Improvement in Patients’ Ability to Care for Anxiety and Impaired Body Image: A Case Report of Acceptance and Commitment Therapy and Family Psychoeducation

Rasmawati Rasmawati, Budi Anna Keliat, Herni Susanti
| Abstract views: 603 | PDF views: 602

Abstract

Heart failure and hypertension are non-communicable diseases that are responsible for 70% of deaths worldwide and cause anxiety and impaired body image. Nursing interventions (therapy in general) and acceptance and commitment therapy increase patients’ acceptance of the disease and commitment to alleviate anxiety and improve impaired body image. Meanwhile, family psychoeducation improves the family’s ability to care for the patient. This case report presents two patients with heart failure and hypertension. The two patients experienced a decrease in symptoms on the cognitive aspects (difficulty concentrating, focusing on self, and decline body changes), affective aspects (worry, shame, and despair), physiological aspects (sleep disorders and appetite), and behavioral aspects (daydreaming, decreased productivity, and social difficulties). Patients who find difficulty enjoying daily activities and increasing their ability and commitment to overcome anxiety and impaired body image should receive nursing intervention, acceptance and commitment therapy, and family psychoeducation as part of nursing services.

 

Abstrak

 

Peningkatan Kemampuan Klien Merawat Ansietas dan Gangguan Citra Tubuh: Laporan Kasus Acceptance and Commitment Therapy dan Psikoedukasi Keluarga. Gagal jantung dan hipertensi merupakan penyakit tidak menular yang menjadi penyebab 70% kematian di dunia serta menyebabkan ansietas dan gangguan citra tubuh. Tindakan keperawatan ners dan ners spesialis Acceptance and commitment therapy diberikan pada klien agar dapat meningkatkan penerimaan terhadap penyakit dan komitmen merawat ansetas dan gangguan citra tubuh. Psikoedukasi keluarga dilakukan agar keluarga mampu membantu merawat klien dalam menghadapi penyakitnya. Metode yang digunakan berupa laporan kasus dalam bentuk case series pada dua klien dewasa dengan gagal jantung dan hipertensi. Hasil menunjukkan bahwa kedua klien mengalami penurunan gejala pada aspek kognitif berupa sulit konsentrasi, fokus pada diri sendiri, tidak menerima perubahan tubuh; afektif: khawatir, malu dan putus asa; aspek fisilogis: gangguan tidur dan tidak nafsu makan; perilaku: melamun, penurunan produktivitas; dan sosial: sulit menikmati kegiatan harian serta terjadi peningkatan kemampuan klien dalam menerima penyakit dan komitmen merawat ansietas dan gangguan citra tubuh. Pemberian tindakan keperawatan ners dan ners spesialis acceptance and commitment therapy serta psikoedukasi keluarga perlu dibudayakan dalam pemberian pelayanan keperawatan di unit umum.

 

Kata Kunci: acceptance and commitment therapy, ansietas, gangguan citra tubuh, hipertensi, psikoedukasi keluarga

Keywords

acceptance and commitment therapy; anxiety; family psychoeducation; hypertension; impaired body image

Full Text:

PDF

References

Callaghan, G.M., Duenas, J.A., Nadeau, S.E., Darrow, S.M., Van der Merwe, J. & Misko, J. (2012). An empirical model of body image disturbance using behavioral principles found in functional analytic psychotherapy and acceptance and commitment therapy. International Journal of Behavioral Consultation and Therapy, 7 (2–3), 16–24. http://dx.doi.org/10.1037/h0100932.

Caqueo-Urizar, A., Rus-Calafell, M., Urzua, A., Escudero, J., & Gutierrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: Challenges and solutions. Neuropsychiatr Disease and Treatment, 11, 145–151. doi: 10.2147/NDT.S51331.

Codd, R.T., Twohig, M.P., Crosby, J.M., & Enno, A. (2011). Treatment of three anxiety disorder cases with acceptance and commitment therapy in a private practice. Journal of Cognitive Psychotherapy, 25 (3), 203–217. Retrieved from https://search.proquest.com/docview/878896027?accountid=17242.

Fatimah, S., Maideen, K., Sidik, S. M., Rampal, L., & Mukhtar, F. (2014). Prevalence, associated factors and predictors of depression among adults in the community of Selangor. PloS One, 9 (4), 1–14. http://doi.org/10.1371/journal.pone.0095395.

