Penerapan Art Therapy pada Pasien Halusinasi Pendengaran dan Penglihatan di Rumah Sakit Jiwa: Laporan Kasus

Dewi Purwati; Aat Sriati; Indra Maulana; Yofi Purnamagiri

doi:10.71456/jik.v5i1.2475

Authors

Dewi Purwati* Fakultas Keperawatan, Universitas Padjadjaran
Aat Sriati Departemen Jiwa Fakultas Keperawatan, Universitas Padjadjaran
Indra Maulana Departemen Jiwa Fakultas Keperawatan, Universitas Padjadjaran
Yofi Purnamagiri Fakultas Ilmu Kesehatan, Universitas Bhakti Kencana Bandung

DOI:

https://doi.org/10.71456/jik.v5i1.2475

Keywords:

Halusinasi, Skizoafektif, Manajemen Halusinasi, Art Therapy, Keperawatan Jiwa

Abstract

Halusinasi, terutama halusinasi pendengaran yang memiliki prevalensi 70–80% pada pasien dengan gangguan psikotik, merupakan gejala yang sering ditemukan pada pasien skizoafektif dan dapat mengganggu fungsi sosial, perilaku, serta kualitas hidup. Manajemen halusinasi merupakan intervensi keperawatan penting untuk membantu pasien mengontrol gejala yang dialami. Tujuan penelitian ini adalah mendeskripsikan penerapan art therapy sebagai intervensi keperawatan pendukung dalam membantu pasien mengontrol halusinasi pendengaran dan penglihatan. Penelitian menggunakan metode deskriptif dengan pendekatan laporan kasus pada seorang pasien perempuan usia 26 tahun dengan diagnosis skizoafektif tipe manik yang dirawat di rumah sakit jiwa selama delapan hari. Data dikumpulkan melalui wawancara, observasi, pemeriksaan status mental, dan telaah rekam medis. Intervensi yang diberikan meliputi teknik menghardik, kepatuhan minum obat, bercakap-cakap dengan orang lain, serta art therapy berupa menggambar dan mewarnai. Hasil menunjukkan penurunan frekuensi halusinasi, peningkatan kemampuan mengenali dan mengontrol halusinasi secara mandiri, berkurangnya perilaku berbicara dan tertawa sendiri, serta peningkatan keterlibatan dalam aktivitas sehari-hari. Kombinasi intervensi generalis dan art therapy membantu meningkatkan orientasi realitas, regulasi emosi, dan kemampuan koping. Penerapan manajemen halusinasi berpengaruh dalam membantu pasien mengontrol halusinasi dan mendukung proses pemulihan. Perawat jiwa disarankan mengintegrasikan art therapy sebagai intervensi pendukung dalam manajemen halusinasi.

References

Agustin, N. L., Kurniyawan, E. H., Kusumaningsih, A., & Deviantony, F. (2022). The Effectiveness of Occupational Therapy: Drawing on Mrs.“K” on The Ability to Control Auditory Hallucinations in The Flamboyant Room Dr. RSJ. Radjiman Wediodiningrat Lawang. D'Nursing and Health Journal (DNHJ), 3(2), 1-11.

Al Dameery, K., Valsaraj, B. P., Qutishat, M., Obeidat, A., Alkhawaldeh, A., Al Sabei, S., Al Omari, O., ALBashtawy, M., & Al Qadire, M. (2023). Enhancing medication adherence among patients with schizophrenia and schizoaffective disorder: Mobile app intervention study. SAGE Open Nursing, 9, 1–11. https://doi.org/10.1177/23779608231197269

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR). American Psychiatric Publishing.

Baumeister, D., Sedgwick, O., Howes, O., & Peters, E. (2020). Auditory verbal hallucinations and continuum models of psychosis: A systematic review of the healthy voice-hearer literature. Clinical Psychology Review, 51, 125–141. https://doi.org/10.1016/j.cpr.2016 .10.010

Charlson, F. J., Baxter, A. J., Dua, T., Degenhardt, L., Whiteford, H. A., & Vos, T. (2015). Excess mortality from mental, neurological and substance use disorders in the Global Burden of Disease Study 2010. Epidemiology and psychiatric sciences, 24(2), 121-140.

Dewi, L., & Rahmawati, A. N. (2023). Asuhan keperawatan pada pasien halusinasi pendengaran dengan penerapan terapi generalis. Community Health Nursing Journal, 1(1), 31–36.

Du, S. C., Li, C. Y., Lo, Y. Y., Chen, C. H., Hsieh, C. J., & Chien, W. T. (2024). Effects of visual art therapy on positive symptoms, negative symptoms, and emotions in individuals with schizophrenia: A systematic review and meta-analysis. Healthcare, 12(11), 1156. https://doi.org/10.3390/healthcare12111156.

