EFEKTIVITAS SPIRITUAL EMOTIONAL FREEDOM TECHNIQUE (SEFT) DALAM MENURUNKAN TINGKAT KECEMASAN PADA PRIMIGRAVIDA TRIMESTER TIGA

ASRI HIDAYAT, Prof. dr. Ova Emilia, Sp.OG., M.Med.Ed., Ph.D.; dr. Fatwa Sari Tetra Dewi, MPH., Ph.D.; DR Sumarni, M.Si.

2021 | Disertasi | DOKTOR ILMU KEDOKTERAN DAN KESEHATAN

Latar belakang: Dalam menghadapi persalinan, rasa cemas melahirkan sering terjadi. Kecemasan yang tidak teratasi dengan baik, menyebabkan perubahan fungsi sistem saraf otonom/ANS, memperberat adaptasi kardiovaskuler dan berisiko terjadi komplikasi pada ibu hamil. Cognitive behavior therapy (CBT) adalah standar emas di bidang psikoterapi, tapi penggunaan emotional freedom technique (EFT) memiliki keuntungan praktis, sementara Mindfulness Efficiency Based on Islamic-Spiritual Scheme lebih efektif dibandingkan dengan CBT. SEFT adalah teknik yang menggabungkan spiritualitas berupa doa, keikhlasan, kepasrahan dan syukur dengan EFT/energi psikologi, melalui teknik yaitu set-up, tune-in dan tapping. Tujuan: Melakukan identifikasi perbedaan perubahan tingkat kecemasanan, perubahan nilai rasio Low Frequency (LF)/High Frequency (HF) dari heart rate variability/HRV primigravida trimester tiga, lama persalinan kala II, berat badan lahir bayi, tingkat risiko depresi postpartum antara ibu yang mendapat SEFT dan yang tidak mendapat SEFT. Metode: Penelitian Mixed Method dengan pendekatan explanatory sequential. Penelitian kuantitatif menggunakan rancangan quasi eksperimen noneqivalent control group design with pre-post test. Rancangan penelitian kualitatif menggunakan studi kasus untuk mengetahui proses dan hasil SEFT terhadap kecemasan primigravida trimester tiga. Populasi penelitian adalah primigravida yang periksa di puskesmas Bantul DIY. Perhitungan sampel dengan rumus uji hipotesis terhadap 2 proporsi 2 kelompok independen, ditemukan jumlah sampel sebanyak 62 orang (intervensi: 31 orang, kontrol 31: orang), dengan accidental sampling. SEFT dilakukan pada usia kehamilan 36 minggu dan 1 minggu sebelum hari perkiraan lahir (2 kali), diantaranya ibu melakukan sendiri pada waktu cemas, dengan melihat panduan SEFT. Uji statistik untuk mengetahui perbedaan perubahan tingkat kecemasan, tingkat risiko depresi postpartum antara kelompok intervensi dengan kontrol menggunakan uji t-test. Uji statistik untuk mengetahui perbedaan perubahan nilai rasio LF/HF dari HRV, lama kala II antara kelompok intervensi dengan kontrol menggunakan uji Mann Whitney. Uji statistik untuk mengetahui perbedaan berat badan lahir bayi pada kelompok intervensi dengan kontrol menggunakan uji X2. Hasil: Penelitian kuantitatif membuktikan terdapat perbedaan perubahan nilai rasio LF/HF dari HRV pada kelompok intervensi dengan kontrol (uji Mann Whitney; p < 0,05). Tidak terdapat perbedaan perubahan tingkat kecemasan, lama kala II, berat badan lahir bayi, tingkat risiko depresi postpartum antara kelompok intervensi dengan kontrol (Uji T-tes, uji Mann Whitney, uji Chi-square, uji T-tes p > 0,05). Penelitian kualitatif membuktikan bahwa pada informan yang mendapat SEFT baik yang mengalami penurunan maupun peningkatan tingkat kecemasan, sama-sama merasakan manfaat dan efektifitas SEFT. Kesimpulan: SEFT efektif dalam menurunkan nilai rasio LF/HF dari HRV, tapi tidak efektif dalam menurunkan tingkat kecemasan. Hasil penelitian kualitatif menunjukkan adanya perbaikan kecemasan secara klinis pada kelompok intervensi, demikian juga penurunan tingkat kecemasan secara deskriptif lebih besar pada kelompok intervensi.

Background: In the face of labour, the anxiety of giving birth often occurs. Anxiety that is not handled properly causes changes in the function of the autonomic nervous system/ANS, aggravates cardiovascular adaptation and risks complications in pregnant women. Cognitive behaviour therapy (CBT) is the gold standard in the field of psychotherapy, but the use of emotional freedom technique (EFT) has practical advantages, while Mindfulness Efficiency Based on Islamic-Spiritual Scheme more effective than CBT. SEFT is a technique that combines spirituality in the form of prayer, sincerity, submission, and gratitude with EFT/psychological energy, through techniques namely set-up, tune-in and tapping. Aim: Identify differences in changes in anxiety levels, changes in ratio values Low Frequency (LF)/High Frequency (HF) from heart rate variability Third trimester primigravida HRV, duration of second stage of labour, baby's birth weight, level of depression risk postpartum between mothers who received SEFT and those who did not. Method: Study Mixed Method with approach explanatory sequential. Quantitative research using a quasi-experimental design non-equivalent control group design with pre-post-test. This qualitative research design used a case study to determine the process and results of SEFT on third trimester primigravida anxiety. The study population was primigravida who were examined at the Bantul Yogyakarta Health Centre. Calculation of the sample using the hypothesis test formula for 2 proportions of 2 independent groups, it was found that the number of samples was 62 people (intervention: 31 people, control 31: people), with accidental sampling. SEFT is performed at 36 weeks of gestation and 1 week before the due date (2 times), including mothers who do it themselves when they are anxious, by looking at SEFT guidelines. Statistical test to determine differences in changes in anxiety levels, depression risk levels postpartum between the intervention group and the control group using the test t-test. Statistical test to determine the difference in changes in the value of the LF/HF ratio of HRV, the length of the second stage between the intervention group and the control group using the test Mann Whitney. Statistical test to determine differences in infant birth weight in the intervention group with the control using X2 test. Results: Quantitative research proves that there is a difference in the change in the value of the LF/ HF ratio of HRV in the intervention group and the control group (-test). Mann Whitney; p < 0.05). There is no difference in changes in anxiety levels, duration of second stage, baby's birth weight, level of depression risk postpartum between the intervention group and the control group (Test T-test, test Mann Whitney, test Chi-square, test T-test p > 0.05). Qualitative research proves that the informants who received SEFT, both those who experienced a decrease or an increase in their level of anxiety, both felt the benefits and effectiveness of SEFT. Conclusion: SEFT is effective in reducing the LF/HF ratio of HRV, but not effective in reducing anxiety levels. The results of the qualitative study showed an improvement in clinical anxiety in the intervention group, as well as a greater reduction in anxiety levels descriptively in the intervention group. Keywords: SEFT, anxiety, third trimester primigravida

Kata Kunci : SEFT, kecemasan, primigravida trimester tiga