the second session in memory of
adolescence with 2 meetings, third session in memory of adulthood with
two meetings, fourth session in memory of a family with one meeting, the fifth
session of reminiscing elderly period with 2 meetings, and the sixth session is
the evaluation of the achievement of self-integrity. Implementation of the
reminiscence performed with a duration of 20-30 minutes, every meeting held
3xweek, was done 2 days in a period of 4 weeks. The final assessment carried
out by the end of the 4th week, performed on all groups using a
score 14-28. Instruments for the
questionnaire form self-acceptance back independent variable reminiscence
therapy is SAK. Retrieval of data held in
Jombang Institution and Geriatric of Puhjarak Community Health Center
Kediri in March 2015, while the process of research carried out on April 23,
2015- May 16, 2015. The respondents determined in accordance with the
criteria of the sample and sampling techniques. Respondents who have been
selected will be given an explanation about the purpose and benefits of
research. Respondents that had been collected was then given an explanation
of the technical guidelines of treatment researchSAK in accordance with the
group treatment or control in order to obtain informed consent from each
respondent. Pretest is done by using a questionnaire form self-acceptance, so
the initial score obtained before the intervention. Scores of self-acceptance
questionnaire obtained from questionnaires acceptance modification
of psychological well being questionnaires Ryff 1989.
The data collection process is assisted by observers who have studied
and understand the research activity. Respondents in the treatment group was
given the research activities in the form of reminiscence therapy as much as six
sessions, the first session that activities
534 to find out the scores after the
intervention. Respondents in the control group was not given any intervention,
just doing everyday actions of each respondent, but after the study ended,
the control group will also be given the same treatment as the reminiscence of
older treatment group before.
Data were analyzed using paired t test to determine the difference before
and after implementation of an intervention and t test independent to
determine the comparison between the groups treated and untreated.
RESULT AND DISCUSSION
Results of observations about the characteristics of survey respondents
which include gender, age, marital status, and length of stay in Jombang
institution or longer follow Geriatric of Puhjarak Community Health Center
Kediri will be described below.
Tabel 1 Respondent characteristics in Jombang institution or longer follow Geriatric of
Puhjarak Community Health Center Kediri April-May 2015
Jombang Institution Geriatric of Puhjarak
CHC No
Characteristic s
Treatme nt group
Control group
Treatme nt group
Control group
Total Gender
f f
f f
Ʃ 1.
2. Male
Female 3
1 21,4
78,6 3
11 21,4
78,6 1
1 7,1
92,9 1
1 7,1
92,9 8
48 14,3
85,7 1
3 3
Amount 1
100 14
100 1
100 1
100 56
100 4
4 4
Age year f
F f
f Ʃ
1. 2.
3. 60-65
66-70 71-75
Amount 4
2 8
1 28,6
14,3 57,1
100 1
1 12
14 7,1
7,1 85,7
100 4
4 6
1 28,6
28,6 42,9
100 3
5 6
1 21,4
35,7 42,9
100 12
12 32
56 21,4
21,4 57,1
100 Bartlett‟
s test of Sphericity
4 4
p=0,848 4
Marital status f
f f
f Ʃ
1. 2.
Married Widow
2 1
14,3 71,4
1 11
7,1 78,6
4 9
28,6 64,3
5 8
35,7 57,1
12 38
21,4 67,9
3. Widower
Amount 2
1 14,3
100 2
14 14,3
100 1
1 7,1
100 1
1 7,1
100 6
56 10,7
100 4
4 4
Length of f
f f
f Ʃ
stay
1. 2.
3 month 3 month
–1 4
28,6 1
1 7,1
7,1 6
42,9 6
42,9 1
17 1,7
30,4 year
3. 4.
1-5 year 5 year
Amount 8
2 1
57,1 14,3
100 6
6 14
42,9 42,9
100 8
1 57,1
100 8
1 57,1
100 30
8 56
53,6 14,3
100 4
4 4
Characteristics of respondents in Jombang institution and Geriatric of
Puhjarak Community Health Center Results of the assessment of
self-acceptance older people in Jombang institution in the treatment group and the
majority are female, are in the age range control group
before and after 71-75 years old, a widow, length of stay
in Jombang institution is in the period of 1-5 years, and longer follow Geriatric of
Puhjarak Community Health Center also within 1- 5 years for respondents who
are older people in the Geriatric of Puhjarak Community Health Center.
535 reminiscence therapy can be seen in the
following table:
Tabel 2 Assessment of self-acceptance older people in Jombang institution in the
treatment group and the control group before and after reminiscence therapy of the April-May 2015
Self acceptance Treatmen group
Control group
Pretest Posttest
Pretest Posttest
F f
f f
Well Enough
Less Amount
12 2
14 85,7
14,3 100
12 2
14 85,7
14,3 100
13 1
14 92,9
7,1 100
1 13
14 7,1
92,9 100
Mean
±SD 32,14±2,742
50,14±4,258 34,07±3,832
37,36±3,003
Mean difference Wilcoxon signed
rank test
18 p=0,001
3,29 p=0,021
The results showed that after treatment reminiscence therapy, self-
acceptance older people in the treatment group experienced a significant
improvement after reminiscence therapy. Older people before
implementation reminiscence therapy more focus on the lack of theirselves and
desire to change the past, after the reminiscence therapy become more
grateful and accept all its shortcomings as a gift from God that must be grateful.
At the level of self gerotransenden perspective, there is a change of
rationality eolder people obsession with body switch with self-acceptance and
become more focused on the needs of others, resulting in life satisfaction. Self-
acceptance is an introduction to personal abilities and accomplishments
is marked by the return of past memories and conflicts Butler, 1996.
Implementation of therapy have a positive influence in improving self-
acceptance in the older reminiscence people.
Increased self-acceptance in the treatment group after treatment
reminiscence therapy still not up on all the respondents, there are two categories
of respondents who have enough self- acceptance despite given reminiscence
therapy, there are respondent 2 and 6. Self acceptance on respondents 2 and 6
does not increase significantly in both categories, although there is an increase
in the value of her acceptance. Respondent 2 are aged 75 years old, a
widow, and lived in Jombang institution for 7 years. Interviews showed that
themselves, along with the acceptance of during
the research process that the limitations of self Corsini, 2002.
Reminiscence therapy carried by coincided with the arrival of the students
practice makes respondent 2 motivating
the elderly to recall remembered her grandchildren that are
capabilities, whether biological, psychological, social, spiritual, and
cognitive, so the limitations due to the aging process can be minimized.
Memories, in the Gerotransenden perspective seen as an important element
in the development process of the older people, because contribute in developing
an identity and a sense of reality through memories Tornstam in Wadensten,
2006. Butler 1996 illustrates that people of all ages reviewing their past in
various ways in life. Remembering the past is a normal developmental task that
536 outside Java were sorely missed, so
make respondent 2 feel sad. Pannes in Hurlock 1978 argued that a person
who receives him is someone who is not troubled by itself, does not have the
burden of feeling of self, so it has plenty of opportunity to adapt to the
environment.
The research of Tornstam 1994, 1997a, b, 1999, 2003, quantitatively
demonstrate that the gerotransenden theory positively correlated with age,
but in fact, only about 20 of the population, which reached a high degree
of gerotransenden without difficulty Tornstam, 2011.
Increased of self-acceptance older people in the treatment group after
Gerotransendence process
reminiscence therapy in accordance with towards this, some people may be
hampered by a variety of reasons, one of which is retained hope. Self-acceptance
older people besides influenced by reminiscence therapy is also affected by
age, adaptation to the environment and circumstances in the individuals own
personal self.
