Budi Anna Keliat

The influence of metacognitive training on delusion severity and metacognitive ability in schizophrenia

ACCESSIBLE SUMMARY Individualized metacognitive training is an effective therapy for reducing delusion severity and at the same time increasing metacognitive ability. Correlations emerged between delusion severity and metacognitive ability was needed to be established. Current research findings on cognitive biases and their link to schizophrenia/delusions are explained in a comprehensible and non-stigmatizing manner to patients and illustrated by multiple (everyday life) examples. The article is a report of a study conducted to explore the influence of individualized metacognitive therapy (MCT) on delusional severity and metacognitive ability. Delusional beliefs are at the core of schizophrenia. While there is emerging evidence on the usefulness treatment for psychosis of the group training MCT, so far only one study has investigated the effectiveness of individualized metacognitive training. A quasi experimental approach was adopted: The sample consisted of each 26 patients in the intervention group and in the control group. We found that delusion severity as assessed with the Psychosis Rating Scales and metacognitive abilities using the Metacognitive Ability Questionnaire improved significantly in the intervention group. Group differences achieved significance in favour of the MCT for all measures. Correlations that emerged between delusion severity and metacognitive ability were needed to be established. Metacognitive training appears to be effective in decreasing delusion severity and increasing metacognitive ability. We recommend that individualized MCT for a schizophrenic client should become a standard procedure in the treatment of psychosis, which can be administered by a qualified nurse.

Assertive training and family psychological education therapy on adolescents self-esteem in prevention of drug use in boarding school

Adolescents are prone to use drugs when they have low self-esteem. Assertiveness training and family psychological education therapies are mental health nursing specialist interventions that are expected to increase adolescent self esteem so that adolescent has ability to prevent drug use. This study aims to determine the effect of assertiveness training and family psychological education therapy on adolescent self-esteem in the prevention of drug use in boarding schools. The research design was a quasi-experimental pre-post test with a control group. Sixty four adolescent students at the boarding school were selected using purposive sampling technique and cluster random sampling. The intervention group 1 only received general nursing intervention and the intervention group 2 received general nursing intervention, assertiveness training, and family psychological education therapy. The results showed that the self-esteem of adolescent students increased significantly after receiving nursing intervention and in the high self-esteem category (p = 0.017), after assertiveness training and family psychological education therapy, adolescent self-esteem in the intervention group 2 increased greater than only general nursing intervention ( P = 0, 000) with the high self-esteem category. There is the influence of assertiveness training and family psychological education therapy on adolescent self-esteem in prevention of drugs uses in a boarding school. Community health center is recommended to do nursing care in school through school health unit program either by primary care nurse or nurse specialist of mental health nursing.

Implementing an innovative intervention to increase research capacity for enhancing early psychosis care in Indonesia

WHAT IS KNOWN ON THE TOPIC?: In low- and middle-income settings (LMICs) such as Indonesia, the burden from psychotic illness is significant due to large gaps in treatment provision Mental health workers and community nurses are a growing workforce requiring new evidence to support practice and enhanced roles and advanced competencies among UK mental health nurses also requires greater research capacity Research capacity building projects can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. WHAT THIS PAPER ADDS?: Delivering innovative, cross-cultural workshops to enhance research capacity to multidisciplinary, early career researchers in Indonesia and the UK are rated highly by attendees Supporting people in this way helps them to gain competitive grant funding to complete their own research which can improve the health of the population To our knowledge, there are no other studies reporting the attainment of grant income as a successful outcome of international research partnerships for mental health nursing so our finding is novel. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This method could be implemented to improve networking and collaboration between UK academics and early career researchers in other lower- and middle-income settings This strategy can also strengthen existing partnerships among early career researchers in the UK to meet the demands for greater research mentorship and leadership among mental health nurses and enhance nurses capabilities to contribute to evidence for practice. ABSTRACT Aim To strengthen research capacity for nurses and early career researchers in Indonesia and the UK to develop a local evidence base in Indonesia to inform policy and improve the nations health. These strategies can strengthen research institutions, enhance trial capacity, improve quality standards and improve attitudes towards the importance of health research. Methods Four days of workshops were held in Jakarta, Indonesia developing collaborative groups of academic nurses and early career researchers from the UK and Indonesia (30 people including mentors) to produce competitive grant bids to evaluate aspects of early psychosis care. Qualitative and quantitative evaluations were conducted. Results Participants evaluated the workshops positively finding benefit in the structure, content and delivery. Research impact was shown by attaining several successful small and large grants and developing offshoot collaborative relationships. Discussion These novel findings demonstrate that collaborative workshops can strengthen research capacity by developing partnerships and instigating new collaborations and networks. No other studies of international research partnerships among mental health nurses have reported this outcome to our knowledge. Implications for Practice This method could be implemented to improve networking and collaboration between UK academics and early career researchers and also with external colleagues in other LMICs.

