THEORETICAL BACKGROUND

OF HALUSINATION

A. MAIN PROBLEMS
Sensory perception disorders: hallucinations
B. PROCESS OF THE PROBLEM
1. Definition
Hallucinations are disorders or changes in perception where
patients perceive something that actually doesn't happen. An application
of the five senses is a sign of external stimulation. An experience
experienced by a perception through the five senses without external
stimuli: false perception. (Prabowo, 2014: 129)
Hallucinations are the loss of human ability to distinguish internal
stimuli (thoughts) and external stimuli (external world). Clients give
perceptions or opinions about the environment without any real objects or
stimuli. For example, the client said he heard a voice even though no one
spoke. (Kusumawati & Hartono, 2012: 102)
Hallucinations are one of the symptoms of a mental disorder in
which the client experiences sensory changes in perception, feeling a false
sensation in the form of sound, vision, taste, touch or seduction. The client
feels a stimulus that actually isn't there. (Damaiyanti, 2012: 53)
2. Causes
a. Predisposing factors
1) Developmental Factors
The task of developing the patient is disrupted eg low control and
warmth of the family causing patients unable to be independent
since childhood, easily frustrated, loss of confidence and more
vulnerable to stress.
2) Sociocultural Factors
Someone who feels unacceptable in his environment since the
baby will feel excluded, lonely, and does not believe in his
environment.
3) Biochemical factors
Has an influence on the occurrence of mental disorders. Excessive
stress is experienced by someone so that in the body a substance
that can be neurochemical hallucinogenic can be produced. As a

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 result of prolonged stress, it causes activation of brain
neutransmitters.
4) Psychological Factors
Weak and irresponsible personality types easily fall into addictive
substance abuse. This has an effect on the patient's inability to
make the right decisions for the future. Patients prefer momentary
pleasure and run away from reality to the natural world.
5) Genetic Factors and Parenting Patterns
Research shows that healthy children raised by schizophrenic
parents tend to experience schizophrenia. The results of the study
show that family factors show a very influential relationship to this
disease. (Prabowo, 2014: 132-133)
b. Precipitation Factor
1) Biology
Disorders in communication and turning the brain, which regulates
the process of information and abnormalities in the entrance
mechanism in the brain which results in the inability to selectively
respond to stimuli received by the brain to be interpreted.
2) Environmental Stress
The tolerance threshold for tress that interacts with environmental
stressors to determine the occurrence of behavioral disorders.
3) Koping Source
Source of coping affects the response of individuals in responding
to stress. (Prabowo, 2014: 133)
4) Behavior
The client's response to hallucinations can be suspicion, fear,
feelings of insecurity, anxiety, and confusion, withdrawal behavior,
lack of attention, unable to make decisions and unable to
distinguish between real and not.
a) Physical dimension
It can be caused by some physical conditions such as extreme
fatigue, the use of drugs, fever to delirium, alcohol intoxication
and difficulty sleeping for long periods of time.
b) Emotional dimensions
Excessive feelings of anxiety on the basis of problems that
cannot be overcome are the causes of hallucination that occur,
the contents of hallucinations can be forcing and frightening.

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 The client is no longer able to oppose the order until the
condition the client does something about the fear.
c) Intellectual dimension
In this intellectual dimension explains that individuals with
hallucinations will show a decrease in ego function. Initially
hallucinations are usha from the ego itself to resist pressing
impulses, but it is a matter that raises awareness that can take
all the attention of the client and often control all client
behavior.
d) Social dimensions
Clients experience impaired social interaction in the initial
phase and comforting, the client considers that life socializing
real life is very dangerous. The client is engrossed with his
hallucinations, as if he is a place to fulfill the needs for social
interaction, self control and self-esteem that is not found in the
real world. The contents of hallucinations are controlled by the
individual, so that if the hallucinatory command is a threat,
himself or someone else tends to nursing the client by seeking
an interaction process that gives rise to satisfying interpersonal
experiences, and seeks the client to not be alone so the client
always interacts with the environment and hallucinations do
not take place.
e) Spiritual dimension
Spiritually the hallucinatory client begins with the void of life,
routine, meaningless, loss of worship activities and rarely
spiritually seeks to purify oneself, the circadian rhythm is
disturbed. (Damaiyanti, 2012: 57-58)
3. Type
Shutting consists of several types, with certain characteristics, including:
a. Hearing Hallucinations (acoustic, audiotoric)
Impaired stimulus where the patient hears voices, especially the voices
of people, usually the patient hears the voice of a person who is talking
about what he is thinking and orders to do something.
b. Hallucinations (visual)
Visual stimuli in various forms such as the form of light scattering,
geometric images, cartoon images and / or wide and complex
panorama. Shadow bias can be fun or scary.

