The Effectiveness of Group Activity Therapy:Aerobic Low Impact

(Poco-Poco) to Socialization Ability in Social Isolation Patients

Siti Munawaroh, Dya Sustrami, Ninik Ambar Sari

and Nur Muji Astuti

STIKES Hang Tuah Surabaya, Indonesia

Keywords: Aerobic Low Impact (Poco-Poco), Social Isolation Patients, Socialization Ability.

Abstract: Social decline occurs when a person experiences an inability or failure to adjust (maladaptif) to the

environment, causing psychiatric disorders resulting in decreased ability to socialize. One way to improve

socialization skills is by applying socialization therapy. It could be in the form of low impact Aerobic (poco-

poco). The aims of the study is to analyze the effect of low impact Aerobic (poco-poco) therapy on

socialization skills in social isolation patients at Menur Mental Hospital Surabaya. The Design of this study

was one group with pretest and posttest groups. The Independent variable was group activity therapy poco-

poco aerobic gymnastics and the dependent variable was socialization ability. The population in this study

were 14 patients of social isolation. - Samples were recruited by probability sampling with Simple Random

Sampling technique, The study used observation sheet social ability socialization. The Data were analyzed

using Wilcoxon Signed Rank Test. The resu showed group activity therapy:aerobic low impact (poco-

poco)had an effect on social socialization ability. Wilcoxon Signed Rank Test Results p = 0.002 means there

is a significant differencei between pre and post test. of group activity therapy:aerobic low impact (poco-

poco) to increase their social ability. The implication of this research is the influence of group activity

therapy:aerobic low impact (poco-poco) has an effect on socialization ability in social isolation patient. Nurses

has could improve their gymnastics activities to improve their social skills.

1 BACKGROUND

Mental disorder is a condition of disruption of mental,

emotional, mind, will, psychomotor and verbal

behavior, which is a group of clinical symptoms

accompanied by the patient and results in disruption

of the individual's humanistic function (Purwaningsih

and Karlina 2010). One of the signs of symptoms

experienced by people with mental disorders is the

occurrence of social decline. This social decline

occurs when a person experiences an inability or

failure to adapt (maladaptif) to the environment,

causing a psychiatric disorder that resulted in

maladaptif behavior towards the environment, social

decline experienced by someone called social

isolation.

Based on World Health Organization data WHO

(2009) estimates 450 million people worldwide

experience mental disorders. WHO says at least one

out of four people have mental health problems

around the world (Yosep 2014). According to the

National Institutes of mental health psychiatric

disorders account for 13% of the overall disease and

are thought to grow to 25% by 2030. Data from the

(Basic Health Research) Riskedes 2013 indicates a

substantial amount, 50 million or about 25% of the

population Indonesia experienced mental health

disorder and East Java Province shows the number of

2.2 million people based on data of the population of

east Java is 38005,413 inhabitants. So it can be

concluded that 83,613 souls who have mental

disorders in East Java.

Preliminary survey data conducted by researchers

at Menur Mental Hospital Surabaya on 12 January

2017 in the period of 1 year last 2016 obtained data

of hospitalized patients in January to March there are

3 the highest diagnosis of 211 unspecified

schizophrenia, schizophrenia as many as 91 patients

and schizophrenia hebefrenik as many as 70 patients.

The cause of mental disorders can result from

relationships with others who are treated unfairly,

mistreated, unrequited love, the loss of a loved one,

loss of work and so on. One sign of the negative

symptoms of mental disorder is to withdraw from

social interaction (social isolation). The impact of

developmental disorders and relationships can result

586

Munawaroh, S., Sustrami, D., Sari, N. and Astuti, N.

The Effectiveness of Group Activity Therapy: Aerobic Low Impact (Poco-Poco) to Socialization Ability in Social Isolation Patients.

