Jurnal Aisyah : Jurnal Ilmu Kesehatan

Volume 5, Issue 1
1, June 2020, pp. 59 – 66
ISSN 2502-4825
4825 (print), ISSN 2502
2502-9495 (online)

The effectiveness of mindfulness application "SI

"SI-SIWATA
SIWATA (Sistem
Informasi Sehat Jiwa dengan Cinta) to increase the spirituality of
schizophrenia patients: Experimental study
Feri Agus Triyani 1*); Meidiana Dwidiyanti 2; Titik Suerni3
*1,2
Universitas Diponegoro
3
RSJD Dr Amino Gondohutomo Semarang

ARTICLE INFO ABSTRACT

Spirituality is an important aspect in human life and individuals with

Article history: schizophrenia are no exception, where the problem of spirituality in
Received November 07, 2019 schizophrenia patients can be handled with spiritual mindfulness
Accepted January 30, 2020 psychotherapy which is currently starting to be developed eloped based on an
Published June 05, 2020 android application. The purpose of this study was to determine the effect
of spiritual mindfulness interventions through the android application SI- SI
Keyword: SIWATA on the spirituality of schizophrenic patients. This research is a
Spirituality quasi-experimental
tal study with a sampling technique using purposive
Schizophrenia sampling. The sample in this study was 46 schizophrenic patients divided
Mindfulness into intervention and control groups. Spiritual mindfulness intervention
Android application was carried out six times and was carried out pre-testtest and post-test using
SI-SIWATA application the Daily Spiritual Experience Scale questionnaire and analyzed using
paired sample t-test. Statistical test results show the p--value = 0,000 with α
*) corresponding author (0.05) it means that there is an influence of spiritual mindfulness
Mahasiswa Program Studi Magister interventions on the spirituality
pirituality of schizophrenic patients. An increase in
Keperawatan Universitas Diponegoro patient spirituality was related to the emphasis on the mindfulness
intervention stage, namely the muhasabah (introspection) stage and the
Email: feriagustriyani88@mail.com independent healthy target stage so, the patient can consciously consciousl
understand the conditions experienced, accept the treatment process and
DOI: https://doi.org/10.30604/jika.v5i1.243
perform the independent healthy target in worship. Spirituality
independence is very important in helping patients growing faith in Allah
SWT when undergoing the treatment process.

This open access article is under the CC–BY-SA license.

Peningkatan spiritualitas pasien skizofrenia dengan

mindfulness melalui aplikasi SI-SIWATA
SIWATA (Sistem
Informasi Sehat Jiwa Dengan Cinta
Cinta)
ABSTRAK
Kata kunci: Spiritualitas merupakan aspek penting dalam kehidupan manusia, tidak
Spiritualitas terkecuali individu dengan skizofrenia dimana masalah spiritualitas pasien
Skizofrenia skizofrenia dapat ditangan dengan psikoterapi mindfulness spiritual yang
Mindfulness saat ini mulai dikembangkan dengan berbasis asis aplikasi android. Tujuan
Aplikasi android penelitian ini untuk mengetahui pengaruh intervensi mindfulness spiritual
Aplikasi SI-SIWATA melalui aplikasi android SI-SIWATA
SIWATA terhadap spiritualitas pasien
skizofrenia. Penelitian ini merupakan penelitian quasi-eksperimental
quasi
dengan tehnik pengambilan
ambilan sampel menggunakan purposive sampling.
Sampel pada penelitian ini berjumpal 46 pasien skizofrenia yang dibagi
dalam kelompok intervensi dan kelompok kontrol. Intervensi mindfulness
spiritual dilakukan selama enam kali dan dilakuakn pre-test
pre dan post-test
menggunakan kuesioner Daily Spiritual Experience Scale dan dianalisis

Available online at: https://aisyah.journalpress

aisyah.journalpress.id/index.php/jika/
Email: jurnal.aisyah@gmail.com
jurnal.aisyah@
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(1),
5 June 2020, – 60
Feri Agus Triyani; Meidiana Dwidiyanti;
Dwidiyanti Titik Suerni

menggunakan paired sample t test. Hasil uji statistic menunjukan nilai p =

0,000 dengan α (0,05) artinya ada pengaruh intervensi mindfulness spiritual
terhadap spiritualitas pasie
pasien
n skizofrenia. Adanya peningkatan spiritualitas
pasien berhubungan dengan penekanan tahapan intervensi mindfulness
yaitu tahapan muhasabah dan tahap target sehat mandiri, sehingga pasien
secara sadar mampu memahami kondisi yang dialami, menerima proses
pe
pengobatan
ngobatan dan melakukan target sehat mandiri dalam beribadah.
Kemandirian spiritualitas sangat penting dalam membantu pasien
menumbuhkan keyakinan kepada Allah SWT dalam menjalani proses
perawatan.