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 c. Objection Hallucinations (Olfaktori)
Impaired stimulation of the smell, which is characterized by a foul
odor, fishy, and disgusting smell like: blood, urine or feces.
Sometimes it smells nice. The bias is related to strokes, tumors,
seizures and dementia.
d. Hallucinations of Feelers (Tactile, Kinaestatik)
Impaired stimulus characterized by the presence of sick or unpleasant
sara without visible stimulus. Examples of feeling an electrical
sensation come from the ground, inanimate objects or other people.
e. Gustatorik's Hallucinations
Impaired stimulus characterized by feeling something rotten, fishy,
and disgusting.
f. Sinestetic hallucinations
Impaired stimulus characterized by feeling bodily functions such as
blood flowing through a vein or artery, digestible food or urine
formation. (Yosep Iyus, 2007: 130)
g. Viseral hallucinations
The emergence of certain feelings in his body.
1) Depersonalization is a strange feeling in him that his personality is
not as usual anymore and not in accordance with the reality. Often
in schizophrenia and parietal obus syndrome. For example, often
feel that the two are divided.
2) Derelization is a strange feeling about the environment that is not
in accordance with reality. For example the feeling of everything
he experienced as in a dream. (Damaiyanti, 2012: 55-56)
4. Response Range
Perception refers to the identification and initial interpretation of a
stimulus based on information received through the five senses.
Neurobiological responses throughout the healthy range of pain range
from adaptive logical thoughts, accurate perceptions, consistent emotions,
and behavior according to maladaptive responses which include delusions,
hallucinations, and social isolation. The response range can be described
as follows:

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Neurobiological Response Range
Adaptive response Maladaptive Response

Logical mind The mind sometimes Mind disorder

deviates
Accurate perception Illusion Hallucinations
Consistent’s Emotions Excessive/unreacted Difficulty in processing
emotional reactions emotions
Behavior is appropriate Unusual behavior Chaotic behavior
Social relations Experiencing Social isolation
irregularities
Range of neurobiological responses (Stuart and Sundeen, 1998)
a. Adaptive response
Adaptive response is an acceptable response to prevailing socio-
cultural norms. In other words the individual is within normal limits if
facing a problem will be able to solve the problem. Adaptive
response:
1) Logical thoughts are views that lead to reality
2) Accurate perception is the right view of reality
3) Emotions are consistent with experience that is feelings that arise
from the experience of experts
4) Social behavior is an attitude and behavior that is still within
reasonable limits
5) Social relations is the process of interaction with other people and
the environment
b. Psychosossial response
Includes:
1) The thought process is disturbed is the thought process that causes
interference
2) Illusions are miss interpretations or wrong judgments about the
application that actually happened (real object) because of sensory
stimuli
3) Excessive or reduced emotions
4) Unusual behavior is attitude and behavior that exceeds the limits of
reasonableness