Cognitive Behavioral and Family Psychoeducational Therapies for Adolescent Inmates Experiencing Anxiety in a Narcotics Correctional Facility

ABSTRACT Illicit substance use is becoming a major global issue. In Indonesia, inmates imprisoned for illicit substance offences accounted for 40% of the total inmate population. This study aimed to identify the effects of cognitive behavioral and family psychoeducational therapies on inmates’ anxiety in the narcotics correctional facility. Quasi-experimental pre-test–post-test with control group was employed in this study. Intervention Group 1 received a general nursing intervention whereas Intervention Group 2 received a combination of general nursing intervention with cognitive behavioral and family psychoeducational therapies. This study involved 31 inmates for each group. Data were collected using the Hamilton Anxiety Rating Scale (HAM-A) and were analyzed using repeated ANOVA and independent t-tests. The study demonstrated that anxiety was significantly lower among those who received the combination of those three therapies compared to those who received general nursing intervention standalone (p < .005). This study suggested the implementation of both general nursing intervention and specialty therapies, particularly cognitive behavioral and family psychoeducational therapies, to address the anxiety problems experienced by adolescent inmates suffering from illicit substance dependence.

Improving Quality of Life on Cancer Patient by Implementation of Psychosexual Health Care

Introduction: The contribution of nurses in improving the quality of life of patients with cancer has caused them to have needs of getting knowledge and skills to provide services on psychosexual health care. Training on psychosexual health care has been developed, implemented and given to oncology nurses in Indonesia in order to fulfill the needs so that the nurses are able to provide psychosexual health care to cancer survivors and their spouse. Method: The training utilized a method of preand post-test evaluation to identify outcomes including changes of evaluation scores of knowledge, belief, practice, and self-efficacy of trainees before and after receiving psychosexual health care training. Result: The training has been implemented on 46 oncology nurses in Indonesia so that they can have knowledge, practice, belief and self-efficacy in providing psychosexual health care to patients with cancer and their spouse. After training and mentorship had been provided, there were significant changes on knowledge, belief and self-efficacy in providing psychosexual health care services to patients with cancer and their spouse; however, there were no significant changes on practices. Discussion: The training has become a standard nursing care for cancer in Indonesia and has provided scientific evidences that nurses have contribution in improving quality of life of patients with cancer by providing a comprehensive nursing care through implementation of psychosexual health care in their daily nursing care for patients with cancer and their spouse.

EFEKTIVITAS RATIONAL EMOTIVE BEHAVIOUR THERAPY BERDASARKAN PROFILE MULTIMODAL THERAPY PADA KLIEN SKIZOFRENIA DENGAN MASALAH KEPERAWATAN PERILAKU KEKERASAN DI RUMAH SAKIT DR. H. MARZOEKI MAHDI BOGOR TAHUN 2012

Penelitian ini bertujuan untuk mengetahui efektivitas rational emotive behavior therapy (REBT) profil terapi multimodal berdasarkan perubahan gejala dan kemampuan perilaku kekerasan klien di RSMM Bogor. desain penelitian Quasi-eksperimental dengan sejumlah 56 responden. 28 responden harus mendapatkan Profil terapi multimodal Terapi REBT sebagai kelompok intervensi, 28 responden sebagai kelompok non intervensi. Penelitian ini menemukan penurunan gejala perilaku kekerasan yang lebih besar daripada tidak mendapatkan profil berdasarkan REBT terapi multimodal (p value <0,05). Kognitif, afektif klien dan perilaku yang mendapatkan REBT berdasarkan profil terapi multimodal meningkat secara signifikan (p value <0,05) hasil klien mengalami pengurangan gejala kekerasan perilaku 48%, secara efektif meningkatkan kognitif, afektif dan perilaku untuk 57%. Profil terapi multimodal direkomendasikan sebagai skrining klien akan diberikan pengobatan spesialis dalam rational emotive behavior therapy. Kata kunci : profil terapi multimodal, terapi perilaku rasional emotif, gejala perilaku kekerasan, kognitif, afektif, perilaku Pustaka 93 (1976-2011).

