Effect of Psychodrama Model Activities Therapy In

Reducing The Level Of Depression In Elderly In The

Seruni Environment Of Taman Sari Village Working
Area Of Tanjung Karang Community Health Center
Mataram City
Arif Munandar
Department of Psychiatric Nursing, Master of Nursing Program, Postgraduate Program, University
Muhammadiyah Yogyakarta, Bantul, Indonesia.

ABSTRACT

Objective : Group Activity Theraphy of Psychodrama Model is one of many health thraphies using
specific dramatic method to discover patients’ emotional problem. This thraphy is relevant for
patients with depression especially for the elderly people. This theraphy is aimed at changing one’s
behaviour as interaction takes place among the group members and is very effective to lessen the
depression level of the elders. Methods : This study employs the quasi experiment using the
approach of pre-test and post-test with control group design. Using the purposive sampling
technique, 32 respondents are taken as samples and are devided into two groups of 16 (in
experimental group) and 16 (in control group) respectively. Data is collected through documentation
and questionnaire. The study takes 1 month to finish the with 8 to meet time of 40 minute. Data
analysis is conducted using the difference group no same with the kolmogorov smirnov and the
difference group same with wilcoxon at significance level of 5%. Result : The result of research, at
experimental group these are 8 respondents (50%) who have no depression and 8 respondents (50%)
still have light depression, in the control group there are 13 respondents (81,25%) still have light
depression and 3 respondents (18,75%) still have heavy depression. Conclusion : It seems that there a
significant change has taken place towards the experimental group after the treatment of Group
Activity Theraphy. At comparison of the experimental group and of the control group at post test the
difference to method the meaning (p = 0,037, p < 0,05), and the proceeds the wilcoxon pre and post
test at experimental group, the proceeds in difference to method the meaning (p = 0,003, p < 0,05).
For to complete this study employs of data about the group Activity Theraphy of the Psychodrama
Model to hope researcher next at to modification frekuensi and time to meet with respondents and in
the work data to take at to meet.

KEYWORD : The Group Activity Of The Psychodrama Model, Depression, Elderly People.

* Corresponding Author
Email: arifm96553@gmail.com
Tel : +6285253708078
Master of Nursing, Postgraduate Program, Level 2,
Jalan Brawijaya Tamantirto, University Muhammadiyah
Yogyakarta, 55183, Bantul, Indonesia.
INTRODUCTION

Aging is the inability of tissues to replace or change and control musculoskeletal functions, so they
cannot refrain from germs and reconstruct the organs they experience (Nugroho, 2000). Elderly is
representative in the process of growth and development. Parents may not immediately become
elderly, the process of making neonates, children, adults to old age. According to the rule number
13/1998 on the welfare of the elderly Bab I Pasal 1 Ayat 2, that the elderly are someone over the
age of 60 years. Elderly is not only related to physical problems, but also mental disorders, several
factors that cause mental disorders, for example depression. Depression is an expression of sadness
and pessimism that is released with suffering and psychological attack on him (Nugroho, 2000).

Statistical data put forward by WHO (2012) states that the elderly population in the world as many
as 564 million people or 8% of the 7 billion people in the world, with the number of sufferers
suffering from depression as many as 350 million people. The population in Indonesia is 24 million
(BKKBN RI, 2011), and sufferers suffering from depression amount to 11.6% of the population
(Riskesdas, 2007). In West Nusa Tenggara Province with a population of 280,938 people (BPS NTB,
2011) and depressed patients 545,000 (13.8%). 45,000 people with severe depression (1.0%)
(Riskesdas, 2007). For the city of Mataram with a population of 356,141 people with an elderly
population of 6.9% (BPS Kota Mataram, 2007) and sufferers who experienced pressure as much as
6.2% from a mild negative ratio of 5.3% and those who experienced Severe depression as much as
0.9%. In the working area of Tanjung Karang Health Center with a population of 60,121 people and
an elderly population of 2775 people (Profile of PKM Tanjung Karang, 2012). In the Taman Sari
Village area the population is 6,035 people with an elderly population of 284 people. In the area of
Taman Sari sub-district consists of 6 neighborhoods, namely: in the Kapitan Park neighborhood with
a population of 1940 people and an elderly population of 53 people, in Gajah Mada Park with a
population of 506 people and an elderly population of 30 people, in the Gatep Indah neighborhood
with a population of 704 people and a population of around 50 people, in the Gatep Permai area
with a population of 878 people and a population of about 51 people, in the Irrigation environment
the population is 561 people and the elderly population is 45 people and in Taman Seruni
environment with a population of 1,446 people and a population of elderly people as many as 55
people (Data from Taman Sari Village, 2012). Of the 6 environments above only in the Seruni Park
area, which has the largest number of elderly people, 55 people. Based on the results of the
researchers' preliminary survey in April 2012 of 55 respondents, the number obtained was the
number of 32 people and 2 people who were experiencing moderate depression.