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 5) Withdrawing is an experiment to avoid interaction with other
people.
c. Maladaptive response
Maladaptive response is the response of individuals in solving
problems that deviate from socio-cultural and environmental norms,
there is also a maladaptive response, among others:
1) Mind abnormalities are beliefs that are firmly maintained even
though they are not believed by others and are contrary to social
reality.
2) Hallucinations are wrong sensory perceptions or external
perceptions that are not real or nonexistent.
3) Damage to the emotional process is a change in something that
arises from the heart.
4) Unorganized behavior is irregular
5) Sausage isolation is a condition of solitude experienced by an
individual and accepted as a provision by another person and as a
negative threat. (Damaiyanti, 2012: 54)
5. The Process of Problems
The stages of hallucinations consist of 4 phases and each phase has
different characteristics, namely:
a. Phase I
Patients experience deep feelings such as anxiety, loneliness, guilt and
fear and try to focus on pleasant thoughts to relieve anxiety. Here the
patient smiles or laughs inappropriately, moves the tongue without
sound, the eye movements are fast, silent and engrossed themselves.
b. Phase II
A disgusting and frightening sensory experience. The patient begins to
lose control and tries to distance himself from the perceived source.
Here there is an increase in signs of the autonomic nervous system due
to anxiety such as increased vital signs (heart rate, breathing, and
blood pressure), engrossed in sensory experiences and loss of ability to
distinguish hallucinations with reaita.
c. Phase III
Patients stop stopping resistance to hallucinations and succumb to the
hallucinations. Here patients find it difficult to get in touch with other
people, sweat, tremor, are unable to obey orders from other people and

6
 are in a very stressful condition especially if they are going to connect
with other people.
d. Phase IV
The sensory experience becomes threatening if the patient follows a
hallucinatory order. In this case there is violence, agitation, withdrawal,
unable to respond to complex orders and unable to respond to more
than one person. The patient's condition is very dangerous. (Prabowo,
2014: 130-131)
6. Signs and Symptoms
The behaviors associated with hallucinations are as follows:
a. Talk, smile, and laugh yourself
b. Moving lips without sound, rapid eye movement, and slow verb
response
c. Withdraw from others, and try to avoid yourself from other people
d. Cannot distinguish between real conditions and unreal circumstances
e. An increase in the pulse rate, breathing and blood pressure
f. Attention with less environment or just a few seconds and concentrate
on the sensory experience.
g. Suspicious, hostile, destructive (yourself, others and the environment)
and afraid
h. It's hard to connect with other people
i. Tense, irritable, irritated and angry
j. Unable to follow orders
k. Tremors and sweating appear, panic behavior, agitation and catatonic.
(Prabowo, 2014: 133-134)
7. Consequences
The result of thirst is the risk of injuring yourself, other people and
the environment. This is because the patient is under his hallucinations
asking him to do something beyond his consciousness (Prabowo, 2014:
134)
8. Coping mechanism
a. Regression: being lazy in daily activities
b. Projections: describe changes in a perception by trying to drain
responsibility to others
c. Withdrawing: it's hard to trust others and is absorbed in internal
stimuli. (Prabowo, 2014: 134)
9. Management

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 Treatment must be given as quickly as possible, here the
family's role is very important because after getting treatment at the
RSJ patients are declared allowed to go home so that the family has a
very important role in terms of caring for patients, creating a
conducive family environment and as a supervisor to take medicine
a. Pharmacotherapy
Effective doses of neuroleptics are beneficial in patients with
chronic schizophrenia, the results are more if they start being given
in two years of illness. Nolololeptics with high doses of effect are
beneficial in psychomotor patients who are increasing.
CHEMICAL CLASS GENERIC NAME DAILY DOSAGE
Phenothiazine Asetofenazin (Tidal) 60-120 mg
Klopromazin (Thorazine) 30-800 mg
Flufenazine (Prolixine, Permit) 1-40 mg
Mesoridazin (Serentil) 30-400 mg
Perfenazin (Trialon) 12-64 mg
Prokloperazin (Compazine) 15-150 mg
Promazine (Sparine) 40-1200 mg
Tiodazin (Mellani) 150-800 mg
Trifluopromazine (Stelazine) 2-40 mg
Trifluopromazine (Vesprin) 60-150 mg
Toxantene Kloproktisen (Tarctan) 75-600 mg
Tioktiksen (Navane) 8-30 mg
Butirophenone Haloperidol (Haldol) 1-100 mg
Dibenzodiazepines Klozapin (Clorazil) 300-900 mg
Dibenzoxazepine Loksapin (Loxitane) 20-150 mg
Didraindolon Molindone (Moban) 225-225 mg
b. Electrical seizure therapy
Electrical seizure therapy is a treatment for artificially causing
grand mall seizures by passing electricity through an electrode
mounted on one or two temples, electrical seizure therapy can be
given to schizophrenia that does not work with oral or injection
neuroleptic therapy, therapeutic dose of electrical seizures 4-5
joule / second.
c. Psychotherapy and rehabilitation
Individual or group supportive psychotherapy is very helpful
because it deals with practical purposes with the intention of