The Effectiveness of Nursing Care: Social Isolation Implementation in Mental PMHNPM to Patient’s Capability

Introduction: Nursing care: social isolation is one of the pillars in Professional Mental Health Nursing Practice Model (PMHNPM). This study was aimed to determine the relationship between the implementation of nursing care in PMHNPM with the ability of clients and families client’s. Methods: This study was used a correlational design with cross-sectional approach. Samples were associate nurse who already follow PMHNPM training 58 respondents, client with social isolation problem who hospitalized at RSJD Prov. Jambi 32 respondents, and client’s family 12 respondents. Independent variable was PMHNPM implementation by associate nurse, while dependent variables were the result of nursing care to client with social isolation problem and family. Data were collected by using questionnaire. Data were then analyzed by using frequency distribution for categoric data, central tendency for numeric data, and pearson correlation. Results: The results showen that nursing management capabilities signifi cantly associated (p < 0.05) with the client’s ability and the ability of the family. The ability of nurses in providing nursing care social isolation were signifi cantly associated (p < 0.05) with a decrease in signs and symptoms of client upgrades. Conclusion: Associate nurses ability on nursing care and PMHNPM implementation could reduce a signs and symptoms, improve an ability of the client and families client’s social isolation.

The Family Support for Schizophrenia Patients On Community a Case Study

One of the impact of stigmatization on mental disorder was the increasing of estimation number on community based psychiatric mental health restrictive in Indonesia from 2007 until 2012. The lack of family support cause improper care for schizophrenia patient. However, while there is evidence of family psycho-education in caring schizophrenias patient, there is limited understanding how the family support could give benefit for the schizophrenia recovery. The aim of this study was to qualitatively describe how was the family support for schizophrenia patients on community. Data were drawn from audio tapes, and conducted in-depth individual interviews with ten family whose schizophrenia patients member of family ever been hospitalized. The transcripts of family support were analyzed. A thematic analysis was conducted to identify what was occurring in the family support for caring schizophrenia on community. There were three descriptions of the family support which consisted of the compliance of antipsychotic administration, the better family understanding of caring schizophrenia, and the increasing quality life of schizophrenia patient. A family support appears to be useful in reducing the stigma on community. We recommend that family support should be increased so that the schizophrenia patient get better life on community.

Pengaruh Terapi Self-Help Groupterhadap Koping Keluarga dengan Anak Retardasi Mental

