Effectiveness of Happy Spiritual Intervention in Reducing Hallucination Levels Among Schizophrenia Patients

  • Annisa Mazda Firdaus Department of Health, Subang State Polytechnic, Subang, Indonesia
  • Habsyah Saparidah Agustina Department of Health, Subang State Polytechnic, Subang, Indonesia
  • Muhammad Zaenal Muttaqin Department of Health, Subang State Polytechnic, Subang, Indonesia
Keywords: Hallucinations, Happy Spiritual Intervention, Schizophrenia

Abstract

Hallucinations are the main symptom of schizophrenia that negatively affect patients’ social and psychological functioning. Reducing the level of hallucinations is crucial, particularly during the recovery phase when patients require a holistic approach to improve their quality of life. Spiritual-based non-pharmacological interventions represent an alternative therapy with the potential to help decrease hallucination levels. The objective of this study was to determine the effect of the happy spiritual intervention on hallucination levels in patients with schizophrenia at the West Java Provincial Mental Hospital. Methods: This study employed a pre-experimental one-group pretest-posttest design with a quantitative approach. The sample consisted of 30 respondents selected through purposive sampling. The happy spiritual intervention was administered for 6 days, with each session lasting 15 minutes. Hallucination levels were measured using the Psychotic Symptom Rating Scale (PSYRATS). Data were analyzed using the Wilcoxon test with a significance level of 0.05. The findings showed a significant effect, namely a reduction in hallucination levels after the intervention (p = 0.001). Conclusion: The happy spiritual intervention significantly reduced hallucination levels in patients with schizophrenia during the recovery phase. This intervention can be used as a complementary Islamic spiritual-based therapy in psychiatric nursing practice and is recommended for routine implementation in mental health facilities

References

Amir, N., Malik, K., & Evawani, S. (2018, August). Validation of the Indonesian version of psychotic symptom rating scale (Ina-PSYRATS) hallucination subscale. In Journal of Physics: Conference Series (Vol. 1073, No. 2, p. 022026). IOP Publishing. https://doi.org/10.1088/1742-6596/1073/2/022026

Andika, H., Jamal, M. A., Huda, M., Maseleno, A., & Point, S. (2021). The effect of Islamic spiritual mindfulness therapy on the drugs adherence of skizofrenia patients through SI-POS android application. International Journal of Grid and Distributed Computing, 14(1), 305-312.

Basrowi, R. W., Wiguna, T., Samah, K., Moeloek, N. D. F., Soetrisno, M., Purwanto, S. A., ... & Pelangi, B. (2024). Exploring Mental Health Issues and Priorities in Indonesia Through Qualitative Expert Consensus. Clinical Practice and Epidemiology in Mental Health: CP & EMH, 20, e17450179331951. https://doi.org/10.2174/0117450179331951241022175443

Bell, A., Toh, W. L., Allen, P., Cella, M., Jardri, R., Larøi, F., Moseley, P., & Rossell, S. L. (2024). Examining the relationships between cognition and auditory hallucinations: A systematic review. Australian and New Zealand Journal of Psychiatry, 58(6), 467–497. https://doi.org/10.1177/00048674241235849

Biahimo, N. U. I., & Djafar, N. (2025). Pengaruh Though Stopping dan Psikoreligius Dzikir Pada Pasien dengan Gangguan Halusinasi Pendengaran di Puskesmas Telaga. Jurnal Keperawatan Muhammadiyah, 10(1), 26-33. https://doi.org/10.30651/jkm.v10i1.25077

Cleeland, C. S. (2007). Symptom burden: multiple symptoms and their impact as patient-reported outcomes. Journal of the National Cancer Institute Monographs, 2007(37), 16-21. https://doi.org/10.1093/jncimonographs/lgm005

Cleeland, C. S., Mendoza, T. R., Wang, X. S., Chou, C., Harle, M. T., Morrissey, M., & Engstrom, M. C. (2000). Assessing symptom distress in cancer patients: the MD Anderson Symptom Inventory. Cancer: Interdisciplinary International Journal of the American Cancer Society, 89(7), 1634-1646. https://doi.org/10.1002/1097-0142(20001001)89:7%3C1634::AID-CNCR29%3E3.0.CO;2-V

Dwidiyanti, M., Rahmawati, A. M., & Sawitri, D. R. (2021). The Effect of Islamic Spiritual Mindfulness on Self-Efficacy in Anger Management among Schizophrenic Patients. Nurse Media Journal of Nursing, 11(3), 404–412. https://doi.org/10.14710/nmjn.v11i3.37401

Dwidiyanti, M., Wijayanti, D. Y., Munif, B., Kandar, K., & Suerni, T. (2025). Reducing Violent Behavior in Schizophrenia Patients using Happy Spiritual Intervention through Rufa Caring System Monitoring. Nursing Information Journal, 5(1), 1-11.