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 preparing patients back to the community, besides that work
therapy is very good for encouraging patients to get along with
other people, nurses and doctors. That is so that patients do not
isolate themselves because they can form bad habits, it is
recommended to hold games or joint exercises, such as therapy
modalities which consist of:
d. Activity therapy
1) Music therapy
Focus; hear; playing a musical instrument; sing. that is
enjoying relaxation music that patients like.
2) Art therapy
Focus: to express feelings through some art work.
3) Dancing therapy
Focus on: expression of feeling through body movements.
4) Relaxation therapy
 Learning and relaxation practices in groups.
 Rational: adaptive / descriptive mall behavior / behavior
increases patient participation and pleasure in life.
5) Social therapy
Patients learn to socialize with other patients.
6) Group therapy
a) Group therapy (therapeutic group)
b) Group activity therapy (adjunctive group activity therapy)
c) GAT Perception Stimulus; Hallucinations
 Session 1: Get to know hallucinations
 Session 2: Control hallucinations with rebuke
 Session 3: Control hallucinations by carrying out
activities
 Session 4: Prevent hallucinations by talking
 Session 5: control hallucinations by obediently taking
medication 14
e. Environmental therapy
The atmosphere of the hospital is made like a home like
atmosphere (Home Like Atmosphere) (Prabowo, 2014: 134-136)

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10. Problem of tree
Risk for directed violence Effect

Perceptual sensory changes Core Problem

Social isolation Cause

11. Nursing problems and data that need to be reviewed

1) Nursing problems
a. Risk for other-directed and self-directed violence
b. Perceptual sensory changes: hallucinations
c. Social isolation: withdrawing
2) Data that needs to be reviewed
a. The risk of injuring yourself, others and the environment
Subjective Data:
- Clients say hate or resent someone.
- Clients like to yell and attack people who disturb them if they
are upset or angry.
- History of violent behavior or other mental disorders.
Objective Data:
- Red eyes, slightly red face.
- High and loud tone of voice, master talk: shouting, screaming,
hitting yourself / others.
- Expressions angry when talking about people, sharp eyes.
- Damaging and throwing things.
b. Perceptual sensory changes: hallucinations
Subjective data :
- Clients say they hear sounds that are not related to the real
stimulus
- Clients say they see images without any real stimulus
- The client said he smelled without stimulus
- The client feels he is eating something
- The client feels something on his skin
- Clients are afraid of sounds / images / images that are seen
and heard

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 - The client wants to hit / throw things
Objective Data:
- Clients talk and laugh themselves
- Clients behave like hearing / seeing something
- The client stops talking in the middle of a sentence to hear
something
- Disorientation
c. Social isolation: withdrawing
Subjective Data:
- The client said I was incapable, unable, ignorant, stupid, self-
criticizing, expressing feelings of shame towards myself.
Objective Data:
- Clients look more like themselves, confused when told to
choose alternative actions, want to injure themselves / want to
end their lives, Apathy, Sad expressions, Verbal
communication, Activity decreases, Position of the fetus
during sleep, Refuse to relate, Less attention to cleanliness
12. Nursing Diagnosis
1) Perceptual sensory changes: hallucinations
2) Social isolation: withdrawing
13. Nursing Interventions
DIAGNOSIS GENERAL SPECIAL INTERVENTION
PURPOSE PURPOSE
Perceptual Clients do not 1. Clients can 1.1. Establish a trusting
sensory injure build a relationship using the
changes: themselves, relationship of principles of therapeutic
hallucinations others and the mutual trust in communication by:
environment the basis for the a. Greet clients with
smooth verbal and non
interaction of verbal friendliness
the relationship b. Introduce yourself
further politely
c. Ask the client's full
name and preferred
nickname
d. Explain the purpose

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 of the meeting
e. Be honest and keep
promises
f. Show empathy and
accept clients as they
are
g. Give attention to the
client and attention
to the client's basic
needs