Dudley, R., Watson, F., O’Grady, L., et al. (2022). Prevalence and nature of multi-sensory and multi-modal hallucinations in people with first episode psychosis. Psychiatry Research. https://doi.org/10.1016/j.psychres.2022.114988.

Fauzania, S. N., Hendrawati, H., & Amira, I. (2024). Generalist therapy intervention for a schizoaffective patient with auditory hallucinations: A case report. Journal of Multidisciplinary Research, 1(4).

Fusar-Poli, P., Salazar de Pablo, G., Correll, C. U., Meyer-Lindenberg, A., Millan, M. J., Borgwardt, S., … Arango, C. (2020). Prevention of psychosis: Advances in detection, prognosis, and intervention. JAMA Psychiatry, 77(7), 755–765. https://doi.org/10.1001/jamapsychiatry.2019.4779

GBD 2019 Mental Disorders Collaborators. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9(2), 137-150.

Grande, I., Berk, M., Birmaher, B., & Vieta, E. (2016). Bipolar disorder. The Lancet, 387(10027), 1561-1572.

Haddad, P. M., Brain, C., & Scott, J. (2014). Nonadherence with antipsychotic medication in schizophrenia: Challenges and management strategies. Patient Related Outcome Measures, 5, 43–62. https://doi.org/10.2147/PROM.S42735

Haeyen, S., van Hooren, S., van der Veld, W. M., & Hutschemaekers, G. (2018). Measuring the contribution of art therapy in multidisciplinary treatment of personality disorders: The construction of the Self‐expression and Emotion Regulation in Art therapy Scale (SERATS). Personality and mental health, 12(1), 3-14.

Howes, O. D., McCutcheon, R., Owen, M. J., & Murray, R. M. (2017). The role of genes, stress, and dopamine in the development of schizophrenia. Biological Psychiatry, 81(1), 9–20. https://doi.org/10.1016/j.biopsych.2016.07.014.

Joschko, J., Flatau, J., Beckmann, K., & Koch, S. C. (2024). Active visual art therapy and health outcomes: A systematic review and meta-analysis. Frontiers in Psychology, 15, 1437624.

Kementerian Kesehatan Republik Indonesia. (2018). Laporan nasional Riset Kesehatan Dasar (Riskesdas) 2018. Badan Penelitian dan Pengembangan Kesehatan. https://www.litbang.kemkes.go.id/laporan-riset-kesehatan-dasar-riskesdas-2018/

Kementerian Kesehatan Republik Indonesia. (2022). Bahaya ketidakpatuhan minum obat antipsikotik pada pasien skizofrenia. Direktorat Jenderal Kesehatan Lanjutan.

Kementerian Kesehatan Republik Indonesia. (2022). Pedoman nasional pelayanan kedokteran tata laksana skizofrenia. Kementerian Kesehatan RI.

Kim, J., Ozzoude, M., Nakajima, S., Shah, P., Caravaggio, F., Iwata, Y., ... & Gerretsen, P. (2020). Insight and medication adherence in schizophrenia: an analysis of the CATIE trial. Neuropharmacology, 168, 107634.

Larøi, F., Sommer, I. E. C., Blom, J. D., Fernyhough, C., Ffytche, D. H., Hugdahl, K., Waters, F., et al. (2022). The characteristic features of hallucinations in clinical and non-clinical populations: A systematic review. Neuroscience & Biobehavioral Reviews, 132, 1000–1018.

Lemvigh, C., Brouwer, R. M., Hilker, R., Anhøj, S., Baandrup, L., Pantelis, C., & Fagerlund, B. (2023). The relative and interactive impact of multiple risk factors in schizophrenia spectrum disorders: A combined register-based and clinical twin study. Psychological Medicine, 53(4), 1266–1276. https://doi.org/10.1017/S0033291721002749

Li, I. H., Hsieh, W. L., & Liu, W. I. (2023). A systematic review and meta-analysis of the effectiveness of adherence therapy and its treatment duration in patients with schizophrenia spectrum disorders. Patient Preference and Adherence, 17, 769–780. https://doi.org/10.2147/PPA.S401650

Loreskär, E., & Binder, P. E. (2024). Nothing less than a creative triumph: Experiences of art therapy among hospitalized children and adolescents. Frontiers in Psychology, 15, 1353507. https://doi.org/10.3389/fpsyg.2024.1353507.

