∑ 15
100
No Pain 13,3
No Analgesic
f Dull Pain
33,3 66,7
Consumption Moderate
60 20
1 Yes
Pain 2
No
∑
15 15
100 100
Severe Pain Very Severe
6,7
Wilcoxon signed rank test
: p value =
B. SPECIFIC DATA Table 2 Distribution of the frequency of
menstrual pain scale disminorea primary girls before being given a warm compress
on the boarding school in the village Jatinom Maftahul Uluum Kanigoro
District of Blitar on 30 July to 5 August 2015 in which n = 15
0,004
DISCUSSION
Based on the results of research conducted in accordance table 4.7 in
boarding school in the village Jatinom Maftahul Uluum Kanigoro District of
No 1
Pain Scale No Pain
f Blitar, showed that 15 respondents got the
whole 100 of the respondents of young 2
Dull Pain 5
33,3 women experience menstrual
pain 3
4 5
Moderate Pain Severe Pain
Very Severe 9
1 60
6,7 disminorea primary with nearly half
33.3 , in the mild pain scale before being given a warm compress, most 60
Pain on the pain scale was before warm
∑ 15
100 compresses, and a small portion 6.7 in
severe pain scale before warm compresses. Table 3 Distribution of the frequency of
menstrual pain scale disminorea primary girls after being given a warm compress
on the boarding school in the village Jatinom Maftahul Uluum Kanigoro
Intensity of pain was an idea of how severe the pain felt by the individual,
very subjective measurements of pain intensity. The possibility of the same
intensity perceived very differently by two
District of Blitar on 30 July to 5 August different people. This situation was
2015 in which n = 15. influenced by various factors, such as age,
No Pain Scale
f sex, socio-cultural
background, 1
2 3
4 5
No Pain Dull Pain
Moderate Pain Severe Pain
Very Severe 2
10 3
13,3 66,7
20 environment and experience Andarmoyo,
2013. Based on the research results
according to table 4.1 showed that majority 60 of respondents of young
Pain women aged 16-19 years and almost all
∑ 15
100 93.3 of respondents are studying high
school. Age and education greatly affects a Table 4 Comparison of the frequency
distribution scale menstrual pain dysmenorrhoea primary girls before and
after being given a warm compress on the boarding school in the village Jatinom
Maftahul Uluum Kanigoro District of Blitar on 30 July to 5 August 2015 in
which n = 15
Pain Scale Scale Scale Before After
Warm Warm Compresses Compresses
825 persons pain scale because it affects the
readiness of respondents in facing menstruation and disturbances that arise.
Readiness itself more associated with psychological factors. Pain can be caused
or aggravated by psychological state. Often after marriage disminorea lost and
rarely settled after childbirth Judha, et al. 2012.
By the age of 16-19 years old and studying high school student are teenagers
who should already have sufficient
experience and information about
being given a warm from 60 to 20. menstrual pain disminorea during
menstruation every month, but in reality only silence young women just because
they know they are experiencing menstrual pain only lasts short only 1-2 days during
menstruation. Because painful menstruation disminorea primer happens
on the first day or before the first day of menstruation due to the emphasis on the
cervical canal cervical and will usually Then, the increase in scale of menstrual
pain dysmenorrhoea primer on mild pain scale from 33.3 to 66.7 and no pain on
a scale from 0 to 13.3. This shows a decrease of pain scale from hingh to low.
Based on statistical test Wlicoxon Signed Rank Test was obtained p value = 0.004,
so the p value = 0,004 α = 0.05, indicating the effect of a warm compress
to decrease menstrual pain
disappear over the next day of
dysmenorrhoea primer in adolescent menstruation Judha, dkk.2012 . While
nearly all 86.7 of women respondents have menstrual period on day 1-2 and all
100 of the respondents not take anti- pain analgesic or do an alternative way to
help cope with menstrual pain disminorea they experienced. This may because of
lack of information on reproductive health, especially on painful menstruation
disminorea primer which almost all 80 of respondents have never heard or
received information about menstrual pain girls. Warm compress is a method that can
reduce pain when dismenorea come. Thus these actions are expected to the young
women to make them not to leave school activities and other activities due to
menstrual pain experienced disminorea primer so that the activities can be run
well.