2. Clients can 2.1 Hold frequent and short

recognize their contacts in stages
hallucinations 2.2 Observation of client
behavior related to
hallucinations: talking
and laughing without
stimulus looking left /
right / forward as if there
were interlocutors
2.3 Help clients know their
hallucinations
a. Ask if there is a
sound heard
b. What was said was
hallucinations
c. Tell the nurse to
believe the client
heard the sound, but
the nurse himself did
not hear it.
d. Say that there are
also other clients
like that
e. Say that the nurse
will help the client

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 2.4 Discuss with clients:
a. Situations that cause
/ do not cause
hallucinations
b. Time and frequency
of hallucinations
(morning, afternoon,
evening, night)
2.5 Discuss with the client
what is felt if
hallucinations occur
(anger, fear, sadness,
pleasure) give the client
a chance to express his
feelings

3. Clients can 3.1 Identify with the client

control their how the actions taken if
hallucinations hallucinations occur
(sleep, anger, busy
themselves etc.)
3.2 Discuss the benefits of
the way the client uses it,
if it is useful to
compliment
3.3 Discuss new ways to
decide / control the
appearance of
hallucinations:
a. Say "I don't want to
hear"
b. Meet other people
c. Make a schedule of
daily activities
d. Ask family / friends
/ nurses to say hello

13
 if the client seems to
be speaking alone
3.4 Help clients choose and
practice ways to break
the hallucinations in
stages
3.5 Give an opportunity to
do the way you have
been trained
3.6 Evaluate the results and
give praise if successful
3.7 Encourage clients to
follow GAT, orientation,
reality, perception
stimulation

4. The client gets 4.1 Encourage the client to

support from notify the family if they
the family in experience hallucinations
controlling the 4.2 Discuss with family
hallucinations (during a visit / during a
home visit):
a. Hallucinations
symptoms
experienced by
clients
b. Ways that clients
and families can do
to break
hallucinations
c. How to care for
family members
who are
hallucinating at
home, given
activities, don't let

14
 yourself, eat
together, travel
together
d. Give information on
the time of follow-
up or why you need
to get help:
uncontrolled
hallucinations, and
the risk of injuring
yourself or others

5. Clients make 5.1 Discuss with clients and

good use of family about the dosage,
drugs frequency and benefits of
taking medication
5.2 Encourage the client to
ask the nurse for her own
medication and feel the
benefits
5.3 Advise the client to talk
to the doctor about the
benefits and side effects
of taking the medication
that is felt
5.4 Discuss the
consequences of
stopping drugs without
consultation
5.5 Help clients use drugs
with principle 5 right.

Social Client wouldn’t 1. Clients can 1.1 Build a trusting

isolation: have perceptual foster trusting relationship: therapeutic
withdrawing sensory changes relationships greetings, introduce
yourself, explain the

15
 purpose of the
interaction, create a calm
environment, make a
clear agreement about
the topic, place and time.
1.2 Pay attention and
appreciation: accompany
the client even if he
doesn't answer.
1.3 Listen with empathy:
give a chance to talk,
don't be in a hurry, show
that the nurse follows the
client's conversation.

2. Clients can 2.1 Assess client knowledge

mention the about withdrawal
causes of behavior and its signs
withdrawal 2.2 Give the opportunity to
the client to express the
feeling of the cause of
withdrawal or want to
get along
2.3 Discuss with clients
about withdrawal
behavior, signs and
causes that arise
2.4 Give praise to the client's
ability to express his
feelings

3. Clients can 3.1 Assess client knowledge

mention the about the benefits and
benefits of benefits of dealing with
dealing with others
other people a. Give the client an

16
 and losses not opportunity to express
related to feelings about the
others. benefits associated
with other people
b. Discuss with clients
about the benefits of
dealing with others
c. Give positive
reinforcement of the
ability to express
feelings about the
benefits of dealing
with others
3.2 Assess client knowledge
about losses if not related
to others
a. Give the client an
opportunity to express
feelings with others
b. Discuss with clients
about losses not
related to others
c. Give positive
reinforcement of the
ability to express
feelings about loss not
related to others