This open access article is under the CC–BY-SA license.

Introduction
Schizophrenia is a persistent brain disease that results in smartphones are Android-basedbased and the Indonesian people
psychotic behavior, concrete thinking, and difficulties in include the nurses spend approximately
oximately 5 hours in front of
processing information, interpersonal relationships and their cellphones. This is because cellphones can be carried
difficulty in solving problems. Schizophrenia patients anywhere and anywhere. Several Android applications on
experience positive symptoms and negative symptoms. mindfulness-based
based nursing interventions have been
Positive symptoms include hallucinations, delusions, speech developed in Indonesia such as the SI-BESUTA SI (Sistem
and irregular behaviour. Then, the negative symptom was Informasii Belajar Sukses dengan Cinta) android application
flat affect, apathy and social withdrawal (Sudeen & Sudart, to measure the stress adjustment level of nursing students
2007). (Ningsih H, 2018) and the SI-DESIS DESIS application (Sistem
Individuals suffering from schizophrenia often Informasi Deteksi Interaksi Sosial) to measure the social
experience negative views (stigma) from their family and interaction of schizophrenic patients
ents (Kurniasari, CI, 2019).
environment (Dadang hawari, 2014). The impact of This study aims to determine the mindfulness effect on
stigmatization can cause schizophrenia patients to spirituality level in schizophrenic patients through the
experience social isolation, lack of life opportunities
ies such as android application. SI-SIWATA
SIWATA (Sistem Informasi Sehat Jiwa
work and also social discrimination, which results can dengan Cinta) is an Android-based based spiritual mindfulness
decrease the life quality of schizophrenia patients application design. SI-SIWATA
SIWATA application has several
(Koutsouleris N et al, 2009). People with schizophrenia show features such as patient identity, pre-testtest feature wherein
more maladaptive coping changes that react emotionally. this feature there is a DSES questionnaire so that nurses can
The use of maladaptive coping would have an impact on measure the patient spirituality level before mindfulness
spiritual dissatisfaction and religious passivity (Ariyani S & intervention. There arere steps in implementing mindfulness
Mamnu'ah, 2014). to patients and there is a daily spiritual patient where nurses
Negative religious couping have a higher risk of suicide can monitor the patients' daily spiritual activities. The post-
post
attempts because a person was only able to surrender for the test feature is the same as the pre-test test where the nurse
situation experienced which ich can increase despair. Suicides measures the patient spirituality level evel using the DSES
also occur in 9% to 13% of clients with schizophrenia (Mohr S questionnaire after the patient has performed a mindfulness
et al, 2006). In this case, the nurses have the responsibility of intervention and documentation features as a progress note
carrying out nursing care related to the provision of the each time the patient is mindfulness intervened and
intervention to the patients. Interventions
ventions performed in monitored for the ability to worship so, the patient's
schizophrenic patients consist of pharmacological and non non- condition is expected to be better and accelerate
pharmacological treatment. In non-pharmacological
pharmacological maintenance process
treatment usually done cognitive behavior, family support
support,
environmental modification therapy, PACT (Program for
Method
Assertive Community Treatment)) (William H &, Simmons LA
TP, 2015). Mindfulness therapy was a holistic therapy which This research is a quasi-experimental
experimental research with
useful in providing calmness, comfort, increasing the focus of pretest-posttest
posttest with control group design. The sample of
awareness and helping in achieving the independence target this study was schizophrenia patients in the inpatient room
(Dwidiyanti, M. 2018). of Dr. Aminogondo Hutomo Psychiatric Hospital as many as
The research
arch showed that spiritual mindfulness 46 respondents were selected using a purposive sampling
interventions can improve medication adherence in patients technique. Previous respondents had received an
mental disorders. Mindfulness therapy can be a deliberate explanation regarding voluntary participation and signed
awareness therapy with full acceptance without judgment, informed consent.. This research lasted for one month with
awareness brings unexpected feelings and sensations
nsations with the help of ten enumerators, where the enumerators in this
the aim of recognizing the experiences experienced and study were
ere inpatient nurses who had previously been given
receiving them with spaciousness (Sari, Sri Padma & spiritual mindfulness training.
Dwidiyanti M. 2014)
Mindfulness therapy development was currently not
only done directly to patients but has begun to be developed Participant
in the
he form of an android application (Ningsih H, 2018). The
selection of Android as a system that helps in this Respondents in this study were divided into two groups:
intervention is due to the fact that almost 80% of Indonesian 23 patients in the intervention group and 23 patients in the

Jurnal Aisyah: Jurnal Ilmu Kesehatan ISSN 2502-4825

4825 (print), ISSN 2502-9495
2502 (online)
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(1), June 2020, – 61
Feri Agus Triyani; Meidiana Dwidiyanti; Titik Suerni

control group. Respondents in this study were patients with

a schizophrenia diagnosis, young adults to cooperative
elderly (PANSS score 10), Muslims, who could read and
write. The control and intervention groups differed based on
inpatient rooms available at the hospital to avoid
interactions during the research.