Respondent 6 is a 60-year-old, widow, and the length of stay in
Jombang institution is 3 years. Respondent 6 said that during the
process of research, respondents still work as usual and maintain good
relations with friends, but from observation during the research process,
respondent 6 is not too interact with other. Other respondents said that
respondent 6 did not like to associate with other, because of differences in the
background.
Hurlock 1980 explains that the attitude or response from the
environment to form an attitude towards oneself self attitude, the individual
who received the appropriate attitude and fun of their environment tend to
receive him. Baltes Baltes in Newman Newman 1979 said that the
adaptability make an important contribution for older people to achieve
successful aging. This is because successful aging strategies involve older
people who used to accept the changes that happened to him. Other factors that
lead to self-acceptance is the age of maturity, according to Akçakoca in
Ceyhan and Ceyhan 2011, age may affect the level of self-acceptance on a
person, the more a persons age, the higher the level of acceptance of
himself. Implementation of reminiscence therapy in improving self-
acceptance in the older people through gerotransenden theoretical approaches
do not all give good results, but is also influenced by the history of ones life
that should help understand and provide coherence of life Tornstam, 2005.
537 previous studies, the research Moral et al
2013, which indicates that the reminiscence therapy given positive
effect in improving the psychological well being of older people in the post-
test and follow-up, with self-acceptance as one dimension of psychological well
being. This is supported by the observation of memories during therapy
in Jombang institution group, which showed that out of 14 respondents, all of
them participated in the therapy with enthusiasm.
The respondents recalled independently after listening to
instructions and rules of conduct. Results of the evaluation showed
activity of all respondents score more than 3 per session, which indicates that
in following the activities, the respondents can be followed with
enthusiasm and complete from start to finish.
The evaluation results are supported by previous studies that the
use of reminiscence therapy can motivate the elderly to remember the
ability he has, whether biological, psychological, social, spiritual, and
cognitive, so the limitations due to the aging process can be minimized
Syarniah, 2010. Memories in the gerotrancendence perspective seen as an
important element in the development process of the older people, because
contribute in developing an identity and a sense of reality through memories
Tornstam in Wadensten, 2006. In the process of gerotransenden changes
materialistic and rational view of the world becomes more cosmic and
transcendence, which is usually accompanied by an increase in life
satisfaction. At the level of self-change view of themselves and the physical
retrospect and acceptance of, the individual and social relationships occur
selectivity against superficial relationships, while at the cosmic level
changes the feeling that grew into a part
of the universe. This perspective changes resulted in a lot of thought back
to childhood, a period that was revised and understood in a new way Tornstam,
2005. Reminiscence therapy given significant influence in increasing
acceptance in the older people, but increase self-acceptance in the older
people is also affected by age, length of stay, and an environment that is not
observed in this study.
Kelompok kontrol yang tidak mendapatkan terapi kenangan, sebagian
besar responden lanjut usia mengalami social support is one of the factors that
influence the high and low levels of psychological well being of individuals,
with self-acceptance is one dimension of psychological well being. Observation
and extracting information to clients that support this theory is the data obtained
that the respondent 9 during the study period was very pleased with the visit of
the students, the respondent 9 can talk and express their feelings to the students
companion, every day someone accompany, as a granddaughter.
The participation of students peningkatan
penerimaan diri, dan practice that can not be controlled
terdapat satu responden lanjut usia yang mengalami peningkatan penerimaan diri
yang signifikan, yaitu pada kategori cukup meningkat menjadi kategori baik,
yaitu pada satu responden 7,1. Peningkatan tertinggi terdapat pada
responden 9, yaitu dari penerimaan diri kategori cukup menjadi penerimaan diri
kategori baik.
The control group that did not receive therapy memories, most
optimally in this study, because the study period coincides with the time
gerontik nursing practice students from several institutions. It is also consistent
with research Masyithah 2012 who said that there is a significant
relationship between self-acceptance and social support for patients with post-
stroke. The data obtained from the study in the control group showed that the
cause of the increase in the older people
respondents increased self-acceptance, acceptance in Jombang
institution and there is an respondents who
experienced a significant increase self- acceptance, which is in the category
increased to a category quite well, which is on one of the respondents 7.1 .
The highest increase contained in the respondent 9, which is quite a category
of self-acceptance into either category of self-acceptance.
Respondent 9, aged to 75 years, widow, and the length of stay in Jombang
institution is 3 years. Observed during the research activities underway indicate
that the respondents in the control group who did not receive therapy during the
study period memorable stay abreast of daily activities in Jombang institution. In
the second week, the student practices of some institutions do gerontik nursing
practice, and the existence of these students can not be controlled optimally
in this study. Ryff 1989 says that
538 influenced by social support factors that
are not observed in this study. Results of the assessment of self-
acceptance differences in Jombang institution between the treatment group
and the control group can be seen in the following table:
Tabel 3 Assessment of self-acceptance differences in Jombang institution between the
treatment group and the control group in April-May 2015
Self acceptance
Pretest Postest
Treatment group
Control group Treatment
group Control
group
Mean
± SD 32,14±2,742
34,07±3,832 50,14±4,258
37,36±3,003
Mean difference
1,93 12,78
t test independent Mann whitney
p=0,139 p=0,000
Results of self-acceptance older people in the treatment group and the
control group before being implemented reminiscence therapy indicate that the
level of self-acceptance older people between the treatment group and the
control group was no difference value of acceptance between the two groups
before being implemented reminiscence therapy, showed the data homogeneous,
and among the treatment group and the control group there was no difference
between the two background prior to the reminiscence therapy. Strict control is
needed on research, because many factors can affect self-acceptance in the
oder people, such as self-understanding, realistic expectations, the absence of
environmental barriers, social behavior accordingly, the absence of emotional
group and the control group after reminiscence therapy showed that there
are differences in the value of self- acceptance significant between
treatment groups who received reminiscence therapy and a control
group that did not receive reminiscence therapy. Moral et al 2013, explained
that the therapy has positive effect in improving the psychological well being
of older people in the post-test and follow-up, with acceptance of ourselves
as one dimension of psychological well being. Acceptance of self-assessment
results indicate conformity with the results of previous studies showing that
reminiscence therapy can increase self- acceptance in the older people.
Results of the assessment of self- acceptance in Geriatric of Puhjarak
stress, memories of success, good self- Community Health Center
in the identification good, self perspective,
parenting good childhood, and self- concept steady Hurlock, 1974.
treatment group and the control group before and after reminiscence therapy on
can be seen in the following table: Results of the assessment of self-
acceptance elderly in the treatment
Tabel 4. Assessment of self-acceptance older people in Geriatric of Puhjarak Community
Health Center in the treatment group and the control group before and after reminscence therapy of the April-May 2015
Self acceptance Treatment group
Control group
Pretest Posttest
Pretest Posttest
f f
f f
Well Enough
Less Jumlah
14 14
100 100
12 2
14 85,7
14,3 100
13 1
14 92,9
7,1 100
13 1
14 92,9
7,1 100
Mean±
SD 36,21±3,867
49,71±5,980 34,29±3,361
34,29±3,292
Mean difference Wilcoxon signed
13,5 p=0,001
p=1,000
rank test
539
Results of the assessment of self- acceptance in Geriatric of Puhjarak
that can affect the older people self- acceptance. The process towards
Community Health Center in the
gerotransenden hampered or stopped, treatment group before and after the
implementation of the reminiscence therapy showed that there is a significant
can cause psychiatric symptoms including depression, anxiety, fear of
death, hate and a feeling that life has increase in self-acceptance
after been stolen, that for some people
reminiscence therapy. Reminiscence therapy of an activity that aims to learn
about theirselves, in the perspective of gerotransenden aims to develop,
reorganize, change of identity, and perception of the world Tornstam,
1999b.