4. Clients can 4.1 Assess the client's ability

carry out to build relationships
social relations with others
4.2 Encourage and help
clients to connect with
others through stages:
- K-P
- Other K-P-P

17
 - Other K - P - P -
another K
- K - Kel / Klp / Masy
4.3 Give positive
reinforcement of the
success achieved
4.4 Help the client to
evaluate the related
benefits
4.5 Discuss the daily
schedule with the client
in filling time
4.6 Motivation of clients to
participate in room
activities
4.7 Give positive
reinforcement of client
activities in the activities
of the room

5. Clients can 5.1 Encourage clients to

express their express their feelings
feelings after when dealing with other
dealing with people
other people 5.2 Discuss with the client
about the benefits of
dealing with others
5.3 Give positive
reinforcement of the
client's ability to express
feelings of benefits
related to others

6. Clients can 6.1 Establish a trusting

empower a relationship with family:
support system - Greetings, self-

18
or family introduction
- Explain the purpose
- Make a contract
- Exploration of client
feelings
6.2 Discuss with family
members about:
- Withdrawal behavior
- Causes of withdrawal
behavior
- As a result of what
happens when
withdrawal behavior
is not addressed
- The way families deal
with withdrawing
clients
6.3 Encourage family
members to provide
support to clients to
communicate with others
6.4 Encourage family
members regularly and
take turns visiting clients
at least once a week
6.5 Give positive positive
reinforcement of the
things that have been
achieved by the family

19
 IMPLEMENTATION STRATEGY: CHANGE OF HALUSINATION
SENSORS PERCEPTION

A. Client Conditions
 The clerk said that the client often was alone in the room
 Clients often laugh and smile to themselves
 The client said he often heard voices whispering and the contents were
unclear and saw demons.
B. Nursing Diagnosis
Sensory perception disorders: hearing hallucinations
C. Purpose
The goals of action for patients include:
1) Patients recognize the hallucinations they experience
2) Patients can control their hallucinations
3) Patients follow an optimal treatment program

D. Strategies for Implementing Nursing Actions

IS 1: Helps patients know hallucinations, explains ways to control
hallucinations, teaches patients to control hallucinations in the first way:
screams hallucinations
Orientation:
"Good morning, sir, I am a nursing student from UMB who will take care of you. My
name is Mutia Adeline, usually i called Mutia. What is your name, sir? What do you
like to be called?
"How are you feeling today? What are your complaints right now? "
"Well, what if we talk about the voice that you have heard but does not appear?
Where do you want to sit? In the living room? How long? How about 30 minutes?”

Work:
"Did you hear the voice without intentions? What did the voice say?"
"Is it constantly heard or at any time? When do you hear most often? How many
times a day do you hear these voices? Under what circumstances does that sound
sound? Is it at own time or when together with others? "
"What do you feel when you hear that voice?"
"What did you do when you heard that voice? Does that sound disappear? What if
we learn ways to prevent the voices from appearing?

20
"Sir, there are four ways to prevent these voices from appearing. First, by rebuking or
yelling at the sound. Second, by talking to other people. Third, carry out scheduled
activities, and the fourth takes medication regularly. "
"What if we learn one method first, by rebuking snaps".
"The trick is as follows: when the voices appear, you immediately say, go away I
don't want to hear, ... I don't want to hear. You are fake voice. Once repeated until the
sound was not heard again. Try it! Well, that is ... good! Try again! Yes, very good,
you can do it. "

Termination:
"How do you feel after the exercise demonstration?" If the voices appear again,
please try the method! How do we make the training schedule. What time do you
want to practice? (You enter a hallucinating activity in the patient's daily activity
schedule). What if we meet again to learn and practice controlling sounds in the
second way? What time do you want, sir? How about two more hours? How long will
we train? Where do you want to be?
"Okay, see you later."

SP 2 Patients: Train patients to control hallucinations in a second way:

conversing with other people
Orientation:
"Good morning, sir. How are you feeling today? Do the voices still appear? Have you
used the method we have practiced? Decreasing the voices? Good! According to our
promises, I will train the second way to control hallucinations by chatting with other
people. We will practice for 20 minutes. Where do you want? Here?”