CONCLUSION The research and data analysis had
following results: disminorea primer along with ways to
overcome the pain. Based on the results of research
conducted according to table 4.8 in the boarding school in the village Jatinom
Maftahul Uluum Kanigoro District of Blitar, that of the 15 girls gained a small
portion 20 on a scale of moderate pain, the majority 66.7 of respondents girls
on mild pain scale, and little else 13.3 on a scale of no pain after being given a
warm compress. Warm compress is to give a sense of warmth to patients to reduce
pain by using a liquid that serves to dilate a.
b.
c. Painful menstruation dysmenorrhea
Before being given a warm compress nearly half 60 on a scale of
moderate pain, almost half 33.3 on a scale of mild pain and a small
portion 6.7 in severe pain scale. b. Menstrual pain dysmenorrhoea
primer in young women after giving a warm compress get large proportion
66.7 on a scale of mild pain, a small portion 20 on a scale of
moderate pain, and little else 13.3 on the scale painless.
In accordance with data analysis
blood vessels and increase local blood flow, and reduce muscle tension. Whereas
during menstruation endometrial cells release the hormone prostaglandin F2
alpha which may increase the amplitude and frequency of uterine contractions and
lower abdominal cramps Bobak, 2005.
Not only decrease the pain, warm using statistical test of Wilcoxon
Signed Rank test showed p value: 0,004, where it was demonstrated that
administration of warm compresses affect the decreasing primer painful
menstruation dismenorea.
ACKNOWLEDGEMENT
The limitations of this study are compress can also stimulate the brain to
researchers could
not definitively
release endorphins that cause respondents experienced a sense of comfort when
determine a persons pain because pain is subjective. In addition, the classification of
given a warm compress. Based on the primary and secondary
dismenorhea results of the study showed a decrease in
the percentage scale menstrual pain dysmenorrhoea primer before and after
826 require further medical examination.
REFERENCES
Andarmoyo, Sulistyo. 2013.
Konsep Proses Keperawatan Nyeri
. Yogyakarta: ar-ruzz media.
Anurogo, dito. 2011.
Cara jitu mengatasi nyeri haid
. Yogyakarta: ANDI Bobak. 2005.
Buku Ajar Keperawatan Maternitas Edisi 4
. Jakarta : EGC Judha, dkk. 2012.
Teori Pengukuran Nyeri Nyeri Persalinan.
Yogyakarta: Nuha Medika.
Wiknjosastro, Hanifa. 2005
. Ilmu Kandungan
. Jakarta : Yayasan Bina Pustaka Sarwono Prawirohardjo.
827
THE EFFECT OF STIMULATION THERAPY GROUP ACTIVITIES PERCEPTION ON THE LEVEL OF DEPRESSION IN THE ELDERLY
IN PAMOTAN SAMBENG LAMONGAN Siti Sholikah
Stikes Muhammadiyah Lamongan Email: Sholikhahsiti292yahoo.co.id
Abstract
Depresion is a mood disorder characterized by feelings of sadness excessive empty feeling worthless, hopeless, feels like a failure until three is the idea of suicide. The purpose of rescarh
to identify the influence rescarh before and after therapy perceptions stimulation group activity level of depression in the elderly. Rescarh design uses pre-experimental methods to design a
pretest-posttest group in which no comparison group control. A sample of 45 patients who met the inclusion criteria with a random sampling technique. This analysis rescarh using testing
techniques and data collection Mc Nemar with orientation task Activity Group Therapy TAK Perception of stimulation and Observation Sheet. The results of this Rescarh is depressed
patients were given the activity level of group therapy most 45 patients 25 individuals 56.8 could to decrease depression. So based on the calculation results obtained p = 0.000 p 0.05,
the HO is rejected and H1 accepted many significant effects on the administration of TAK perception stimulation level of depression in the elderly in rural area Pamotan Sambeng
Lamongan Regency. The rresults are expected to provide awareness of the benefits of group therapy activities for health care, educational institutions and other research.
Keyword :Stimulation Therapy Group Activities, Depression, Elderly.
1. Introduction
factors, 2 predisposes factors, it means Mental health is a balanced state of a
persons soul, which he could organize and execute its function in society.
Quantification of people tendency of the increasing of mental disorders causes for
concern. Almost 50 of Indonesian experiences mental disorders Siti Saidah
2007. Mental health disorder is a public and social health problem in the world that
increases from year to year. Nearly 1 of Indonesian suffers from psychotic during
their lives Sulistyowati, 2007.