Procedure

The initial study began with the division of respondents

into intervention and control groups. Then the two groups
were done the pre-tested to determine the spirituality level
by the researchers and enumerators using the DSES
questionnaire contained in the pre-test feature on the SI-
SIWATA android application. The pre-test results were a
reference in providing spiritual mindfulness interventions.
Spiritual mindfulness interventions are only given to
intervention groups and carried out 6 times over 3 weeks.
First meeting conducted inform concent and pre-test to
patients, then conducted mindfulness interventions, second
up to fifth meeting provided mindfulness interventions,
evaluated the obstacles, the patient's ability to do
mindfulness and evaluated the patient independence target
in conducting worship spiritual activities. Then att sixth
meeting was to evaluate the mindfulness ability and did the
post-test measurements of patients' spirituality level by
nurses.
The steps to do Islamic spiritual mindfulness by using 3. Return to the main menu then select the Pre-test feature
the stages of Tazkiyatun Nafs, (Dwidiyanti M, 2019): 1) which contains a 16-point questionnaire (DSES) to
Intentions and Muraqabah, relax, believe in Allah SWT 2) measure the spirituality level in intervention and control
muhasabah / self-introspection from mistakes that have patients. After being filled out and submitting, the pre-
been made, 3) repentance with pleading forgiveness to Allah test result will appear and can be seen in the pre-test
SWT, 4) body scan by feeling the heart response, 5) praying documentation feature.
confidently to Allah SWT and making healthy targets
independently in worship spiritual activities. In the control
group, only pre-tests and post-test and were not given
spiritual mindfulness intervention. Post-tests were
conducted after the intervention group received spiritual
mindfulness for six times, then the data analysis process was
carried out.
Steps to use the SI-SIWATA application:
1. Login using the username and password that has been
registered through the admin

2. Select the patient identity feature then select add the

patient to enter patient data

Peningkatan spiritualitas pasien skizofrenia dengan mindfulness melalui aplikasi SI-SIWATA (Sistem Informasi Sehat Jiwa dengan Cinta)
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(1), June 2020, – 62
Feri Agus Triyani; Meidiana Dwidiyanti; Titik Suerni

5. After clicking add patients’ note, then fill in all items

according to the patient's condition after the mindfulness
intervention, then submit

6. Select the documentation feature for viewing the

patient's progress
4. After the pre-test score is known, then return to the main
menu and select the Mindfulness feature to do the 5
steps of mindfulness intervention to the patient, then
document it by clicking on the add patients’ note

7. Post-tets can be done if the intervention has been carried

out for 6 times then submitted and recorded in the
documentation feature

Jurnal Aisyah: Jurnal Ilmu Kesehatan ISSN 2502-4825 (print), ISSN 2502-9495 (online)
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(1), June 2020, – 63
Feri Agus Triyani; Meidiana Dwidiyanti; Titik Suerni

results> 0.850 so, this questionnaire can be stated reliable.

The DSES questionnaire was designed to measure spirituality
level and spirituality belief in one's life. The spirituality scale
was designed to find out how one's perception of God's
presence in daily life. This scale illustrates how the
relationship of spirituality beliefs with daily life events. DSES
consists of 15 positive statement items.
Data Analysis
The analysis in this study was a univariate analysis using
frequency distribution and bivariate analysis to determine
the effect of mindfulness interventions on the spirituality
level of schizophrenic patients through the application of SI-
SIWATA using paired sample t-test. This research has
obtained ethical permission from Dr.Aminogondo Hutomo
Instrument Semarang Psychiatric Hospital with number: 420/1/02609.

The measuring instrument used is the Daily Spiritual

Results and Discussion
Experience Scale (DSES) questionnaire that has been tested
for validity using face validity conducted by 20 respondents
All 46 respondents participated in this study. Analysis
as samples with characteristics according to the research
result of respondent characteristic as follows:
inclusion criteria. Reliability test using the alpha method (a)
Cronbach was conducted for 20 respondents with alpha

