Family Support Relationships with Patient Adaptation Ability above

with Diagnosis Hallucination of Post Care

Lela Nurlela, Meiana Harfika and Laelani Eka Novitasari

Sekolah Tinggi Ilmu Kesehatan Hang Tuah Surabaya

Keywords: Family Support, Adaptability, Hallucination.

Abstract: Hallucinations are one of the most common symptoms of mental disorder, considered a peculiarity of others

in relation to society and conditions in the family. Family is the main support system that plays a role to

provide direct care in good health and illness. The purpose of this study identified the relationship of family

support to the adaptability of outpatients with post hospital hallucinatory diagnosis. Design of quantitative

research in form of descriptive correlation, using non probability sampling technique with purposive sampling

approach. Samples taken were patients of post-treatment hallucination, as many as 10 people. Independent

variable is family support, and dependent is adaptability. Instruments of family support are questionnaires of

Friedman and adaptation skills using questionnaires from Nursalam. Data were analyzed using Spearmen rho

test with result ρ 0.005. The result of the study shoe that most families provide good support, and the

adaptability of patients with hallucinations is largely adaptive. Based on correlation results obtained r = 0,807,

which means good family suppotr associated with adaptive ability of adaptation patiens. The implications of

this study indicate that family support has an effect on the adaptability of post-treatment hallucination patients,

so families need to provide good family support to enable patients to adapt adaptively.

1 INTRODUCTION

Mental disorder according to PPGDJ III is a

syndrome of a person's behavioral pattern typically

associated with a symptom of distress or impairment

in one or more important functions of human beings,

psychological, behavioral, biological, and disorder

functions not only lies in the relationship between the

person but also with society (Maramis, 2010).

Schizophrenia is a disease that affects the brain and

causes strange and disturbed thoughts, perceptions,

emotions, movements, and behaviors (Videbeck,

2010). This schizophrenia shows both negative and

positive symptoms. Positive symptoms or real

symptoms that include delusions, hallucinations,

disorganization of the mind, disorderly speech and

irregular behavior (Videbeck, 2008). Based on these

positive symptoms that drew considerable attention to

the problem of mental nursing is a matter of

hallucinations.

Signs and symptoms of hallucinations are often

shown, among others, by the change in behavior as

often laugh alone, hear something and speak for

themselves.sensory function. Other changes that

occur are a decrease in problem-solving ability,

orientation to time, place, and people, anxiety, and

changes in Hallmarks and hallucinations must be an

abnormal condition of a person who will be

considered an oddity of others in relation to society

and conditions in the family, such as sadding a head

in a certain direction, talking and laughing, and

pacing (Suwardiman, 2013)

The family is the main support system that

plays a role in providing direct care to every healthy

and ill situation of schizophrenic patients. Generally

families request the help of health workers if they are

unable to care for it (Keliat, 2002).

According to WHO (2007), estimates there are

about 450 million people in the world who have

mental health problems, at least 1 (one) out of 4 (four)

people in the world experiencing mental problems.

One of the most common mental disorders is

schizophrenia, which ranks 4th out of 10 major

diseases around the world, regarding this, reports that

25,000,000 people worldwide are experiencing

schizophrenia (Stuart, 2007). Indonesia based on

mental health data PUSLITBANG Depkes RI

(2007), as much as 0.46% of Indonesian people

suffering from schizophrenia and experiencing severe

psychotic disorders. While the prevalence of severe

626

Nurlela, L., Harﬁka, M. and Novitasari, L.

Family Support Relationships with Patient Adaptation Ability above with Diagnosis Hallucination of Post Care.

DOI: 10.5220/0008329906260630

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 626-630

ISBN: 978-989-758-336-0

mental disorders, such as schizophrenia is 1.7% or

400,000 people (Depkes, 2014). Our preliminary

study at Mental Hospital Menur Surabaya, on January

17, 2017 in Ithe last three months, there are 5,816

people who are registered as outpatient patients, and

237 people who are inpatient at Menur Mental

Hospital. While patients with hallucinatory nursing

diagnosis there are 98 people who do hospitalization.

Previous studies have found that 70% of the ten

families of patients do self-care patients sincerely,

usher patients treated, supervise patients taking

medication and invite patients to activity. It shows

that family support that includes emotional,

informational, instrumental and research support is

done by the client's family in following the

therapeutic regimen (Friedman, in Suwardiman

2013).

Hospital-based care is excluded from planning for

nursing action. Therefore, families are included in the

preparation to go home. The purpose of home

planning is not only aimed at patients so that family-

focused nursing care not only restores the patient's

condition but aims to develop and improve the

family's ability to cope with family health problems

(Keliat In Wahyuningrum, 2013)

Home services reinforce and enhance the services

provided by family members and relatives also

maintain the independence and dignity of quality

clients that are often lost even from the best

institutions (Videbeck, 2010). The family is the unit

closest to the patient, and is the "primary nurse" for

the patient. The family plays a role in determining the

care necessary for the patient at home. The success of

nurses in the hospital will be in vain if it is not

continued at home which then leads the patient to be

treated again (relapse). Participation will increase the

ability of the family from the beginning of home care,

so the possibility of relapse can be prevented

(Wahyuningrum, 2013).