Results of the assessment of self- acceptance in Geriatric of Puhjarak
commit suicide is the final breakout Jung in Tornstam, 2011.
Results of observations during the study showed that all respondents were
keen to follow the activities of the 14 respondents, all of them participated in
the presence of 100. All respondents recount memories of the good old days
with an enthusiastic from the start of
Community Health Center in the
operations until the activity is over, even treatment group before and after the
implementation of the reminiscence therapy showed that there is a significant
respondent 9, 10, and 13 show the objects memories of the past that still
exist, such as the gramophone, tools increase in self-acceptance
after knitting and embroidery equipment.
reminiscence therapy. Reminiscence therapy of an activity that aims to learn
about yourself, in the perspective of Results of the evaluation showed
activity of all respondents score more than 3 per session, which indicates that
gerotransenden aims to develop,
in following the activities, the reorganize, change of identity, and
perception of the world Tornstam, 1999b.
Increased self-acceptance in the treatment group is not maximized, there
are two respondents increased acceptance, but did not arrive at either
category, despite an increase in the value of self-acceptance, that the respondents
11 and 14. Respondent 11, 62 years old, a widow, and a long follow Geriatric of
Puhjarak Community Health Center is 1 year. Respondent 11 said that the time of
her life in old age, respondent 11 was not able to enjoy her old age in peace,
because they still have to take care of her grandchildren were entrusted by his
respondents can be followed with enthusiasm and complete in accordance
with SAK. Respondents 4, 6, and 13 said that
the memory of the good old days to make happy, accept aging as an
advantage that can motivate to live better longer. This is consistent with
previous studies that show that reminiscence therapy significantly
improved psychological well being in the treatment group compared with the
control group Jo Chiang et al., 2009. Reminiscence therapy given significant
influence in increasing acceptance in the older people, but increase self-
acceptance in the older people is also
parents who worked as Labor Indonesia, influenced
by the activities and when returning home, a job taking care
of grandchildren is always wait. Respondent 14 was 60 years old,
married, long followed Geriatric of Puhjarak Community Health Center is 3
years, said that in her old age still have to support themselves busy, although her
husband also worked odd jobs.
Kalimaftika Saifuddin 2013 stated that the activity increases fatigue
540 environments that can not be strictly
controlled in this study. Results of the assessment of self-
acceptance in Geriatric of Puhjarak Community Health Center in the control
group during the pretest and posttest showed that the respondents level of
self-acceptance still remains as the pretest, which means there is increasing
acceptance during the pretest and
posttest. This means that the background in the treatment group and the control
group before implementation psychological well being, that self-
acceptance is one of the dimensions after treatment reminiscence therapy
reminiscence therapy is the same Afonso et al., 2011. Meiner and
background. Observed during the study
showed that the respondents in the control group perform daily activities as
usual, and actively participates in older people in Geriatric of Puhjarak
Community Health Center every month. Low self-acceptance in the older people
if left untreated will cause a negative impact, as expressed by Kalimaftika
Saifuddin 2013, that self-acceptance older people is low will correlate with
high rates of depression in the older people. Older people who have low self-
acceptance will easily fall in depression conditions and limitations due to the
aging process can not be minimized.
Results of the assessment of self- acceptance older people in the treatment
group and the control group before the reminiscence therapy showed that there
was no difference in the value of acceptance between the two groups
before treatment reminiscence therapy. Strict control is needed on research,
because many factors can affect self- acceptance in the older people, such as
Lueckenotte 2006 describes the therapeutic use of memories with the
motivation and discussion on the older people about past experiences that
experienced and problem solving efforts undertaken at the time, so as to develop
the identity and rationality elderly. Effect of reminiscence therapy of the
most significant role in increasing self- acceptance in the older people.
Results of the assessment of self-acceptance differences in Geriatric
of Puhjarak Community Health Center between the treatment group and the
control group can be seen in the following table:
self-understanding, realistic
expectations, the absence of environmental barriers, social behavior
accordingly, the absence of emotional stress, memories of success, self-
identification good, self perspective, parenting good childhood, and self-
concept steady Hurlock, 1974.
Results of the assessment of self-acceptance older people in the
treatment group and the control group after therapy performed a memorable
show differences in the value of self- acceptance significant between
treatment groups
who received reminiscence therapy and a control
group that did not receive reminiscence therapy. This is consistent with previous
studies, that there is an increased
541
Tabel 5. Assessment of self-acceptance older people in Geriatric of Puhjarak Community Health Center between the treatment group and the control group after reminiscence
therapy of the April-May 2015
Self acceptance
Pretest Postest
Treatment group
Control group Treatment
group Control
group
Mean
± SD 36,21±3,867
34,29±3,361 49,71±5,980
34,29±3,292
Mean difference Mann whitney
1,92 p=0,226
15,42 p=0,000
is support from the surrounding Results of the assessment of
environment. Memories in the self-acceptance
differences in the gerotransendence perspective seen as an
control group aged between Jombang institution and Geriatric of Puhjarak
Community Health Center at the time of the posttest show that there are
differences in the value of self- acceptance among older people control
group. Such differences may be caused by environmental factors that may affect
the acceptance of older memories that are present in addition to therapy when
the study took place, and less can be controlled optimally.
The existence of students as one of social support can affect self-acceptance
elderly, this is in accordance with the statement of Hjelle and Ziegler 1981,
that acceptance would be better if there important element in the development
process of the older people, because contribute in developing an identity and
a sense of reality through memories. Gerotransenden processes associated
with age, but in fact, this process can hampered by various things, such as
expectations restrained, life crisis, grief, and the environment. The results
showed that the effect of therapy remains the most significant
reminiscence therapy in increasing self- acceptance older people, because they
can be trained themselves independently by the respondents without having to
wait another supporting role.
CONCLUSIONS RECOMMENDATION
Conclusions AND
Implementation of reminiscence therapy can improve the acceptance of
older people in the treatment group compared to the control group in
Jombang institution and Geriatric of Puhjarak Community Health Center. In
the control group there was an increase in Jombang institution self-acceptance
because of the lack of strict controls on the environment during the process of
the study. Self-acceptance older people in Jombang institution and Geriatric of
Puhjarak Community Health Center between the treatment group and the
control group before implementation reminiscence therapy showed
homogeneous values. Memories as an important element in the development
542 process of the older people in
developing identity and a sense of reality. Implementation of reminiscence
therapy in improving self-acceptance in the older people through
gerotransendence theoretical approaches do not all give good results, but is also
influenced by the history of life, including life crisis, grief, and
environment should help understand and provide coherence of life. Comparison
of self-acceptance older people in the treatment group in Jombang institution
and Geriatric of Puhjarak Community Health Center provide equally good
effect in improving self-acceptance older people. The value of self-
acceptance that differ between the older
people control group in Jombang institution and Geriatric of Puhjarak
Community Health Center posttest when
Recommendation
Jombang institution as the residence of the older people and
Geriatric of Puhjarak Community Health Center as implementing health care for
the older people is expected to use the reminiscence therapy as a way to
increase self-acceptance in the older people.
Nurses can use the reminiscence therapy to improve self-acceptance in the older
people so that limitations due to aging can be minimized.