Ma, R., Hui, L., & Wong, C. (2021). Behavioral interventions for auditory hallucinations in schizophrenia: A systematic review. Archives of Psychiatric Nursing, 35(5), 472–480.

McCarthy-Jones, S., Smailes, D., Corvin, A., Gill, M., Morris, D. W., Dinan, T. G., ... & Dudley, R. (2017). Occurrence and co-occurrence of hallucinations by modality in schizophrenia-spectrum disorders. Psychiatry research, 252, 154-160.

McCutcheon, R. A., Marques, T. R., & Howes, O. D. (2020). Schizophrenia—An overview. JAMA Psychiatry, 77(2), 201–210. https://doi.org/10.1001/jamapsychiatry.2019.3360

Pardede, J. A., Siregar, L. M., & Siregar, A. (2020). Edukasi kepatuhan minum obat untuk mencegah kekambuhan orang dengan skizofrenia. Jurnal Abdimas Mutiara, 2(2), 1–5.

Parkinson, S., Cole, B., & Trevelyan, C. (2024). Art and mentalizing in early intervention psychosis: Rationale and therapist insights on a new psychoeducational course. Frontiers in Psychiatry, 15, 1243990.

Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., Chisholm, D., Collins, P. Y., Cooper, J. L., Eaton, J., Herrman, H., Herzallah, M. M., Huang, Y., Jordans, M. J. D., Kleinman, A., Medina-Mora, M. E., Morgan, E., Niaz, U., Omigbodun, O., Prince, M., Rahman, A., Saraceno, B., Sarkar, B. K., De Silva, M., Singh, I., Stein, D. J., Sunkel, C., & Unützer, J. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392(10157), 1553–1598. https://doi.org/10.1016/-6736(18)31612-X

Pratiwi, M., & Setiawan, H. (2021). Tindakan menghardik untuk mengatasi halusinasi pendengaran pada pasien skizofrenia di rumah sakit jiwa. Jurnal Kesehatan, 7(1), 7–13.

Santomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., Bang-Jensen, B. L., Bertolacci, G. J., Bloom, S. S., Castellano, R., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R. M., Collins, J. K., … Ferrari, A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet, 398(10312), 1700–1712. https://doi.org/10.1016/ S0140-6736(21)02143-7.

Stojcevski, M., Cheung, A., Agwu, V., & Fan, X. (2023). Exploring Zentangle as a virtual mindfulness-based art intervention for people with serious mental illness. Frontiers in Psychiatry, 14, 1260937. https://doi.org/10.3389/fpsyt.2023.1260937

Stuart, G. W. (2021). Principles and practice of psychiatric nursing (11th ed.). Elsevier.

Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis.

Tullius, J. M., De Kroon, M. L. A., Almansa, J., & Reijneveld, S. A. (2022). Adolescents’ mental health problems increase after parental divorce, not before, and persist until adulthood: A longitudinal TRAILS study. European Child & Adolescent Psychiatry, 31, 969–978. https://doi.org/10.1007/s00787-020-01715-0

Utas-Akhan, L., Avci, D., & Basak, I. (2023). Art therapy as a nursing intervention for individuals with schizophrenia. Journal of Psychosocial Nursing and Mental Health Services, 61(12), 7–10.

Verhallen, A. M., Renken, R. J., Marsman, J.-B. C., & ter Horst, G. J. (2021). Working memory alterations after a romantic relationship breakup. Frontiers in Behavioral Neuroscience, 15, 657264. https://doi.org/10.3389/fnbeh.2021.657264

Videbeck, S. L. (2020). Psychiatric-mental health nursing (8th ed.). Wolters Kluwer.

Vigo, D., Thornicroft, G., & Atun, R. (2016). Estimating the true global burden of mental illness. The Lancet Psychiatry, 3(2), 171–178.

Waters, F., Blom, J. D., Jardri, R., Hugdahl, K., & Sommer, I. E. C. (2018). Auditory hallucinations, not necessarily a hallmark of psychotic disorder. Psychological Medicine, 48(4), 529–536.

White, R., Haddock, G., Campodonico, C., Haarmans, M., & Varese, F. (2021). The influence of romantic relationships on mental wellbeing for people who experience psychosis: A systematic review. Clinical Psychology Review, 86, 102022. https://doi.org/10.1016/j.cpr.2021.102022

World Health Organization. (2022). World mental health report: Transforming mental health for all. World Health Organization. https://www.who.int/publications/i/item/9789240049338

World Health Organization. (2023). Schizophrenia. https://www.who.int/news-room/fact-sheets/detail/schizophrenia

World Health Organization. (2025, October 6). Schizophrenia. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/schizophrenia