Kekambuhan pada klien skizofrenia perlu mendapat perhatian khusus karena menunjukkan angka yang tinggi serta memberikan dampak yang buruk terhadap klien dan keluarga. Tujuan penelitian untuk mengetahui pengaruh tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga terhadap pencegahan faktor risiko kekambuhan klien perilaku kekerasan dan halusinasi di rumah sakit jiwa. Desain yang digunakan dalam penelitian ini adalah quasi experimental pre-post test with control group. Pengambilan sampel menggunakan teknik purposive sampling dengan jumlah sampel 61 klien dan keluarga yang dibagi menjadi 2 kelompok. Kelompok intervensi 1 berjumlah 31 klien dan keluarga diberikan tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga, sedangkan kelompok intervensi 2 berjumlah 30 klien dan dikeluarga diberikan tindakan keperawatan ners. Pengumpulan data menggunakan kuesioner dan lembar observasi kemudian dianalisis secara univariat dan bivariat. Analisis univariat menggunakan distribusi frekuensi dan tendensi sentral. Analisis bivariat menggunakan uji dependent t-test, independent t-test, dan korelasi pearson untuk data yang berdistribusi normal sedangkan untuk data yang berdistribusi tidak normal menggunakan uji wilcoxon, mann-whitney test, dan korelasi rank spearman. Hasil penelitian menunjukkan peningkatan kemampuan klien dan keluarga mencegah kekambuhan serta penurunan tanda dan gejala perilaku kekerasan dan halusinasi pada kelompok yang mendapatkan tindakan keperawatan ners, cognitive behaviour therapy, dan psikoedukasi keluarga lebih besar secara bermakna dibandingkan kelompok yang mendapatkan tindakan keperawatan ners saja (p value < 0,05). Tindakan keperawatan ners direkomendasikan dilakukan oleh perawat generalis serta cognitive behaviour therapy dan psikoedukasi keluarga direkomendasikan dilakukan oleh perawat spesialis jiwa di rumah sakit jawa dalam mencegah faktor risiko kekambuhan klien skizofrenia dengan diagnosis keperawatan perilaku kekerasan dan halusinasi.
Relapse in schizophrenia clients needs to get special attention, because it shows high numbers and has a negative impact on clients and their families. The purpose of research was to determine the effects of standard nursing intervention, cognitive behavioural therapy, and family psychoeducation on preventing the risk factors of relapse among client with violent behaviour and hallucinations in mental health hospital. The design used in this study was a quasi experimental pre-post test with control group. Sampling used purposive sampling technique with 61 clients and their families divided into 2 groups. The intervention group 1 consisted of 31 clients and their families were given standard nursing intervention, cognitive behavioural therapy, and family psychoeducation, while the intervention group 2 consisted of 30 clients and their families were given standard nursing intervention. Data were collected using questionnaires observation sheets then analyzed by univariate and bivariate. Univariate analysis used frequency distribution and tendency central. Bivariate analysis used dependent t-test, independent t-test, and pearson correlation for normally distributed data, while for data that was not normally distributed using wilcoxon, mann-whitney test, dan rank spearman correlation. The results showed that an increased in ability of clients and their families to prevent relapses, and the decreased in signs and symptoms of violent behaviour and hallucinations in the group that received standard nursing intervention, cognitive behavioural therapy, and family psychoeducation was significantly greater than the group that only received general nursing intervention (p value < 0,05). Standard nursing intervention are recommended performed by generalist nurses, while cognitive behavioural therapy and family psychoeducation performed by mental nurses specialist in mental health hospital to prevent relapses risk factors of schizophrenic clients with nursing diagnosis of violent behaviour and hallucinations. |
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