Erduran-Tekin, Ö. (2019). The impact of spirituality and spiritually-oriented therapeutic interventions on schizophrenia patients. Spiritual Psychology and Counseling, 4(3), 309-320.

Erlanti, S., & Suerni, T. (2024). Penerapan terapi musik untuk mengurangi halusinasi pendengaran pada pasien dengan skizofrenia. Ners Muda, 5(1), 28. https://doi.org/10.26714/nm.v5i1.13163

Fan, Y., Fan, A., Yang, Z., & Fan, D. (2025). Global burden of mental disorders in 204 countries and territories, 1990–2021: results from the global burden of disease study 2021. BMC psychiatry, 25(1), 486. https://doi.org/10.1186/s12888-025-06932-y

Gasril, P., Suryani, S., & Sasmita, H. (2020). Pengaruh terapi psikoreligious: dzikir dalam mengontrol halusinasi pendengaran pada pasien skizofrenia yang muslim di Rumah Sakit Jiwa Tampan Provinsi Riau. Jurnal Ilmiah Universitas Batanghari Jambi, 20(3), 821-826. https://doi.org/10.33087/jiubj.v20i3.1063

Huguelet, P., Mohr, S., Betrisey, C., Borras, L., Gillieron, C., Marie, A. M., ... & Brandt, P. Y. (2011). A randomized trial of spiritual assessment of outpatients with schizophrenia: patients' and clinicians' experience. Psychiatric Services, 62(1), 79-86. https://doi.org/10.1176/ps.62.1.pss6201_0079

Kane, J. M., & Correll, C. U. (2010). Pharmacologic treatment of schizophrenia. Dialogues in clinical neuroscience, 12(3), 345-357. https://doi.org/10.31887/DCNS.2010.12.3/jkane

Knegtering, H., Bruggeman, R., & Spoelstra, S. K. (2024). Spirituality as a therapeutic approach for severe mental illness: insights from neural networks. Religions, 15(4), 489. https://doi.org/10.3390/rel15040489

Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018). Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments. World Psychiatry, 17(1), 12-23. https://doi.org/10.1002/wps.20508

Mabruro, N., Hafifah, V. N., & Heru, M. J. A. (2024). Intervensi Terapi Psikoreligius (Dzikir) terhadap Penyintas Gangguan Jiwa dengan Halusinasi Pendengaran di RSJ dr. Radjiman Wediodiningrat Lawang. TRILOGI: Jurnal Ilmu Teknologi, Kesehatan, Dan Humaniora, 5(1), 115–124. https://doi.org/10.33650/trilogi.v5i1.7782

Makhruzah, S., Putri, V. S., & Yanti, R. D. (2021). Pengaruh Penerapan Strategi Pelaksanaan Perilaku Kekerasan terhadap Tanda Gejala Klien Skizofrenia di Rumah Sakit Jiwa Daerah Provinsi Jambi. Jurnal Akademika Baiturrahim Jambi, 10(1), 39. https://doi.org/10.36565/jab.v10i1.268

McCorkle, R., & Quint-Benoliel, J. (1983). Symptom distress, current concerns and mood disturbance after diagnosis of life-threatening disease. Social science & medicine, 17(7), 431-438. https://doi.org/10.1016/0277-9536(83)90348-9

Miyamoto, S., Miyake, N., Jarskog, L. F., Fleischhacker, W. W., & Lieberman, J. A. (2012). Pharmacological treatment of schizophrenia: a critical review of the pharmacology and clinical effects of current and future therapeutic agents. Molecular psychiatry, 17(12), 1206-1227. https://doi.org/10.1038/mp.2012.47

Mushi, E., Alphonce, R., Waized, B., Muhanga, M. I., Khalili, N., & Rybak, C. (2025). Influence of consumer socio-psychological food environment on food choice and its implications for nutrition: evidence from Tanzania. Frontiers in Nutrition, 12, 1589492. https://doi.org/10.3389/fnut.2025.1589492

Nasution, M. K. (2023). Desain dan analisis data penelitian kuantitatif. Peningkatan Peneliti Bagi Dosen. https://doi.org/10.13140/RG.2.2.13297.86884

Permana, I. Z., Akemat, A., Imelisa, R., Niman, S., & Wisnusakti, K. (2025). Terapi Mindfulness Spiritual Sebagai Upaya Peningkatan Kepatuhan Pengobatan Pada Pasien Skizofrenia. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 16(2), 501-506.