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Vol 42, 166± 177
546
THE EFFECTS ATTITUDE EXERCISE GIVEN TO DECREASE ANXIETY TO TEACHERS
TO CHILD THE FIRST TIME SCHOOL Widhi Sumirat
Akademi Keperawatan pamenang The success of educating in socialization can be seen from the ability of the individual to adapt oneself
to various situations. This research is experimental study with
pretest-posttest control group design
. Giving attitudional guidance to children when they interact with the teacher using
positive conditioning
was aimed at lowering children‟s anxiety. The data was collected using questionnaire and observation, in order to obtain data connected to the characteristic of the children, school components,
and anxiety indicators towards the teacher. The sample used in this study are all the population which comprised of 16 children, divided randomly into the experimental group consisted of 8 children, and
the control group also with 8 children. The result of the analysis showed that the decrease of anxiety towards the teacher in experimental group was higher than that of the control group. Conclusion,
giving attitudional guidance to children with anxiety towards the teacher could lower the children‟s anxiety
Keywords: attitudional guidance, anxiety towards the teacher, children on their first day at school
INTRODUCTION
Socialization is the process whereby an individual‟s standards, skills, motives,
attitudes and behaviors are shaped to conform to those regarded as desirable and appropriate for
his or her present or future role in society. when interacting with teachers, is expected to
reduce his anxiety.
METHOD
The study design was experimental with a Socialization process of education takes place
pretest-posttest control group design. The
throughout ones life through a learning process that guided and supervised. The learning process
can take place within the family through the role of parenting and school environment through
teaching and mentoring role of teacher. The success of the educational process of
socialization can be seen from a persons ability to make adjustments yourself. One common
problem that parents often complained about the ability of self-adjustment of the first children to
school is school refusal with anxiety when in a school environment.
The results of preliminary studies conducted in March 2011 in the working area of preschool
education in kindergartens and elementary UPTD Wates Subdistrict average anxiety
problems were recorded from 30 children 13.3, which is 3.3 of children with anxiety
when interacting with teachers. Handling is done in this case school teachers to the childs anxiety
problems, has not been well standardized. Provision of training with a positive attitude
conditioning in children who experience anxiety
542 exercise is an independent variable and attitude
toward teachers anxiety as the dependent variable. Engineering data collection using
questionnaires and observation, which aimed to obtain data related to child characteristics,
components and indicators of school anxiety about the teacher. The sample used in this study
using the entire population of 16 children, which were randomly divided into study group and
control group of 8 children 8 children. The results were analyzed using descriptive analysis.
Exercise attitude given to children for two weeks with three times the assessment of indicators of
anxiety about the teacher that is before treatment, 1 week after treatment and 2 weeks
after treatment. Assessment conducted on the study group by providing a positive sign on the
indicators of anxiety to the childs teacher can be maintained for 5 minutes and then also the child
is given food or a toy he likes, while the control group given no training but observation of
indicators of anxiety attitude toward teachers is still being done with the assessment the same
study group. Score assessment of indicators of
N o
Responden t’s Father
Characteri stics
Group Total
Study n=8
Control n=8
1 Age year
20 – 25
00 00
00
26 – 30
00 00
00
31 – 35
666,7 333,3
9100
36 – 40
228,6 571,4
7100 2
Education grade
Elementary 120
480 5100
First secondary
school 375
125 4100
High secandary
school 457,1
342,9 7100
University 00
00 00
3 Work
Status Work
750 750
14100
None
150 150
2100 4
Income million
None 150
150 2100
1 00
2100 2100
1 758,3
541,7 12100
N o
Respondent Characteris
tics Group
Total Study
n=8 Control
n=8 1
Age year
6 250
250 4100
≥ 6
650 650 12100
2 Gender
Male 650
650 12100
Female 250
250 4100
3 Birth
Grade
Single child 337,5 562,5 8100 Eldest child 1100
00 1100
Middle child
1100 00
1100
Youngest child
350 350
6100
anxiety about the teacher who determined if the child is able to retain four 4 attitudes toward
teachers anxiety decreased until the end of the study assessed children do not worry, children
are able to maintain a three 3 attitudes toward teachers anxiety decreased until the end of the
study assessed the child mild anxiety, children are able to maintain one or two half attitude
decreased anxiety for teachers until the end of the study assessed the child and the childs
anxiety was not able to maintain four 4 attitudes toward teachers anxiety decreased until
the end of the study assessed the child serious anxiety.
RESULT AND DISCUSS Result
Table. 1 Respondent Characteristics in Study
Table. 2 Respondent’s Father Characteristics in Study Group and
Control of Preschool Education in Kindergartens and Elementary UPTD
Wates Subdistrict, June 2011
Group and Control of
Preschool Education in Kindergartens and
Elementary UPTD Wates Subdistrict June 2011
Characteristics of respondent‟s father in the study group and the control group of Preschool
Education in Kindergartens and Elementary UPTD Wates Subdistrict, are in the age range
31-35 years, high secondary school, work, and income more than 1 million.
Characteristics of respondent in the study group and the control group of Preschool
Education in Kindergartens and Elementary UPTD Wates Subdistrict, are in the age range is
more and equal to six years, male, and birth grade of single child.
543
No Respondent’s
Mother Characteristics
Group Total
Study n=8
control n=8
1 Age year
20 – 25
1 100
1 100
26 – 30
2 100
2 100
31 – 35
5 38,5
8 61,5
13 100
36 – 40
00 00
00 2
Education grade
Elementary 1
33,3 2
66,7 3
100
First secondary school
1 25
3 75
4 100
High secandary school
562,5 3
37,5 8
100
University 1
100 1
100 3
Work Status
Working 350
3 50
6 100
None
550 5
50 10
100 4
Income million
None
550 550
10100
1
1 33,3
2 66,7
3 100
1
2 66,7
1 33,3
3 100
N o
N Levels of
Anxiety After 2 Weeks Treatment
Study n=8
Control n=8
N N
1 None
2 Mild
Anxiety 1
12,5 3
Moderate Anxiety
7 87,5
7 87,5
4 Severe
Anxiety 1
12,5 N
o N
Levels of Anxiety
After 1 Week Treatment Study
n=8 Control
n=8 N
N 1
None 2
Mild Anxiety
3 Moderate
Anxiety 8
100 5
62,5 4
Severe Anxiety
3 37,5
o n=8
n=8 N
N 1
None 2
Mild Anxiety
3 Moderate
Anxiety
4 Severe
Anxiety 8
100 8
100
N NLevels of
Anxiety Before Treament
Study Control
Table. 3 Respondent’s Mother Characteristics in Study Group and
Control of Preschool Education in Kindergartens and Elementary UPTD
Wates Subdistrict, June 2011
Assessment of the level of anxiety towards the teacher in study group and control before
treatment are in the level of severe anxiety.
Table. 5 Assesment of Level Anxiety Towards The Teacher in Study Group
and Control After 1 Week Treatment
Assessment of the level of anxiety towards the teacher in study group and control after 1
week treatment, study group are in the level of moderate anxiety level, and control group 5
62.5 are in moderate level and 3 37.5 are in severe anxiety.
Table. 6 Assesment of Level Anxciety Towards The Teacher in Study Group
Characteristics of respondent‟s mother in the study group and the control group of Preschool
Education in Kindergartens and Elementary UPTD Wates Subdistrict, are in the age range
31-35 years, high secondary school, not work, and no have own income.