Keluarga dengan anak retardasi mental di Kabupaten Sumedang sekitar 10.898 orang dari 1.089.889 penduduk di Kabupaten Sumedang, dan yang tercatat di SLB-C se-Kabupaten Sumedang hanya 218 orang. Tujuan penelitian ini adalah untuk memperoleh gambaran tentang pengaruh pelaksanaan terapi self-help groupterhadap koping keluarga dengan anak retardasi mental di SLB-C Kabupaten Sumedang tahun 2009 sehingga dapat mengurangi faktor risiko terjadinya gangguan. Metode penelitian menggunakan quasi experimental pre-post test with control groupdengan intervensi self-help group. Cara pengambilan sampel menggunakan teknik purposive sampling dengan sampel sebanyak 22 keluarga. Alat pengumpulan data menggunakan kuesioner karekteristik keluarga dan kuesioner koping keluarga. Self-help group dilakukan pada dua kelompok, yaitu: kelompok I diberikan self-help groupdengan enam kali pertemuan (empat kali bimbingan dan dua kali mandiri) dan kelompok II tidak diberikan self-help group.Analisis data menggunakan univariat dengan menganalisis secara deskriptif dengan menghitung distribusi frekuensi dan tendensi sentral. Analisis bivariat menggunakan independent sample t-test, chi-square dan dependent sample t-test. Analisis multivariat menggunakan pearson product moment dan rank spearman. Hasil penelitian menunjukkan adanya peningkatan kemampuan koping setelah self-help group pada keluarga dengan anak retardasi mental secara bermakna dan terjadi perubahan dari koping maladaptive menjadi adaptive(nilai p=0.000). Pada kelompok yang hanya diberikan terapi generalis terjadi juga peningkatan kemampuan koping keluarga dengan anak retardasi mental, tetapi peningkatan tersebut masih berada di koping maladaptive. Direkomendasikan untuk membentuk kelompok self-help grouplainnya di lingkungan SLB-C. Kata kunci: Koping keluarga, retardasi mental, self-help group Abstract Family with children having mental retardation at Sumedang district are almost 10,898 childrenof 1,089,889 population and they are only 218 children which recorded at SLB-C at Sumedang district. The purpose of this study was to find descriptionof the effect of implementing self-help groups therapy toward coping family and children with mental retardation at SLB-C Sumedang district in 2009 and expected to decrease the risk factor of disturbance may occur. This study used quasi experimental pre-post test with control group by self help group intervention. The methode to pick up samples was purposive sampling, getting samples by 22 families. Data were collected using questionares of family characteristic and family coping. Self-help group has been done for two groups where the first group was given self-help group for six times of meeting (four times for guiding and two times for standing alone), while the second group was given self-help group. Data were analyzed using univariate method by calculating frequency distribution and central tendency. Bivariate analysis used independent sample t-test, chi-square and dependent sample t-test. Multivariate analysis used pearson product moment and rank spearman. Study result indicated improvement the abilities of coping family and children with mental retardation as means (pvalue = 0.000). It is recommended to build and implementing self-help group for family who had children with mental retardation. Key words:Coping family, mental retardation, self-help group

Peningkatan Kemampuan Kognitif dan Perilaku Pada Klien dengan Harga Diri Rendah Melalui Cognitive Behaviorur Therapy

Abstrak Seseorang yang mengalami skizoprenia sering diawali dengan masalah harga diri rendah dengan gejala: konsentrasi dan perhatian kurang, kepercayaan diri kurang, rasa bersalah, tidak berguna, pandangan masa depan yang suram dan pesimistis. Tujuan penelitian ini menilai efektivitas cognitive behaviour therapy ( CBT ) untuk meningkatkan kemampuan kognitif dan perilaku klien harga diri rendah. Metode penelitian: quasi eksperimen dengan penerapan cognitive behaviour therapy dengan pendekatan pre-post test. Analisis yang digunakan dependen dan independent sample t-Test, regresi linier sederhana, chi-square dan Anova. Penelitian dilakukan di salah satu RS Jiwa terhadap 58 klien yaitu 29 orang kelompok intervensi dan 29 orang kelompok kontrol. Hasil penelitian menunjukkan c ognitive behavior therapy meningkatkan kemampuan kognitif dan perilaku klien skizoprenia dengan harga diri rendah secara bermakna (p<0.05, α=0.05). Efektifitas CBT meningkatkan kemampuan kognitif sebesar 29,31% dan kemampuan perilaku sebesar 22,4%. Penelitian ini merekomendasikan CBT sebagai salah satu terapi spesialis pada klien skizoprenia dengan masalah harga diri rendah. Abstract Patient with schizophrenia in the beginning is experiencing low self esteem with the following symptoms: concentration difficulty, attention deficit, low self confident, guilty and worthless feelings, and pessimistic. Cognitive behavior therapy is the solutions to enhance cognitive ability as well as to treat behavior of patient with low self esteem. The research aims to study about the effectiveness of cognitive behavior therapy. Method of the research was quasi experiment with pre and post- tests design. The analysis of the research was dependent and independent sample t- test, simple linear regression, chi square, and anova. The research was conducted in mental health hospital with 58 respondents, divided into 29 respondents as intervention group and 29 respondents as control group. The research demonstrated that cognitive behavior therapy has significantly enhanced cognitive ability and treated behavior of patient with low self esteem (p<0.05, α=0.05). The research shown the effectiveness to enhance cognitive ability about 29.31 percent, while the effectiveness to treat behavior about 22.4 percent. This study recommended cognitive behavior therapy as specialty treatment for patient schizophrenia with low self esteem.