Pham, M. D., Wulan, N. R., Sawyer, S. M., Agius, P. A., Fisher, J., Tran, T., ... & Azzopardi, P. S. (2024). Mental Health Problems Among Indonesian Adolescents: Findings of a Cross-Sectional Study Utilizing Validated Scales and Innovative Sampling Methods. Journal of Adolescent Health, 75(6), 929-938. https://doi.org/10.1016/j.jadohealth.2024.07.016

Portenoy, R. K., Thaler, H. T., Kornblith, A. B., Lepore, J. M., Friedlander-Klar, H., Kiyasu, E., ... & Scher, H. (1994). The Memorial Symptom Assessment Scale: an instrument for the evaluation of symptom prevalence, characteristics and distress. european Journal of cancer, 30(9), 1326-1336. https://doi.org/10.1016/0959-8049(94)90182-1

Putri, A. K., Gustriawanto, N., Rahapsari, S., Sholikhah, A. R., Prabaswara, S., Kusumawardhani, A. C., & Kristina, S. A. (2021). Exploring the perceived challenges and support needs of Indonesian mental health stakeholders: a qualitative study. International Journal of Mental Health Systems, 15(1), 81. https://doi.org/10.1186/s13033-021-00504-9

Rahvy, A., Habsy, A., & Ridlo, I. (2020). Actual challenges of mental health in Indonesia: Urgency, UHS, humanity, and government commitment. European Journal of Public Health, 30(Supplement_5), ckaa166-1023. https://doi.org/10.1093/eurpub/ckaa166.1023

Rawlett, K. E., Friedmann, E., & Thomas, S. A. (2019). Mindfulness based intervention with an attentional comparison group in at risk young adolescents: a pilot randomized controlled trial. Integrative Medicine Research, 8(2), 101–106. https://doi.org/10.1016/j.imr.2019.04.002

Rykkje, L., Søvik, M. B., Ross, L., McSherry, W., Cone, P., & Giske, T. (2022). Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review. Journal of clinical nursing, 31(11-12), 1440-1464. https://doi.org/10.1111/jocn.16067

Sadipun, D. K., Dwidiyanti, M., & Andriany, M. (2018). Effect of spiritual based mindfulness intervention on emotional control in adult patients with pulmonary tuberculosis. Belitung Nursing Journal, 4(2), 226–231. https://doi.org/10.33546/bnj.357

Salari, R., & Filus, A. (2017). Using the health belief model to explain mothers’ and fathers’ intention to participate in universal parenting programs. Prevention Science, 18(1), 83-94. https://doi.org/10.1007/s11121-016-0696-6

Same, K., Shobeiri, P., Rashidi, M. M., Ghasemi, E., Saeedi Moghaddam, S., Mohammadi, E., ... & Larijani, B. (2024). A global, regional, and national burden and quality of care index for schizophrenia: Global burden of disease systematic analysis 1990–2019. Schizophrenia bulletin, 50(5), 1083-1093. https://doi.org/10.1093/schbul/sbad120

Silverstein, S. M. (2016). Visual perception disturbances in schizophrenia: a unified model. The neuropsychopathology of schizophrenia: Molecules, brain systems, motivation, and cognition, 77-132. https://doi.org/10.1007/978-3-319-30596-7_4

Syahfitri, S., Gustina, E., & Pratama, M. Y. (2024). Asuhan Keperawatan Jiwa Pada Pasien Skizofrenia Dengan Halusinasi Pendengaran Dirumah Sakit Jiwa Prof. Dr. M. Ildren Medan. SENTRI: Jurnal Riset Ilmiah, 3(4), 1911–1927. https://doi.org/10.55681/sentri.v3i4.2565

Tavares, S. (2017). Severe mental disorders from a cognitive-behavioural perspective: a comprehensive review from conceptualization to intervention. Current Psychiatry Reviews, 13(3), 176-183. https://doi.org/10.2174/1573400513666170502123654

Triana, D. (2025). Implementation Of Psychoreligious Dhikr Therapy In Schizophrenia Patients With Auditory Hallucinations In The Working Area Of The Sukodono Lumajang Community Health Center. Professional Nursing Update Journal, 2(02), 78-87.

Turner, P. R., & Hodge, D. R. (2020). Spiritually informed interventions and psychotic disorders: A systematic review of randomized controlled trials. Research on Social Work Practice, 30(8), 895-906. https://doi.org/10.1177/1049731520946824

Watson, P. W. B., Garety, P. A., Weinman, J., Dunn, G., Bebbington, P. E., Fowler, D., ... & Kuipers, E. (2006). Emotional dysfunction in schizophrenia spectrum psychosis: the role of illness perceptions. Psychological medicine, 36(6), 761-770. https://doi.org/10.1017/S0033291706007458

Wevers, A., San Roman-Mata, S., Navarro-Ledesma, S., & Pruimboom, L. (2024). The Role of Insulin Within the Socio-Psycho-Biological Framework in Type 2 Diabetes—A Perspective from Psychoneuroimmunology. Biomedicines, 12(11), 2539. https://doi.org/10.3390/biomedicines12112539

Published
2025-12-31
How to Cite
Firdaus, A. M., Agustina, H. S., & Muttaqin, M. Z. (2025). Effectiveness of Happy Spiritual Intervention in Reducing Hallucination Levels Among Schizophrenia Patients. Journal La Medihealtico, 6(6), 1574-1584. https://doi.org/10.37899/journallamedihealtico.v6i6.2765