Table. 4 Assesment of Level Anxiety Towards The Teacher in Study Group
and Control Before Treatment
544
and Control After 2 Weeks Treatment
N o
Level N
s of Anxi
ety Before
After 1 Week
Treatment After
2 Weeks Treatment
Stud y
Cont rol
Stud y
Cont rol
Stud y
Contro l
Sc or
e N Sc
or e
N Sc or
e N Sc
or e
N Sc or
e N Sc
or e
N 1 None
0 0 0 0
0 0 0 0
0 0
2 Mild Anxi
ety 0 0
0 0 0 0
0 1 1 0
3 Mode rate
Anxi ety
0 0 0 23 8 15 5 15 7 18 7
4 Sever e
Anxi ety
32 8 32 8 0
0 12 3 0 0 4
1
Median 4
8 4 8 3
8 3 8 2
8 3 8
N o
Leve N
ls of Anxi
ety Before
After Treatment 1
Week After
Treatment 2 Week
Stud i
Kont rol
Studi Kontr
ol Studi
Kontr ol
N N N N N
N 1 Non
e
0 0 0 0
0 0 0 0
0 0 0 0
2 Mild Anxi
ety 0 0
0 0 0 0
0 0 1 12
,5 0 0
3 Mod erat
e Anxi
ety 0 0
0 0 8 10
5 62 ,5
7 87 ,5
7 87,5
4 Seve re
Anxi ety
8 10 8 10
0 0 3 37
,5 0 0
1 12,5
Study Group Age year
Total 6
≥ 6 Levels of
Anxiety After 2
Weeks Treatme
nt None
00 00
00 Mild
Anxiety 00
1100 1
100 Moderate
Anxiety 2
28,6 5
71,4
7 100
Severe Anxiety
00 00
00 Total
2 25
6 75
8 100
Control Group Age year
Total 6
≥ 6 Levels of
None 0 0
0 0 0 0
Assessment of the level of anxiety towards the teacher in study group and control after 2
weeks treatment, study group 1 12.5 are in level mild anxiety and 7 87 , 5 are in
Table. 8 Median Score of Level Anxciety Towards The Teacher in Study Group
and Control Before, After 1 and 2 Weeks Treatment
moderate anxiety, and control group 7 87.5 are in moderate anxiety , 1 12.5 in severe
anxiety.
Table. 7 Level Anxiety Towards The Teacher in Study Group and Control
Before, After 1 dan 2 Week Treatments
Median score of level anxiety towards the teachers in the study group and the control group
before treatmeant is 4. Median score of level anxiety towards the
teachers in the study group and the control group after 1 week treatmeant is 3.
Assessment of the level of anxiety towards the teacher in study group before treatment are
in the level of severe anxiety, after 1 week treatment are in the level of moderate anxiety
level, and after 2 weeks treatment 1 12.5 are in level mild anxiety and 7 87 , 5 are in
moderate anxiety
Assessment of the level of anxiety towards the teacher in control group before treatment are
in the level of severe anxiety, after 1 week treatment 5 62.5 are in moderate anxiety
and 3 37.5 are in severe anxiety, and after 2 weeks treatment 7 87.5 are in moderate
anxiety , 1 12.5 in severe anxiety.
545 Median score of level anxiety towards the
teachers after 2 weeks treatment, in the study group is 2, and control group is 3.
Table. 9 Assesment of Children’s Age in Study Group and Control Between Anxiety
Towards The Teacher After 2 Weeks Treatment, June 2011
Study Group Birth Grade
Total Singl
e Eldes
t Midl
le Youn
gest Total
Level s of
Anxi ety
After 2
Week s
Treat ment
None Mild
Anxi ety
1 100
1 100
Mode rate
Anxi ety
3 42,8
1 14,3
1 14,3
2 28,6
7 100
Sever e
Anxi ety
Total 337,
5 112,
5 112,
5 337,
5 8100
Control Group
Birth Grade Total
Singl e
Eldes t
Mid dle
Youn gest
Level s of
Anxi ety
After 2
Week s
Treat ment
None Mild
Anxi ety
Mode rate
Anxi ety
4 57,1
3 42,9
7 100
Sever e
Anxi ety
1 14,3
1 100
Total 562,
5 00
00 337,
5 8100
Study Group Gender
Total Male
Female Levels
of Anxiet
y After 2
Weeks Treat
ment None
00 00
00 Mild
Anxiety 1100
00 1
100 Moderat
e Anxiety
5 71,4
2 28,6
7 100
Severe Anxiety
00 00
Total 6 75
2 25 8
100 Control Group
Gender Total
Male Female
Levels of
Anxiet y After
2 Weeks
Treat ment
None
00 00
00 Mild
Anxiety 00
00
00 Moderat
e Anxiety
5 71,4
2 28,6
7 100
Severe Anxiety
1100 00
1100 Total
6 75
2 25 8
100 Anxiety
After 2 Weeks
Treatme nt
Mild Anxiety
0 0 0 0
Moderate Anxiety
228,6 5
71,4
7 100
Severe Anxiety
0 0 1100
1 100
Total 2 25
6 75 8
100
Table. 11 Assesment of Children’s Birth Grade in Study Group and Control Between
Anxiety Towards The Teacher After 2 Weeks Treatment, June 2011
Assesment of children‟s age in study group and the control between anxiety towards the
teacher after 2 weeks treatment, is levels of anxiety happening of children less than 6 years
of age is 28.6 , smaller than the above age children and equal to 6 years 71.4 .
Table. 10 Assesment of Children’s Gender in Study Group and Control Between Anxiety
Towards The Teacher After 2 Weeks Treatment, June 2011
Assesment of children‟s birth grade in study group and the control between anxiety towards
the teacher after 2 weeks treatment, is levels of anxiety going on greater than of single child and
Assesment of children‟s gender in study group and the control between anxiety towards
the teacher after 2 weeks treatment, is levels of anxiety is happening in male 71.4 , higher
than female 28.6 .
546 a youngest is almost three times compared to the
eldest and middle child.
Study Group Parent’s Income
million Total
Father None
≤ 1 1
Levels of
Anxiety After 2
Weeks Treatm
ent None
Mild Anxiet
y 1100
1100 Moder
ate Anxiet
y 1
14.3 1
14.3 5
71,4
7 100
Severe Anxiet
y
Total 1
12,5 1
12,5 6
75 8
100
Control Group Parent’s Income
million Total
Father None
≤ 1 1
Levels of
Anxiety After 2
Weeks Treatm
ent None
0 0
Mild Anxiet
y 0 0
Moder ate
Anxiet y
1 14.3
2 28,6
4 57,1
7 100
Severe Anxiet
y 1
100
1 100
Total 1
12,5 2
25 5
62,5 8
100 Study Group
Parent’s Income million Total
Mother None
≤ 1 1
Level s of
Anxi ety
After 2
Week s
Treat ment
None 00
0 0 0 0
Mild Anxiet
y 1
14,3 0 0
1 100
Moder ate
Anxiet y
457,1 1
14,3 2
28,6
7 100
Severe Anxiet
y 00
0 0 0 0
Total 562,5
1 12,5
2 25
8 100
Control Group Parent’s Income million
Total Mother
None ≤ 1
1 Level
s of Anxi
ety After
2 Week
s Treat
ment None
0 0 0 0
Mild Anxiet
y 0 0
0 0
Moder ate
Anxiet y
5 71,4
2 28,6
0 0 7
100 Severe
Anxiet y
1 100
1 100
Total 562,5
225 112,5
8100
Table. 12 Assesment of Father’s Income in Study Group and Control Between Anxiety
Towards The Teacher After 2 Weeks Treatment, June 2011
Assesment of father‟s income in study group and the control between anxiety towards the
teacher after 2 weeks treatment, is levels of anxiety happening to fathers who earn more than
1 million more than who earn less than and equal to 1 million and none .