DOI: 10.5220/0008329105860589

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 586-589

ISBN: 978-989-758-336-0

in individuals not believing in themselves, not

trusting in others, hesitating, fearing wrong,

pessimistic, despairing of others, incapable and

feeling depressed, this situation can lead to behavior

not wanting to communicate with others , prefer to

remain silent, avoid others (Kusumawati and Hartono

2010).

Management of patients with social isolation in

addition to the provision of psychopharmaca drugs

can also be given the therapy group of socialization

in the form of aerobic low impact (poco-poco), while

the general form of socialization is the ability of

socialization, therefore the ability of socialization is

the main requirement of social activities. Within the

group there will be interaction dynamics

interdependent, need each other and become a place

where patients practice new behavior from maladaptif

toward adaptive behavior(Keliat and Al 2011).

Socialization capabilities are dynamic social relations

involving relations between individuals, between

groups of people, as well as between individuals with

human groups(Badrujaman 2010). Thus the purpose

of the study was to find the difference of social

interaction capability before and after performing

Poco-poco.

2 METHODS

This research used pre experimental design with one-

group pre-post test design to know the effectivenessof

group activity therapy: aerobic low impact (poco-

poco) as group therapy in social isolation patient at

Mental Hospital Menur Surabaya. The independent

variable wasthe effectiveness of poco-poco aerobic

gymnastics therapy. Dependent variable was

socialization ability in social isolation patient at

Mental Hospital of Menur Surabaya. The population

in this study were 15 social isolation patients who

experienced impaired socialization ability in

Flamboyan Room at Menur Mental Hospital

Surabaya. Sampling technique used in this research

was probability sampling with simple random

sampling method. The sample in this population is 14

patients of social isolation in Menur Mental Hospital

of Surabaya with the following criteria:

1. Inclusion Criteria: patients with impaired social

interactions, social isolation patients who have

begun interpersonal interactions, socially

responsive social isolates, cooperative social

isolation patients, and socially stable social

isolation patients.

2. Exclusion Criteria: patients who do not

experience social isolation, patients with ill

condition.

This research was conducted 31 March – 14 April

2017 in Flamboyan Room who experienced social

isolation in Menur Mental Hospital Surabaya. Prior to

data collection, ethical clearance was obtained. Poco-

poco theraphy was carried out 45 minutes for each

session, five times in two weeks. It was instructed by

physical education teacher. The instruments of the

study on socialization ability in social isolation

patient at Mental Hospital of Menur Surabaya were

observation sheet containing 14 items of questions

that have been tested for its validity and reliability.

Statistical test used Wilcoxon in pre test and post test

showed significant value p = 0.005 (p <0.05)

socialization by which its significance value was

considered and interpreted as having difference in

pre-and post social interaction activity.

3 RESULTS

Result of statistic test using Wilcoxon Signed Rank

Test was p = 0,002. This shows that p <0,05 indicates

that there is different socialization ability before and

after group activity therapy:aerobic low impact

(poco-poco).

4 DISCUSSION

Social isolation is more often experienced by patients

with impaired socialization skills (Hawari 2007).

Research conducted (Nyumirah 2013) said that

patients with impaired socialization ability can be

done with various kinds of therapy, one of therapy

Table 1: Statistical result (wilcoxon test).

Social

Ability

Pre Test

Post Test

Good

14,3

85,7

64,3

28,6

7,1

Modereate

14,3

85,7

64,3

28,6

7,1

Low

14,3

85,7

64,3

28,6

7,1

Total

100

Wilcoxon signed rank test P = 0,002

The Effectiveness of Group Activity Therapy: Aerobic Low Impact (Poco-Poco) to Socialization Ability in Social Isolation Patients

587

available is in motion therapy, motion therapy is a

physical activity therapy that can be done by

exercising or gymnastics to train the body a person to

be physically and mentally healthy, exercise is one

form of group therapy to move. Poco-poco was

considered as a relevant group activity for mental

disorder patients for a number of reasons. It was a

simple physical exercise that does not require

complicated movement. As a consequence it raises

motivation and enjoyment for its participants. The

ultimate effect that could be perceived is the fact that

enjoyment and excitement could lead the participants

to have more interactions. This could also improve

communication ability where instructions were given

and understood. By the end of the session, the social

capability, in terms of interpersonal relationship

could be established among the participants.