Family social support can weaken the impact of

stress and directly strengthen the mental health of

individuals and families. Social support is an

important coping strategy for a family experiencing

stress. Family social support can also serve as a

preventive strategy to reduce stress and its negative

consequences. A person with schizophrenia with the

inability to perform a social function surely needs

support to become a stronger individual and self-

respecting, so as to achieve better healing and

improve social functioning. Without the support of

the patient's family will be difficult to recover,

experiencing worsening and difficult to adapt in the

community environment.

Family interventions need to be structured and

coordinated in a comprehensive care model to be

more effective in helping patients adapt. Based on the

phenomenon, the authors want to know whether there

is a relationship of family support on the ability of

adaptation in patients hallucinations post-care Mental

Hospital Menur Surabaya.

2 METHODS

This research design is Non-Experimental

(correlation analytic research) which aims to reveal

correlation relationship between family support with

adaptation ability, with cross sectional approach, that

is as a research to study correlation dynamics between

risk factors with effects that emphasize time

measurement/ observation family support data with

adaptability only one time at a time without any

follow-up.

The population in this study were: outpatients

with post-treatment hallucinogenic diagnosis of RSJ

Menur Surabaya for 15 people and family of patients

living in Surabaya area of 15 people.

The samples in this study were some outpatients

with post-hospitalized hallucinatory diagnoses. For

independent variables are family support and

variables depedent is the ability of adaptation. Data

collection with questionnaire filling and analyzed

using SPSS Rank Spearman statistical test at

significance level <0,05.

In conducting the research, the researcher

submits a research request to the Education

Installation and is followed up with a research permit

application from the education side to the Mental

Hospital Menur Surabaya.

3 RESULTS

The distribution of family characteristics including

age, sex, recent education, occupation, outpatient

relationships with hallucinatory diagnoses in Poli

Jiwa Mental Hospital Menur Surabaya are shown on

table 1.

From the tabulation results show that the relation

of family support with the ability of adaptation of

outpatient with hallucinatory diagnosis in psychiatric

Mental Hospital Menur and obtained data that from

10 respondents who were given good family support

and have adaptive adaptation capability of 6 people

(100%), which provided good family support and

adaptive adaptive adaptability of 1 person (25%),

Family Support Relationships with Patient Adaptation Ability above with Diagnosis Hallucination of Post Care

627

which provided good family support and had

maladaptive adaptability of 3 people (75%). Based on

rho spearmen test result obtained p = 0,005 where H1

accepted if p <0,05 mean there is relation of family

support with ability of adaptation patient

hallucination.

4 DISCUSSION

Family support is a process that occurs over a lifetime

with varying nature and type of support (Friedman,

2010). Among them are emotional support,

information support, instrumental support and

assessment support. Such support forms a single

family support unit, especially for family members

who have health problems such as hallucinations.

Family support has a value of each (60%) for good

support, and (40%) for moderate support. This is

supported by Friedman's (2010) research, that family

support is very important to meet the psychosocial

needs of family members such as, caring for each

other, love, warmth and mutual support among family

members (Friedman, 2010). Researchers assume,

family support is very useful for hallucination

patients, especially affective function as an internal

function of the family

The results showed (60%) of the family provided

good emotional support. According to Friedman

(2010), it can be explained that emotional support as

the primary family coping goal to meet an adaptation.

Researchers assume that, emotional support can be

realized in the form of affection, trust, attention,

listening and listening. So this emotional support that

encourages an atmosphere of feeling achieves

compliance in the adaptability of the hallucinatory

patient. Emotional support is also needed to

strengthen the family in order to avoid the

psychosocial impact due to family members who

have hallucinations.

The results showed (60%) of the family provided

good information support. According to Friedman

(2010), the form of information support provided by

the family is to provide advice or advice, advice or

directions and provide important information that is

needed by the patient hallucinations in improving

health status. Researchers assume that, the support of

information provided to the family hallucinations of

patients is one form of family health care function in

maintaining the state of health of family members in

order to maintain high productivity. Thus, it is

important that information relief efforts for

hallucinations patients to improve the spirit and

motivation of patients hallucinations in order to

improve their adaptability optimally.

The results showed (60%) of the families

provided good instrumental support. According to

Friedman (2010), the objective family burden

includes the family burden in the conduct of caring

for one family member experiencing hallucinations,

including in this objective family burden the financial

cost, for care and treatment, shelter, food and

transportation. The instrumental support of the family

is a function of the economy and the function of

health care that the family applies to sick family

members. The researcher assumed that, paying

attention to regularly escorting the patient to a mental

health facility, consulting the progress of patient care

and maintaining medication adherence and providing

activity to the hallucinator. This should be done even

if the burden of families to access mental health is

very difficult, especially related to family finances..