547
Table. 13 Assesment of Mother’s Income in
Study Group and Control Between Anxiety Towards The Teacher After 2 Weeks
Treatment, June 2011
Assesment of mother‟s income in study group and the control between anxiety towards
the teacher after 2 weeks treatment, is levels of anxiety happening of mother no income greater
than who earn more than 1 million and nearly three times the mothers who earn less than and
equal to 1 million.
Discuss 1. Analysis Decrease Levels of Anxiety
Toward The Teachers Results of the assesment of levels anxiety
towards the teachers to child the first time school before and after 1 and 2 weeks treatment,
showed that decrease anxiety scores towards the teachers.
Anxiety to child at the school occured, because of the attitude and behaviors of teachers
less friendly, unfriendly and incompetent Astuti et al, 2010. According to Hurlock 2006, fear
or anxiety to child may be influenced by the intelligence, gender, socioeconomic status,
physical condition, social relationships, birth grade and personality. Negative perceptions to
pre-school child has it happened because the development of cognitive, social, emotional and
moral child not develop optimally, then habituation positive through exercise posture by
giving food or toys are preferred, and in accordance with the childs development, can
reduce attitudes and beliefs of children not good. Freud; in Singgih and Yulia 2003.
Decrease of levels anxiety towards the teachers in the study group occurred because of
the effect attitude exercise, that is positive conditioning to reduce the situation is less fun
and also a process of maturation, while decrease of levels anxiety towards teachers in the control
group occurred as a result of maturation of child and also through the process of imitating or
equate themselves with friends.
Age characteristics of child influence to develop intellectual, so that child can ability to
perceive a stimulus that is received will be carefully and appropriately. Perception child
positive, and a less pleasant experience which can lead to anxiety.
Gender characteristics of child influence to interests and values, in which the interest and
value of boys is higher than women. Birth grade characteristics of child influence
to social and emotional develop. Characteristics of parents, influence to the
role and to take care of the child. Anxiety towards the teacher to child the first time school,
because age of parents in the range of young adult, and elementary education. Thats can
influence to the understand and ability to take care of the child. Parents does not meet the
principles of mental health, less aware of their responsibilities and domestic tranquility can not
be realized, while the father has not been wise.
Anxiety towards the teacher to child the first time school, because the competence of teachers
not good. According Singgih and Yulia 2008, the teacher is the central figure at the school
environment, and guide who learn of the develop personality. The successful achievement
of tasks and obligations lies in the relationship
548 that is conducive that could be created with full
communication of affection, respect, sincerity and the warmth of the teacher to the child.
Favorable relations requires the ability to understand the students, the culture, and the
corresponding value of child development. 2. Analysis The Effects Attitude Exercise
Given To Decrease Anxiety To The Teachers To Child The First Time School
Results of the assesment of median scores in the study group and the control group after 1 and
2 weeks of treatment, showed that difference. Decrease median scores in both groups after 1
week of treatment, and after 2 weeks of treatment of control group did not experience a
decrease in median scores. Decrease of median score that is indicate to given attitude exercise
for 2 weeks have an effect of levels anxiety towards teachers to child the first time school.
According to Hurlock 2006, emotional development of child depends on factors
ripening maturation and learning factors, of which the most important of the two is a factor
of learning because it can be controlled. Process Childrens learning process can be through trial
and error, imitating, likening herself, conditioning and training. Hurlock 2006 also
says that child really like the safe environment that is conducive. This environment can be
created through the control of the environment by making the experience unpleasant emotions
reward.
Exercise attitude is very helpful to reduce the anxiety towards the teacher to child the first
school. Children initially had trouble adjusting in school or have a less pleasant experience
when interacting with teachers, there will be insecurity, lack of confidence and calm.
CONCLUSION AND RECOMENDED Conclusion
1. Results of the assesment of levels anxiety towards the teachers to child the first time
school before and after 1 and 2 weeks treatment, showed that decrease anxiety
scores towards the teachers. Decrease of levels anxiety towards the teachers in the
study group occurred because of the effect attitude exercise, that is positive
conditioning to reduce the situation is less fun and also a process of maturation, while
decrease of levels anxiety towards teachers in the control group occurred as a result of
maturation of child and also through the
process of imitating or equate themselves with friends.
2. Results of the assesment of median scores in the study group and the control group after 1
and 2 weeks of treatment, showed that difference. Decrease median scores in both
groups after 1 week of treatment, and after 2 weeks of treatment of control group did not
experience a decrease in median scores. Decrease of median score that is indicate to
given attitude exercise for 2 weeks have an effect of levels anxiety towards teachers to
child the first time school. Exercise attitude is very helpful to reduce the anxiety towards the
teacher to child the first school. Children initially had trouble adjusting in school or
have a less pleasant experience when interacting with teachers, there will be
insecurity, lack of confidence and calm.
Recomended 1. Create a positive environment when dealing
with children with problems of adjustment at the begin of school, the first of at least 2
weeks 2. Do development and assessment of teacher
competence on a regular basis to stimulate increased understanding and ability of
teachers to master the competence.
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550
STIMULUS EFFECT CUTANEOUS SLOW-STROKE BACK MASSAGE TO INTENSITY OF PAIN HEAD IN ELDERLY WITH HYPERTENSION
Unit Pelayanan Terpadu PSLU Blitar, Tulungagung 2015 Sukanto
1
, Dinda Wahyuningtyas
2
STIKes Hutama Abdi Husada Tulungagung stikeshahtayahoo.co.id
Abtract
Hypertension is systolic blood pressure greater than or equal to 140 mmHg and diastolic blood pressure greater than or equal to 90 mmHg One of the risk factors that
lead to this unstability is aging process so that the primary clinical symptoms of headache. One of the non-pharmacological ways to cope with this pain is by applying
cutaneus stimulation with slow-stroke back massage method. The mechanism of cutaneous stimulation using the principle of gate control theory and the theory of
endorphins. The purpose of this study was to determine the effect of cutaneous stimulus Slow-Stroke Back Massage to the intensity of headache in the elderly with
hypertension. The design used is to one group pretest-posttest. The research began February 23
th
until March 7
th
, 2015. The sample of this study were elderly people aged 55 to 80 years using purposive sampling technique were 30 elderly. The data collected by
observation. The results of the 30 respondents before given stimulus cutaneous mostly experienced moderate pain is there are 21 70 of respondents, and after given stimulus
cutaneus a small portion experienced mild pain is there are 7 23.3 of respondents.
According of Wilcoxon Signed Rank test that p value 0.000 α 0.05, then H is
rejected and H
1
accepted that there is effect of cutaneous stimulus Slow-Stroke Back Massage to the intensity of headache in the elderly with hypertension.This research
showed that administration of cutaneous stimulusis very effective in order to reduce the intensity of headache. Then of the cutaneous stimulus slow-stroke back massage can be
used as an alternative option toreduce the intensity ofheadachein patients with hypertension.
Keywords : Slow-Stroke Back Massage, Headache Intensity,Hypertension, Elderly
PRELIMINARY Indonesia will experience an increase in
the number of elderly population the 21st century. High increase in the
number of elderly who have the potential to cause various problems both
from the aspect of social, economic, cultural, and health Nugroho, 2000.