Slamet 2007 stated that the cause of the abnormal behaviour and mental
disorders are not that simple, but it is related to the complexity of personality
development. Mental disorders generally have many causes multicasual and related
to what existed before the disorder appears in some cases, such as 1 heredity, people
with heredity of mental disorder experience higher tendency to suffer this illness than
people who do not have a hereditary
851 factors behind people experiencing a mental
disorder so that they become more easier to get mentally ill because since they were
born or during their growth, their personality and their coping mechanism is
not optimal, 3 Sensitivity and fragility factors, these factors are the result of the
interaction between the heredity factors and the influences of environment toward them.
Innate factors can be biological and hereditary.
According to the WHO in 2000, approximately 450 million adults of the
worlds population are mentally ill. According to data from the health
department in 2009, the number of people with mental disorders in Indonesia currently
reaches more than 28 million people with 11.6 categorized into mild mental
disorder and 0.46 categorized into severe mental disorder.
The process of aging is a process of the disappearance of tissues‟ ability to
reproducereplace their selves and maintain their normal function, with the increasing of
life expectancy certainly has an impact of declining their function of elderly. That
decreasing of their function can lead to heshe has a high risk of suffering from
depression too because of the genes passed down from parents to their children Mc
Kenzie, 1999. 2 Chemical structure of the brain and body, those hold a big role in
many problems in the elderly, such as lack controlling
one‟s emotions. On the
of support and role of the family. Those will be able to aggravate the problems of
the elderly enabling to lead to the depression Nugroho, 2007.
According to the World Health Organization WHO, it estimates that the
depression prevalence of elderly in the world ranges from around 8-15. The
result of meta-analysis of countries in the world, elderly that get depression
prevalence is 13.5 with a ratio of women and men 14.1: 8.6 and elderly who get
depression prevalence undergoing treatment is approximately 30-45.
Depression is a mood disorder indicated by excessive feelings of sadness,
melancholy, feeling worthlessness, feeling empty, hopeless, and feeling failed all the
depressed people, it is found that there were changes in the chemical structure Kompas,
2008. 3 Age, youth and adolescents may experience depression more Wilikson,
1995. 4 Gender, women are twice more often experiencing depression if compared
to men, it is because women get difficulties to communicate their problems to others
pease, 2001. 5 Lifestyle, many bad habits and unhealthy lifestyle can lead to many
kinds of diseases where those diseases can trigger anxiety and even depression
Hendrananata, 2004. On the other hand, psychological factors that affect depression
are: 1 Personality, one personality who tends to have negative thoughts and
pessimistic personality types experiences introvert depression Retnowati, 2000. 2
Mindset, someone who has negative view
time till having idea of committing suicide toward themselves vulnerable to
get Joseph, 2007
Based on the central Bureau of Statistics BPS East Java, the number of
elderly aged 60 years in the year of 2007 is 4.209.817 people consisting 1.811.995 men
and 2.397.882 women. Population census in the year of 2013 shows that the number of
depression Mc William, 2008. 3 Self- esteem, low self-esteem can lead to
depression Maslow, 2008. 4 Stress, losing someone who you love so much can
trigger recurrent stress which can cause depression Mackenzie, 1999.
From all factors mentioned above, elderly aged 60 years is 141.373 people,
family support becomes the most
while based on an initial survey done by the researchers on 4 October 2014 in Pamotan,
Sambeng, Lamongan, there are 50 elderly in that village, 10 of them are given
questions using the Geriatric Depression scale Yesavage short form obtained six
60 of people showing the symptoms of moderate depression, and 4 40 of them
experiencing mild depression. From the initial survey, the researchers can find the
problem that there are still many elderly who experience moderate depression in
Pamotan, Sambeng, Lamongan.
Factors that can affect depression include Physical and Psychological Factors.
Physical factors consist of: 1 Genetic factors, these factors described that if one‟s
family is suffering from severe depression,
852 important factor that plays salient role on
the depression level of elderly. Poor family claimed elderly as the cause of the
problem resulting in rejection, while the elderly actually are very dependent on
their family so that when they do not get support from their family it can affect the
psychological conditions of elderly.
Depression according to PPDG- 111 2001 is divided into three levels,
namely mild depression, moderate depression and severe depression. The
difference between the three of those depressions lies in the complex that
includes the number, shape and severity of symptoms found.
No Gender Frequency Percentage
1 Male
27 61,4
2 Female
17 38,6
Total 44
100 Depression of elderly is mainly
caused by feelings of sadness, helplessness and pessimism, which is associated with
an affliction that can be an attack shown to yourself or a deep feeling Nugroho,
2008. The management of nursing with depression can be provided with a
therapeutic modality that one of them is Therapeutic Activity Group Group
Activity Therapy TAK.