Gheorghiade, M., Vaduganathan, M., Fonarow, G.C. & Bonow, R.O. (2013). Rehospitalization for heart failure. Journal of the American College of Cardiology, 61 (4), 391–403. http://dx.doi.org/10.1016/j.jacc.2012.09.038.

Grumet, R., & Fitzpatrick, M. (2016). A case for integrating values clarification work into cognitive behavioral therapy for social anxiety disorder. Journal of Psychotherapy Integration, 26 (1), 11–21. http://dx.doi.org/10.1037/a0039633.

Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (2016). Acceptance and commitment therapy: The process and practice of mindful change (2nd Ed.). New York: Guilford Press.

Hsu, N., Tsao, H., Chen, H., & Chou, P. (2014). Anxiety and depression mediate the health-related quality of life differently in patients with cardiovascular and stroke–preliminary report of the Yilan study : A population-based community health survey. PloS One, 9 (9), e107609. doi: 10.1371/journal.pone.0107609.

Ministry of Health Republic of Indonesia. (2016). Peraturan Menteri Kesehatan Republik Indonesia nomor: 43 tahun 2016 tentang standar pelayanan minimal bidang kesehatan. Jakarta: Ministry of Health Republic of Indonesia. Retrieved from https://djsn.go.id/storage/app/uploads/public/58d/486/f01/58d486f010a3f067108647.pdf.

Ministry of Health Republic of Indonesia. (2013). Riset kesehatan dasar. Jakarta: National Institute of Health Research and Development, Ministry of Health Republic of Indonesia. Retrieved from https://www.kemkes.go.id/resources/download/general/Hasil%20Riskesdas%202013.pdf.

Legg, T.J. (2016). Anxiety symptoms. Retrieved from http://www.healthline.com/health/anxiety-symptoms#overview1.

Masuda, A., Ng, S.Y., Moore, M., Felix, I., & Drake, C.E. (2016). Acceptance and commitment therapy as a treatment for a young adult Latina woman with purging: A case report. Practice Innovations, 1 (1), 20–35. http://dx.doi.org/10.1037/pri0000012.

Sharp, K. (2012). A review of acceptance and commitment therapy with anxiety disorders. International Journal of Psychology and Psychological Therapy, 12 (3), 359–372. Retrieved from https://search.proquest.com/docview/1315735287?accountid=17242.

Shields, C.G., Finley, M.A., Chawla, N., & Meadors, W.P. (2012). Couple and family interventions in health problems. Journal of Marital and Family Therapy, 38 (1), 265–280. doi: 10.1111/j.1752–0606.2011.00269.x.

Silitonga, R.O., Keliat, B.A., & Wardani, I.Y. (2013). Pengaruh acceptance and commitment therapy dan family psychoeducation terhadap kemampuan menerima dan berkomitmen dalam mengatasi kondisi depresi dan ansietas pasien HIV/AIDS di RS Ciptomangunkusumo Jakarta (Master Theses, unpublished). Faculty of Nursing Universitas Indonesia, Jakarta.

Sulistiowati, N.M.D., Keliat, B.A., & Wardani, I.Y. (2014). Pengaruh acceptance and commitment therapy terhadap gejala dan kemampuan klien dengan resiko perilaku kekerasan. Jurnal Keperawatan Jiwa, 2 (1), 51–57. Retrieved from https://jurnal.unimus.ac.id/index.php/JKJ/article/view/3910.

Stuart, G.W., Keliat, B.A., & Pasaribu, J. (2016). Prinsip dan praktik: Keperawatan kesehatan jiwa Stuart. Singapore: Mosby Elsevier.

Walloch, J.C. (2015). Acceptance and commitment therapy for the treatment of body image dissatisfaction and maladaptive eating attitudes and behaviors in gay men: A pilot study (Order No. 3613795). Available from ProQuest Dissertations & Theses Global (1512419225). Retrieved from https://search.proquest.com/docview/1512419225?accountid=17242.

World Health Organization. (2017). Noncommunicable diseases. Geneva: World Health Organization. Retrieved from http://www.who.int/mediacentre/factsheets/fs355/en/

Yeni, F., Husna, M., & Dachriyanus, D. (2016). Dukungan keluarga mempengaruhi kepatuhan pasien hipertensi. Jurnal Keperawatan Indonesia, 19 (3), 137–144. doi: 10.7454/jki.v19i3.471.


Refbacks

  • There are currently no refbacks.