Health problems of aging occur on referred to as The Silent Disease or
hidden disease. Hartono, 2012. WHO World Health
Organization said that cardiovascular disease is the largest cause of death in
the population aged 65 years or older with more number of deaths in
developing countries. Based on the data Lancet 2008, the number of
various body systems such as
hypertensive patients world wide
hypertension. Hypertension is one of the most deadly diseases in the world,
because the disease can cause complications such as heart failure and
stroke. Hypertension is a condition in which a persons blood pressure to rise
which systolic blood pressure diastolic exceeds 14090 mmHg. It is often
563 continues to increase. In India, the
number of hypertensive patients reached 60.4 million people in 2002 and an
estimated 107.3 million people in 2025. In China, 98.5 million people have
hypertension and increased to 151.7 million in 2025. In the the other in Asia,
there were 38.4 million people with
hypertension in 2000 and is predicted to be 67.4 million people in 2025. Data
patients with hypertension in Indonesia reach 17-21 of the population and
mostly undetected. In general, more women than men suffer from
hypertension. It is closely related to diet, especially salt intake, which is generally
higher Muhamaddun, 2010.
Based on the results of a preliminary study conducted by
researchers at UPT PSLU Blitar, obtained the data in October 2014 there
experienced endless Potter Perry, 2005.
Based on the above phenomenon, researchers are interested to knowing
and proving there any influence cutaneous stimulus Slow-Stroke Back
Massage to the intensity of headache in the elderly with hypertension in UPT
PSLU Blitar in Tulungagung 2015.
RESEARCH METHODS The design study is using a one-group
pre-post test design. characteristic of this are many elderly
suffer from type of research is the use of a causal
hypertension. For the last 2 months there are 56,25 as many as 45 elderly people
who suffer from hypertension of the total elderly. While the prevalence of
hypertensive patients who experience headaches as many as 30 elderly ie
37.5 of the elderly who are 80 elderly. UPT PSLU Blitar in Tulungagung,
2014.
The impact of hypertension that relationship by engaging a group of
subjects. Group of subjects was observed before the intervention, and
then observed again after the intervention Nursalam, 2003.
The population in this study were all elderly with hypertension in
UPT PSLU Blitar in Tulungagung as many as 45 elderly. In this study sample
used mostly elderly people who suffer
can lead closed
blood vessels from hypertension with headache in
vasoconstriction, there by resulting in a decrease in cardiac output. If there is a
decrease in cardiac output, the tissues of the body will experience a shortage of
UPT PSLU Blitar in Tulungagung that meet the criteria desired by the
researchers, the number of respondents are 30 people.
nutrients and O2. As cardiac In collecting data is used
compensation will increase to meet the needs of network contraction resulting in
increased hydrostatic pressure of the blood vessels. Stiffness and increased
hydrostatic pressure causes the lowest threshold of pain the brain blood vessels
easily touched hit, and the sensation of head pain will be felt hypertension.
According Marlia 2009 general treatment of hypertension that is
pharmacological and non- pharmacological. One of the actions
complementary or non-farmacologist in reduce symptoms of hypertension like
help to reduce the perception of pain or provide comfort in nursing is the
Massage and touch sensory integration techniques that affect the activity of the
autonomic nervous system Potter and observation and interview for measuring
instrument research. This experiment was held on
February 23 until March 7, 2015 in Unit Pelayanan Terpadu PSLU Blitar in
Tulungagung. In analyzing the effect of the
stimulus effect of cutaneous Slow- Stroke Back Massage to the intensity of
headache in the elderly with hypertension in UPT PSLU Blitar in
Tulungagung 2015, using the Wilcoxon Signed Rank test statistic Tes.Bila p
value 0.05 was said to be significant, the hypothesis 0 Ho is rejected, then
H1 accepted meaning stated there Effect of stimulus effect of cutaneous Slow-
Stroke Back Massage to the intensity of headache in the elderly with
Perry, 2006. Relaxation
is very
hypertension, while p value ≥ 0.05, important to helps clients to improve
comfort and free themselves from the hypothesis is accepted and H1 rejected,
which means no cutaneous stimulus fear and the stress of illness and pain
564 effect Effect Slow-Stroke
Back
Massage to the intensity of headache in moderate pain
is 7
23.3 of
the elderly with hypertension.
RESULTS 1. Initensity Head Pain Before Awarded
respondents.
3. The Result of statistical test From the data obtained, the next test
statistics using the Wilcoxon Sign Rank Stimulus cutaneous
Back Massage. Slow-Stroke
T-test and showed sig. 2-tailed less than 5 p = 0.000
= 0.05, thus the results obtained H0 rejected and H1
Table 1. Distribution of frequency accepted meaning
there is effect,
intensity characteristic of the headache before it is given stimulus cutaneous
slow-stroke back massage in UPT PSLU Blitar in Tulungagung on 23
February -7 March 2015. cutaneous stimulus effect Slow-Stroke
Back Massage to the intensity of headache in the elderly with
hypertension in UPT PSLU Blitar in Tulungagung.
No. Categori
Frequen Prosenta
es cy
se DISCUSSION
1 2
No pain Less pain
9 30
A. The results Head Pain Intensity Stimulus Before Giving cutaneous
3 Moderate
21 70
Stimulus Slow-Stroke
Back
pain Massage
4 Hard pain
Jumlah 30
100
From table 1 the data obtained that before given stimulus cutaneous slow-
Source : Penelitian tahun, 2015
Table 1 above shows that out of 30 respondents largely there are 21
experiencing moderate pain 70 of respondents.
2. Head Pain Intensity Stimulus Provided After cutaneous Slow-
Stroke Back Massage. Table 2. Distribution of frequency
characteristics of headache intensity after cutaneous stimulus is given slow-
stroke back massage in UPT PSLU Blitar in Tulungagung on 23 February -7
March 2015. stroke back massage, of 30 respondents
mostly experienced moderate pain that is there are 21 70 of respondents, 9
30 of respondents experienced mild pain and 0 0 respondents did not
complain of the pain.
Pain is everything that someone says about the pain and occurs whenever
someone has told that he felt pain Potter and Perry, 2005, so that each individual
will perceive pain in different ways depending on other factors that affect
pain such as experience past, anxiety, culture, age, the placebo effect Smeltzer
Bare, 2008 and the meaning of pain and coping style Potter Perry, 2006
No.
1 2
3
Categories
No pain Less pain
Moderate
Freque ncy
5 18
7
Prosentase
16,7 60
23,3 and also factors of disease.
Based on the above theory and fact, researchers believe that pain is a natural
response of the body to respond to the presence of an abnormality in the body
pain system. This happens because the
4 Hard pain
response to pain that is felt by each of
Jumlah 30
Source : Penelitian ta hun, 2015
100
the indivitu vary depending on factors other causes such as age, anxiety,
culture, the placebo effect, the meaning Table 2 above shows that of the
30 respondents, some small experience
565 of pain and coping styles. Response to
pain that is felt by the client begins with a decrease in the bodys organ systems,
especially that of blood vessels that can lead to atherosclerosis, resulting in a
decrease in cardiac output may increase the hydrostatic pressure of the blood
vessels arises sensation of pain. The individual response to pain through three
phases: activation starts when the first individual receiving pain stimuli to the
body reacts to pain include muscular and emotional responses. The second stage
is the stage of reflection, at this stage the pain that arises very great but brief. And
the third stage is the stage adaptation, if pain lasts longer then the body will
adapt to a pain, so that individual responses to pain vary. It was also
evident from the research data that showed that before being given
cutaneous stimulus of 11 respondents aged 75-90 years old, all experienced
moderate pain that is there are 11 100 of the respondents, and of the 19
respondents who suffer from mild hypertension, almost all of which pain
was that there were 17 89.5 of respondents.