Work:
"The second way to prevent / control other hallucinations is to chat with other people.
So if you start hearing voices, just find a friend to talk to. Ask friends to chat with
you, for example like this; ... please, I began to hear voices. Let's chat with me! So,
sir, try to do it like I did before. Yes, that is so. Nice! Try once again! Nice! Well,
keep training, sir! "

Termination:
"How do you feel after this exercise? So how many ways have you learned to prevent
those voices? Good, try both ways if you experience hallucinations again. What if we

21
put it in your daily activity schedule. What time do you want to practice
conversations? Well later do it regularly and at any time the sound appears!
Tomorrow I will come again. What if we practice the third way, which is to do
scheduled activities? What time do you want? How about 8:00? Where do you want?
Here again? See you tomorrow Good morning"

SP 3 Patients: Train patients to control hallucinations in a third way: carry

out scheduled activities
Orientation:
"Good morning, sir. How are you feeling today? Do the voices still appear? Have you
used the two methods that we have trained? How is the result ? Good! According to
our promises, today we will learn the third way to prevent hallucinations, namely to
do scheduled activities. Where do we want to talk? Well we will sit in the living
room. How long do we talk? How about 30 minutes? OK."

Work:
"What do you usually do? In the morning, what is the activity, then the next hour
(keep on asking until you get activities until evening). Wow, there are so many
activities. Let's practice two activities today (practice the activity). Very good you can
do. This activity can be done by you to prevent the sound from appearing. We will
train other activities so that there are activities from morning to night.

Termination:
"How do you feel after we have conversed the third way to prevent voices? Very
good! Try to mention 3 ways that we have practiced to prevent voices. Very good.
Let's put it in your daily activity schedule. Try to do it according to schedule! (You
can train other activities at the next meeting until all activities are fulfilled from
morning to night.) What about before lunch, we discuss how to take good medicine.
What time do you want? How about 12.00? In the dining room? See you later."

SP 4 Patients: Train patients to use drugs regularly

Orientation:
"Good morning, sir. How are you feeling today? Do the voices still appear? Have you
used the three methods that we have trained? Has the activity schedule been carried
out? Have you taken medicine this morning? Well. Today we will discuss about

22
medicines that you drink. We will have 20 minutes of discussion while waiting for
lunch. Just here, sir? "

Work:
"Sir, there is any difference after taking medication regularly? Are the voices
reduced/missing? Taking medicine is very important so that the voices that you hear
and interfere with during this time do not appear again. How many drugs do you
drink? (The nurse prepares the patient's medicine) This is the orange color (CPZ) 3
times a day at 7 am, 1 pm and 7 pm is to eliminate the sounds. This white one (THP)
3 times a day is to relaxing your body. And the pink (HP) 3 times a day is to calming
your mind. If the voices are gone the medicine should not be stopped. Later, consult
with your doctor, because if you break the medication, you will relapse and find it
difficult to restore it to its original state. If the medicine runs out, you can ask the
doctor to get the medicine again. you also have to be careful when using these drugs.
Make sure the medicine is correct, you have to make sure it's a medicine that you
really have. Don't get wrong with someone else's medicine. Read the name of the
package. Make sure the medication is taken in time, in the right way. That is to be
taken after meals and at the exact hour, you also have to pay attention to how many
medicines you take once, and you need to drink 10 glasses per day. "

Termination:
"How do you feel after we talk about medicine? How many ways have we trained to
prevent voices? Try to mention! Nice! (if the answer is correct). Let's enter the
medication schedule on the mister's activity schedule Don't forget in time asking for
medication for the nurse or for the family at home. Now the food has arrived.
Tomorrow we meet again to see the benefits of the 4 ways to prevent the sounds we
have talked about. What time do you want? What if it's 10:00? OK see you later."

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 DAFTAR PUSTAKA

Eko Prabowo. 2014. Konsep & Aplikasi Asuhan Keperawatan Jiwa. Yogyakarta:
Nuha Medika.
Mukhripah Damayanti, Iskandar. 2012. Asuhan Keperawatan Jiwa. Bandung: Refika
Aditama.
Wijayaningsih, K. s. 2015. Panduan Lengkap Praktik Klinik Keperawatan Jiwa.
Jakarta Timur: TIM

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