Based on the results of research group activity

therapy:aerobic low impact (poco-poco)is a series of

motion is selected intentionally by following the

rhythm of the selected music so that gave birth to the

provisions of ritmis, continuity. Group activity

therapy:aerobic low impact (poco-poco)can effect the

ability to socialize against other fellow patients, this

is in accordance with theories according to(Yakub

2010) aerobic exercise can provide mental health

benefits that can reduce stress and improve

socialization and socialization with other patients,

because in this gym there is togetherness and

cohesiveness between members of the group, so that

patients can have opportunities for socialization to

others, in addition to the benefits of this gymnastics

activity can increase concentration, creativity and

increase the amount of oxygen in the blood so that

accelerate blood flow to the brain, at the time of doing

gymnastic activities then the activity can increase

hormones - hormones both in the brain such as

adrenaline, serotonin, dopamine and endorphin. The

potensial of group exercise for promoting

psychological vigor in older adults (Engels et al.

1998). Two mechanisms have been proposed to

mediate the effects of exercise on cognition. The first

is that exercise has a nutritive influence on neuronal

function. Exercise has been shown to promote

neurotrophic effects, including synaptic plasticity,

neurogenesis, and vascular function (Farina, Rusted,

and Tabet 2014).

Purwaningsih and Karlina (2010) suggest there

are 3 benefits of group interaction therapy such as:

general benefits, specific benefits and rehabilitation

benefits. Benefits of group activities in general is to

improve the ability through communication and

feedback, socialize and generate motivation

advancement of congnitive and affective functions.

The benefits of group activities in particular are

enhancing self-identity, channeling emotions, and

improving the skills of interpersonal or social

relationships. And the last benefit of rehabilitation

group activities is to improve self-expression skills,

improve social skills, empathy skills, and improve

knowledge-solving skills. According to (Trisnawan

2010). On the implementation of this gymnastics

there are 3 stages of heating for 10 minutes, core

exercise for 15-20 minutes, cooling exercise for 5

minutes.

Group activity therapy:aerobic low impact (poco-

poco) is done as many as 5 times of meetings, in 2

weeks with the duration of each gymnastics activity

for 45 minutes. At the beginning before the patient's

gymnast in a group discussion to know the members

masing2 in accordance with the observation sheet and

the extent to which the ability of patients in

interacting, after doing the gymnastics activities

approximately 30 minutes and when completed the

patient's gymnastics activities in the form of group

circles for discussion back and at the value of the

extent to which interaction ability whether there is a

difference or not in the assessment. The first meeting

when the gymnastics therapy, patients feel shy and

more silent, after being given an explanation by the

researcher patients began to follow gymnastics

activities, when therapy began many obstacles

because patients do not understand about gymnastics

movement but they still can follow even though many

movements wrong. The second meeting when the

patient therapy began to confident to follow this

therapy, although some are less confident or shy to

follow gymnastics activities. The third meeting when

the patient's gymnastics therapy began

enthusiastically following the therapy until the end of

the activity and the fourth meeting and the five

patients look happy in following the therapy

activities. The first meeting until the fifth researcher

chose the same patient that is the patient who suffer

from socialization ability disorder, before being given

the treatment of the researcher first called the patient

by going directly to the patient's chamber, so that not

all patients follow this group activity therapy:aerobic

low impact (poco-poco).

5 CONCLUSIONS

Interaction Ability in Social Isolation Patients in

Flamboyan Room after being given group activity

therapy: aerobic low impact (poco-poco) there is

increased socialization ability to members of the

gymnastic group.

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588

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