Table 1
Research respondents characteristics

Group
Variable Intervention (n(%)) Control (n(%))
p
(Mean±SD) (Mean±SD)
Age 31,57±10,03 27,26±7,75 0,307
Gender
Male 15 (65,2) 16 (69,6) 0,753
Female 8 (34,8) 7 (30,4)
Last Education
Elementary 13 (56,5) 11 (47,8)
0,808
Middle School 8 (34,8) 9 (39,1)
High School 2 (8,7) 3 (13,0)
Profession
Work 11 (47,8) 9 (39,1) 0,552
Does Not Work 12 (52,2) 14 (60,9)
Closeness to Allah
As close as possible 1 (4,3) 0
0,197
Very close 6(26,1) 17(73,9)
A little close 16 (69,6) 6(26,1)

In table 1 it was concluded that the age variants differences in respondent characteristics between the
variables are significantly homogeneous (p = 0.307> 0.05), intervention and control groups.
gender (p = 0.753), education (p = 0.808), profession (p =
0.552) and closeness to Allah (p = 0.197), there were no

Table 2
The spirituality level of schizophrenia patients on pre-test and post-test carried out Spiritual Mindfulness Intervention through
the SI-SIWATA android application

Pre-test Post-test
Mean Difference p
Mean±SD Mean±SD
Intervention 20,83 51,83±10,21 72,65±9,67 0,001
control 1,61 49,09±10,32 50,70±11,96 0,310

Based on table 2 using paired sample t-test was obtained intervention group before and after being given mindfulness
the different levels result of patient spirituality towards the intervention (p= 0,000 < 0,05), while the control group can

Peningkatan spiritualitas pasien skizofrenia dengan mindfulness melalui aplikasi SI-SIWATA (Sistem Informasi Sehat Jiwa dengan Cinta)
 Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(1), June 2020, – 64
Feri Agus Triyani; Meidiana Dwidiyanti; Titik Suerni

be concluded there was no change in the spirituality level (p healthy targets in spiritual worship activities (Dwidiyanti M,
= 0.310> 0.05). 2019).
This showed that spiritual mindfulness intervention The focus in improving spirituality was the introspection
through the SI-SIWATA android application significantly stages and the independent healthy target in worship.
influences spirituality in schizophrenia patients in the According to the research (Dwidiyanti, M. 2018) which
intervention group. The spirituality level in schizophrenia showed that 6 respondents (54%) of 11 respondents
patients has increased, seen from an increase in the average undertook spiritual activities independently after 7 days of
of spirituality level at before and after the mindfulness undergoing spiritual mindfulness therapy with p-value =
intervention was 20.83. 0.024 (α <0.05) where the respondent means that there was
Research (Weinstein et al, 2009) on mindfulness online an influence of spiritual mindfulness therapy on spiritual
interventions prove a positive impact on stress, anxiety, independence and significantly increases medication
depression and well-being. Mindfulness training through adherence in schizophrenic patients with a value (p = 0.023).
digital can have the same impact as training with direct The next important stage was the independent healthy
assistance. This was supported by research (Emerik APP Van, target which is a step to train patients being able to create
2017) stating that mindfulness training provided through independent targets in improving spirituality. The
smartphone applications can improve life quality (p = 0.003), spirituality independence in schizophrenic patients was very
well-being (p = 0.002), independent mindfulness ability (p = important in fostering confidence when undergoing the
0,000), reduce depressive symptoms (p = 0.001). Mindfulness recovery process, controlling anger and awareness in
training through SI-BESUTA android application in reducing forgiving past incidents (Sari, Sri Padma & Dwidiyanti M,
stress (p = 0,000) (Ningsih H, 2018). 2014).
Mindfulness therapy is able to provide a relaxing effect
on the body, calm, comfortable, make individuals closer to Conclusions and Recommendations
Allah, realize mistakes that have been made, interpret the
Mindfulness intervention using the SI-SIWATA android
pain that is being experienced, make individuals believe that
application which is carried out for six times can help
Allah will provide healing. Then being able to make healthy
patients in improving spirituality by growing faith in Allah
targets independently in improving spirituality such as
SWT when undergoing the treatment process. The
increasing worship, praying, dhikr, being patient and
technology role can help nurses to care more about patients
forgiving according to the spiritual mindfulness concept that
and make it easier to document nursing care result. SI-
is in the SI-SIWATA application. Spiritual mindfulness
SIWATA application is used by nurses in hospitals and this
interventions in improving the spirituality of schizophrenic
application must be connected to the internet when it will be
patients consist of five stages of Tazkiyatun Nafs; 1)
used. This research needs to be developed by conducting
Intentions and Muraqabah, relax, faith in Allah SWT 2)
research on patients diagnosed with schizophrenia by
muhasabah / self-introspection of mistakes that have been
sampling using a randomized control trial and factors that
made, 3) repentance with asking for forgiveness from Allah
affect the spirituality level of patients such as age and
SWT, 4) body scan with feeling the heart response, 5) prayer
parenting need to be added.
with confidence to Allah SWT and make independent

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