B. The results Head Pain Intensity Stimulus After Giving cutaneous
the attributes certainly the experience of pain is that pain is an individual Potter
Perry, 2003 so the response that occurs after treatment can not be
compared with others. Mechanisms of pain reduction can be explained by the
gate control theory, the pain intensity lowered by blocking the transmission of
pain at the gate gate, and the endorphin theory, namely the decrease in pain
intensity was influenced by increased levels of endorphins in the body. With
stimulus cutaneous slow-stroke back massage, can stimulate the fibers A beta
are numerous in the skin and responds to a light massage on the skin so that the
impulse delivered more quickly. This makes the stimulation comes from the
dominant impulse input A beta fibers so that the gate closes and pain impulses
can not be transmitted to the cerebral cortex to be interpreted as pain. In
addition, the descending control system will also react by releasing
endorphinyang is the bodys natural morphine that block pain transmission
and perception of pain does not occur Potter Perry, 2005. Cutaneous
stimulus correct use can reduce the
Stimulus Massage
Slow-Stroke Back
perception of pain and helps reduce muscle tension that can increase pain,
decreased pain intensity, anxiety, blood Cutaneous stimulus slow-stroke back
massage for 10 minutes on the subject of the study show the results as listed in
Table 2, which shows that of the 30 respondents, some small experience
moderate pain there are 7 23.3 of respondents, 18 60 of respondents
experienced mild pain and 5 16.7 of respondents did not complain of pain.
According to the theory explained that pain is a condition such as an
unpleasant feeling, is very subjective because the feeling of pain is different
for each person in terms of scale or the level, and only the person who can
explain or evaluate the pain they experienced Alimul, 2006. Decrease in
pain intensity value of each individual is different even though the stimulus that
causes pain and was given the same treatment. It is associated with one of
566 pressure, and heart rate were
significantly Mook E, 2003 Referring to the theory and the above
facts the researchers found the presence of nursing actions such as the provision
of cutaneous stimulus slow-stroke back massage for 10 minutes on the subject
of the research, the intensity of the headache that is felt client can be
decreased. This occurs because of the influence of the fibers A that can block
the transmission of pain impulses and also the presence of endorphins which
are natural morphine in the body so it can reduce the intensity of the headache
that is felt by the client. It was also supported by research data shows that
before being given cutaneous stimulus of 11 respondents aged 75-90 years old,
all experienced moderate pain that is there are 11 100 of the respondents
and after a given stimulus cutaneous nearly half experience moderate pain
that is there are 5 45.5. And of the 19 respondents who suffer from mild
hypertension, almost entirely experiencing moderate pain that there
were 17 89.5 of the respondents and after a given stimulus cutaneous nearly
half experience moderate pain that is there were 5 26.3
C. The results of the analysis of cutaneous Stimulus Effect Slow-
Stroke Back Massage Against Pain Intensity Head On Elderly
with Hypertension
Based on the results of statistical tests Wilcoxon Sign RankT-
testdengan α = 0.05 was obtained p value = 0.000. Thus
the p value 0.000 α 0.05, then Ho is rejected. From the analysis above, it can
be concluded that the stimulus cutaneous slow-stroke back massage has an
influence on the intensity of headache in the elderly with hypertension.
According to the theory, explained that the sympathetic nervous
system stimulates the blood vessels in response to emotional stimuli. The
adrenal glands also stimulated, resulting in additional activity vasoconstriction.
The adrenal medulla secretes atherosclerosis, loss of elasticity of the
connective tissue and a decrease in vascular smooth muscle relaxation,
which in turn lowers the ability of distension and tensile strength of blood
vessels. Consequently, the aorta and large arteries diminished ability to
accommodate the volume of blood pumped by the heart stroke volume,
resulting in decreased cardiac output and increased peripheral resistance
Rohaendi, 2008. Increased pressure may touch peripheral blood vessels
around it so sensation the pain felt by the individual. Management of non-
pharmacological measures can be taken to reduce the intensity of headache is the
stimulus cutaneous slow-stroke back massage. Mechanism of this technique
is with gate control theory, the pain intensity lowered by blocking the
transmission of pain at the gate gate, and the endorphin theory, namely the
decrease in pain intensity was influenced by increased levels of endorphins in the
body. With stimulus cutaneous slow- stroke back massage, can stimulate the
fibers A beta are numerous in the skin and responds to a light massage on the
skin so that the impulse delivered more quickly. This makes the stimulation
comes from the dominant impulse input A beta fibers so that the gate closes and
epinephrine causes vasoconstriction.
pain impulses can not be transmitted to The adrenal cortex to secrete cortisol
and other steroids, which can strengthen the vasoconstrictor response of blood
vessels. Vasoconstriction leading to decreased blood flow to the kidneys,
causing release of renin. Renin stimulate the formation of angiotensin II, a
vasokonstriktorkuat, which in turn stimulate the secretion of aldosterone by
the adrenal cortex. This hormone causes the retention of sodium and water by the
kidney tubules, causing an increase in intravascular volume, all these factors
tend to trigger a state of hypertension. For consideration gerontology,
functional and structural changes in the peripheral vascular system responsible
for blood pressure changes that occur in the elderly. These changes include
567 the cerebral cortex to be interpreted as
pain. In addition, the descending control system will also react by releasing
endorphins which are the bodys natural morphine that block pain transmission
and perception of pain does not occur Potter Perry, 2005.
Based on theory and the facts above, the researchers argue that the
stimulus cutaneous the elderly who experience headache very effective in
order to reduce the intensity of the headache that is felt client, it looks at the
differences in the intensity of headache in the elderly with hypertension before
and after stimulus cutaneous slow- sroke back massage. This stimulus can
dilate blood vessels, muscles become relaxed, can stimulate the fibers A and
stimulate endorphin pengeuaran of the body so as to block the transmission of
impulses to be transmitted to the brain cerebral cortex. It was also reinforced
by research data from Sumartini and Grhasta Dian Perestroika which showed
that this stimulus can reduce pain intensity and can also stimulate the
hormone endorphin which Brazilians of morphine naturally from the body, so the
pain that arises can be neutralized resulting in a decrease in the intensity
experienced by individuals. It was also proved by the research data shows that
before being given stimulus cutaneous hipertensi PSLU Tulungagung Blitar
2015.
SUGGESTION 1. For Developers Sciences
Nursing education institutions should equip students with knowledge of
non-pharmacological treatment in the elderly who suffer from hypertension
with symptoms of headache, which later can be equipped nurses in
applying science and knowledge to the people, especially the elderly.
2. For Developers Program The result is expected as fill material
majority of respondents experiencing for both increased
insight and moderate pain that is there are 21 70
of respondents, and after a given stimulus cutaneous small proportion of
respondents experienced moderate pain that is there are 7 23.3 of
respondents , And from a small portion of respondents who experienced a mild
pain that is there are 9 30 of respondents, having given no cutaneous
stimulus large majority of respondents who experienced a mild pain that is
there 60 of respondents. Thereby providing a stimulus cutaneous slow-
stroke back massage can be used as an alternative option to reduce the intensity
of headache in the elderly with hypertension in non pharmacological
relatively no side effects.
CONCLUSIONS AND SUGGESTIONS
CONCLUSION
Based on the results of the study the influence of stimulus cutaneous
Slow-Stroke Back Massage to the intensity of headache in the elderly with
hypertension in UPT PSLU Blitar in Tulungagung, 2015 can concluded from
30 respondents with analyzed by using statistical test of Wilcoxon Signed
Ranks Test with a value of ρ = 0.000, meaning that ρ α = 0.05, so that H0
rejected H1 accepted and that means the stimulus effect of cutaneous Slow-
Stroke Back Massage to the intensity of headache in the elderly with UPT
568 knowledge and skills nursing in
increasing knowledge about how to lose headache in the elderly, efforts
are made to improve education and health promotion activities to the
public.
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