Research Article - (2020) Volume 5, Issue 2
Received: 01-Apr-2020
Published:
24-Apr-2020
, DOI: 10.37421/2573-0347.2020.05.170
Citation: Jek Amidos Pardede, Budi Anna Keliat, Ice Yulia Wardani. â€The Symptoms of Low Self-Esteem Decline after Being Given Acceptance and Commitment Therapy.“ Adv Practice Nurs 5 (2020):170. doi: 10.37421/apn.2020.05.170
Copyright: © 2020 Pardede JA, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Schizophrenia is a mental disorder characterized by impaired thought processes and weak emotional responses. This situation is generally a chaotic way of speaking and thinking, and is accompanied by significant social and work dysfunction. Early symptoms usually appear during young adulthood. One of the negative symptoms of schizophrenia is low self-esteem. Therapy given in this study is Acceptance and Commitment Therapy (ACT).
The Study: the purpose of this research is to determine the effect of Acceptance and Commitment Therapy on the reduction of symptoms of low self-esteem schizophrenia patients in mental hospitals in Medan, North Sumatra
Methods: This study used a quasi-experimental design with a control group". The sample of this study was schizophrenia patients with nursing problems with low selfesteem at mental hospital in North Sumatra. The sample of this study was 60 respondents, 30 respondents who received ACT and 30 respondents control group.
Results: The results showed no significant differences between the intervention group and the control group (p<0.05).Changes in symptoms of low self-esteem after being given ACT increased by 24, 51% and the control group by 7.74%. This means that the higher the percentage obtained, the lower the symptoms of low self-esteem in schizophrenic patients Conclusion: The results of this ACT study can be applied in public hospitals and mental hospitals and can be combined with other nursing therapies
Acceptance and commitment therapy • Schizophrenia • Low Self-Esteem • Mental disorder
Schizophrenia is a condition that exists in all cultures and in all socioeconomic group [1]. The prevalence of schizophrenia is estimated at about 1 % of the total population [2]. Riskesdas et al. shows the prevalence of mental emotional disorders with symptoms of depression and anxiety at the age of 15 reaching 14 million people [3]. This figure is equivalent to 6% of Indonesia's population. Meanwhile, the prevalence of severe mental disorders such as schizophrenia reaches 400 thousand. 6 to 7 out of 100 households experience schizophrenia or psychosis disorders in Indonesia [4].
Schizophrenia has positive symptoms and negative symptoms. Negative symptoms include low self-esteem [1,5,6]. According to Morton et al. low selfesteem can be a consequence of mental health disorders (such as depression, anxiety and panic) or it can be a vulnerability factor for the development of such problems [7].
Nursing therapy is given to schizophrenic patients with low self-esteem problems, one of which is acceptance and commitment therapy. This therapy has been proven to overcome various diseases. The problem of nursing low self-esteem has been researched by several people but with different therapies. Research conducted by Sasmita et al. shows that cognitive abilities increased by 29.31% as well as behavioral abilities increased by 22.4% in schizophrenic patients using CBT [8]. Another study conducted by Hidayat et al. shows that with CBT and REBT can reduce symptoms of low self-esteem and improve patient ability (p <0.05). The research conducted above shows that CBT and REBT are able to overcome the problem of nursing low selfesteem [9]. So I tried to research using ACT to reduce the symptoms of low self-esteem in patients with schizophrenia.
This study used a quasi-experimental design with a control group". The sample of this study was schizophrenia patients with nursing problems with low self-esteem at mental hospital in North Sumatra. Inclusion criteria of this research are: schizophrenia aged 18-60 years, recurrent schizophrenia patients’ ≥ 1, had being screened, patients can respond when given therapy, the patient is dismissed if he does not attend all the sessions given.
Sampling of this study was used with purposive sampling technique. The sample of this study was 60 respondents, 30 respondents who received ACT and 30 respondents control group.
Patients were screened before the study was given. This study was used with the Rosenberg self-esteem scale (RSES) questionnaire the low selfesteem questionnaire consisted of 10 statement items [10].
It can be seen in Figure 1, before being given an ACT intervention the symptoms of low self-esteem are 41.02% and the control group is 37.92%.
Statistical tests showed there were inequalities between the intervention group and the control group (p<0.05). After being given ACT to the intervention group, the symptoms of low self-esteem increased by 65.53% and the control group by 45.43%. Statistical test results showed no significant differences between the intervention group and the control group (p <0.05). Changes in symptoms of low self-esteem after being given ACT increased by 24, 51% and the control group by 7.74%. This means that the higher the percentage obtained, the lower the symptoms of low self-esteem in schizophrenic patients.
Decreased symptoms of low self-esteem in the group given ACT by 24.51% and found a decrease in cognitive symptoms by 22, 5%, affective symptoms by 24.4%, behavioral symptoms by 22.86% and social symptoms by 25.75%. While the control group decreased symptoms of low self-esteem by 7.74% and found a decrease in cognitive symptoms by 9.32%, affective symptoms by 1.42%, behavioral symptoms by 5.72% and social symptoms by 24.8%. The results of this study indicate that both groups had decreased symptoms.
The results of other studies also showed a decrease in symptoms of low self-esteem after being given therapy. The results of the study [9] showed that using CBT and REBT could reduce symptoms of low self-esteem by 37.83%. The results of this study are also supported by [8] that CBT given to patients can reduce symptoms of low self-esteem by 25.85%. From the description above that nursing therapy is proven to reduce symptoms of low self-esteem and the results of the above study indicate that RECBT is more able to reduce the symptoms of low self-esteem than CBT and ACT. For more clearly, it can be seen in Figure 2.
Symptoms of low self-esteem decreased significantly in the intervention group by 24.51% and the control group by 7.74%. The results of the study prove that ACT can reduce symptoms of low self-esteem in schizophrenic patients. So the results of this ACT study can be applied in public hospitals and mental hospitals and can be combined with other nursing therapies.
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