The results showed (60%) of the families

provided good assessment support. According to

Friedman (2010) family assessment support is a form

of affective function of the family against

hallucinating patients who can improve the health

Table 1: Distribution of family characteristics.

Category Frequency Percentage

Age

a. 15 – 35 years

b. 36 – 55 years

C. 56

–

ears

20%

50%

30%

Gender

a. Male

. Female

20%

80%

Last education

a. Junior

. Senio

20%

80%

Employment

a. Work

. Does not wor

70%

30%

Relationship with

patients

a. mother

b. Husband

c. Brother

d. Brotherk

e. Children

40%

10%

20%

10%

Table 2: The Correlation between family support with

adaptability of patients with hallucination.

Family

Support

Ada

tabilit

Total

Ada

tive Malada

tive

f % f % f %

Goo

6 100 0 0 6 100

Mediu

1 25 3 75 4 100

Total 7 70 3 30 10 100

erman Rho Test

=0.005

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

628

status of patients hallucinations. Through the support

of this assessment, patient hallucinations will gain

recognition of their ability as small and simple as

anything. Researchers assume that the patient's ability

to observe activities from the family as a form of

direct assessment support will increase self-esteem

and patient recognition in the eyes of the family and

the environment. Thus, the adaptability of patients

with hallucinations will gradually improve with

improved assessment support.

Adaptability has a value of each (70%) for

adaptive adaptability, and (30%) are maladaptive.

This is supported by Ambari's research (2010), there

are several factors that can affect the ability of

individual adaptation, namely the existence of social,

spiritual, assessment, and psychological needs.

Researchers assume that maladaptive adaptability is

affected by a lack of basic needs to adapt, such as lack

of family support, and unfulfilled desires.

Adaptation research results show (70%) of

adaptive social responses. This is in accordance with

research Ambari (2010), which states that high

adaptability is greatly influenced by social response.

Researchers assume that, social response can describe

the individual can interact with the environment well,

so the environment can provide an assessment of the

individual, whether adaptive adaptive or maladaptive.

Adaptation study results show (70%) of adaptive

psychological responses. This is in accordance with

the research Ambari (2010), adaptability depends on

the level of stress a person. Researchers assume that,

the adaptability of patients hallucinations tend to

change, because the level of stress experienced by

patients hallucinations tend to change.

Adaptation study results show (70%) assessment

responses in adaptive family support. In accordance

with Ambari's (2010) study, it shows that, patients

with hallucinations are not easy to remember the

stigma of society against "madmen" who consider as

individuals with strange behavior and difficult to

recover and experience social isolation, thus making

patients feel inferior and avoid social contact.

Researchers assume that, the patient's assessment

response is very important to be heard by the family.

so that families are able to provide better support and

patients can reinteract with their environment

Adaptation research results show (70%) spiritual

response in adaptive family support. In accordance

with the research of Ambari (2010), that patient

hallucinations can surrender to God for what trials are

given. Researchers assume that, hallucinations who

have adaptive spiritual responses, are able to accept

circumstances and submit to God

Performed statistical test of spearmen rho

obtained result 蟻 = 0,005 <伪 = 0,05, with value r =

0,802 which belong to perfect category (0,8 - 1) so it

can be concluded that H1 accepted, and H0 rejected.

The results showed that, hallucinations patients were

given good family support and had adaptive

adaptability of 6 people (60%). According to

Friedman (2010), the result of providing good family

support can make the hallucination patient has

adaptive adaptability. This shows the functioning of

the family of the hallucination patient, especially the

affective function as the internal function of the

family to meet the psychosocial needs of family

members such as caring for each other's love of

warmth and mutual support among family members.

Researchers assume that the family is the most

comfortable person for the hallucination patients. The

family can boost the spirit and motivation to behave

adaptively by providing good family support. As well

as providing appropriate care and treatment facilities.

Family support is the attitude, action, and acceptance

of the family to members of the family experiencing

hallucinations with varying nature and type of

support, including emotional support, information

support, instrumental support and assessment

support. Such support forms a single family support

unit, especially for family members who have health

problems such as hallucinatory problems with the

involvement of family support.

Good family support has a significant effect on the

rate of adaptation of hallucinatory patients (85.7%).

The results are supported by Friedman's (2010) study,

which shows the functioning of the patient's family in

the sub-province, especially the affective function as

the internal function of the family to meet the

psychosocial needs of family members such as caring

for each other, love, love, warmth and mutual support

among family members.

5 CONCLUSIONS

Most families of hallucinations give good family

support that provided in the form of emotional

support, information, instrumental and assessment.

Most post-treatment hallucinations have adaptive

adaptability in social, psychological, judgmental, and

spiritual responses. Good family support is highly

correlated with adaptive post-treatment adaptive

adaptability..

Family Support Relationships with Patient Adaptation Ability above with Diagnosis Hallucination of Post Care

629

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