Group activity therapy is very effective to change behavior because in a
group there will be interaction of one to each other that can affect them. In the
group will form a social system interaction to each other and become a place to the
is pre-test as the first observation which allows researchers to examine the changes
that occur after the experiment Soekidjo Notoatmojo, 2010.
Population in this research is 50 elderly, while the sample is partially
patients‟ post laparotomy operation who met the inclusion criteria with a number of
45 elderly. Independent variabel of this research is the perception stimulation group
activity therapy, while the dependent variable is the depression level of elderly.
The data collection used observation sheet and the analysis of this study used Mc
Nemar test.
client to practice new adaptive behaviors to improve long maladaptive behavior
Christopher, 2007. TAK is divided
3. The Result of the Study
a. General Data
according to the clients nursing problems, one of them is TAK Perception
Stimulation. TAK Perception Stimulation is perception stimulation group activity
therapy that uses the activity, perceives a variety of stimuli associated with the
experience or life to be discussed in the group. The results of group discussions
can be either an agreement or a perception of alternative problem solving Keliat,
2006.
Based on the description above, the researchers are interested in doing this
research to determine the extent of the 1. Characteristics by Gender
Table 1 The Characteristics Frequency
Distribution of Patients Experiencing Increased
Level of Depression based on their Gender in Pamotan,
Sambeng, Lamongan on February 2015
perception stimulation group activity
therapy‟s effect of elderly depressed levels, in order to assist clients in handling
health problems faced through the implementation of nursing care in the form
of Group Activity Therapy TAK.
The purpose of this research is to analyze the influence of group activity therapy of
perception stimulation on the depression level in the elderly in Pamotan, Sambeng,
Lamongan. Table 4.1 explains that most of patients
that experience increased level of depression are male with a number of 27
patients 61.4 and female patients experiencing increased level of depression
are 17 38.6.
2. Characteristics by Age
Table 2 The Characteristics Frequency 2.
Research Method Distribution of Patients
The research design used in this study is pre experiment using one group
design pretest-posttest. In this design, there is no comparison group controls, but there
853 Experiencing Increased Level of
Depression based on their Age in Pamotan, Sambeng,
Lamongan on February 2015.
No Education Frequency Percentage
1 Kinder-
garten 10
22,7 2
Elementary School
31 70,5
3 Junior High
School 3
6,8 4
Senior High School
Total 44
100 No Age
Frequency Percentage 1
60-74 y.o. 16
36,4 2
75-90 y.o. 14
31,8 3
90 y.o. 14
31,8 Total
44 100
No Marital Status
Frequency Percentage 1
Married 27
61,4 2
Widower 17
36,6 Total
44 100
No Religion Frequency Percentage
1 Moslem
44 100
Total 44
100 Experiencing Increased Level of
Depression Based on Religion in Pamotan, Sambeng, Lamongan
on February 2015.
Table 2 explains that most of patients experiencing increased level of depression
are them who are in the age of 60-74 years with a number of patients are 16 people
36.4 and them who are in the age of 75- 90 years with a number of patients are 14
people 31.8.
3. Characteristics by Education Table 4 shows that almost entirely Moslem
patients with increased level of depression with a number of 44 patients 100.
5. Characteristics by Marital Status
Table 5 The Characteristics Frequency
Distribution of Patients Experiencing Increased Level of
Table 3 The Characteristics Frequency
Depression Based on Their
Distribution of Patients Marital
Status in Pamotan, Experiencing Increased Level of
Sambeng, Lamongan on February Depression Based on
Their 2015.
Latest Education in Pamotan, Sambeng,
Lamongan on
February 2015.
Table 5 shows that most of the patients getting increased level of depression are
they who were married with a number of 27 patients 61.4 and 17 other patients
36.6 were widower.
b. Special Data
1. Patients who get increased level of depression in pamotan, sambeng,
Table 3 shows that the majority of patients with increased level of depression are
patients from Elementary school with a number of 31 patients 70.5, and patients
from Junior high school with a number of 3 lamongan before giving TAK perception
stimulation session I identification positive things on themselves.
Table 6 The Distribution of Depression
Level before Giving Activity patients 6.8 .
Group Therapy Session I
Identification Positive Things on themselves
in Pamotan,
4. Characteristics by Religion Sambeng,
Lamongan on
Table 4 The Characteristics Frequency
Distribution of Patients
854 February 2015.