In the Taman Seruni neighborhood, Posyandu for the elderly has not been designated as a place of
blessing for their health. In addition, therapeutic modalities that have never been done before,
psychodrama therapy has never been done at all. Group Activity Therapy is very effective,
considering in groups, namely the behavior of one individual with another individual. One model of
Group Accessibility Therapy that is relevant to the condition of the NOT Psychodrama Model.
Psychodrama model for emotional problems experienced by someone with a problem (Kaplan and
Shadock, 1997).
METHODS

The research subjects were all elderly who were scaly in the environment of Seruni Park Taman Sari
Village, Tanjung Karang City Public Health Center Working Area. In this study, the object of the
research was the Group Recreation Therapy Model psychodrama in depressed elderly in the Seruni
Park Taman Sari Village, the working area of the Tanjung Karang City Public Health Center in
Mataram. The population in this study were all the elderly who settled in the Seruni Park Taman
Sari Village as many as 55 people. The sample in this study amounted to 32 inclusion members.
Inclusion criteria are the standards set before the study was conducted (Nursalam, 2011). In this
study the analysis used a purposive sampling technique, namely the determination technique using
samples. (Nursalam, 2011).

The design in this study used quasi experiments, namely the design that regulates say about
causation by including groups that purify the treatment group (Nursalam, 2011). This study used the
Kolmogorov Smirnov test and Wilcoxon test. While the confidence level used in this study is 5%
significance. Ha accepted announced p <0.05. The research instrument used was the TAK
psychodrama model, while the instrument for the dependent variable was Beck's Depression
Inventory (IDB). This study was conducted in order to report the number of population in
determining the number of samples to be used.

RESULT
a. Identifying Depression Levels Prior to the Psychodrama Model Group Activity Therapy.
Table 1.1. Distribution of Depression Levels in the Elderly Prior to the therapy of the
Psychodrama model group activities
Experiment Control
N Depression Level group group
o total % total %
1 No Depression 0 0 0 0
2 Mild depression 15 94 15 94
3 Moderate depression 1 6 1 6
4 Severe depression 0 0 0 0
Total 16 100 16 100

Source: Primary Data.

From the table above, it was carried out in groups before the therapy model (TAK) of the
Psychodrama model of the majority of respondents with a light weight of 15 respondents (93.75%)
and 1 respondent (6.25%) who were experiencing moderate depression. While in the control group
it was found that the number of respondents affected by depression were as many as 15
respondents (93.75%) and 1 respondent (6.25%) were moderate depression.
b. Identifying Depression Level after Applied Therapy Psychodrama Model. Table 1.2. Level of
Elderly Depression After the introduction of the Psychodrama Model Therapy.

Experiment Control group

N Depression Level group
o Total % Total %
1 No Depression 8 50 0 0
2 Mild depression 8 50 13 81
3 Moderate depression 0 0 3 19
4 Severe depression 0 0 0 0
Total 16 100 16 100

Source: Primary Data.

Based on the table above, measurements of therapeutic models (psychotrama) can be carried
out, respondents in the experimental group who did not experience depression were as many
as 8 respondents (50%) and those with mild depression as many as 8 respondents (50%).
Meanwhile groups that can get those who are experiencing mild depression are as many as 13
respondents (81.25%) and 3 respondents (18.75%) who are experiencing moderate depression.

c. Analysis of Psychodrama Group Activity Therapy Model Against Decreased Depression Rate
in the Elderly. Based on the special data above, data analysis can be carried out to
determine whether or not there is a significant effect on the combination given between
the pre test and post test.
1) KOLMOGOROV SMIRNOV TEST
The smirnov kolmogorov test had no difference between pretest-posttest in groups
and groups based on the post-test. Table 1.1 .1 results of the Kolmogorov smirnov test.
Test Statisticsa

Pre Test Post Test

Most Extreme Differences Absolute .000 .500

Positive .000 .000

Negative .000 -.500

Kolmogorov-Smirnov Z .000 1.414

Asymp. Sig. (2-tailed) 1.000 .037

 Test Statisticsa

Pre Test Post Test

Most Extreme Differences Absolute .000 .500

Positive .000 .000

Negative .000 -.500

Kolmogorov-Smirnov Z .000 1.414

Asymp. Sig. (2-tailed) 1.000 .037

Grouping Variable : Treatment

a. Pretest data in the Treatment group and intervention group
had no significant figures (P = 1,000 , P > 0,05).
b. Posttest data in the treatment group and group had
significant differences (p = 0.037, p <0.05). To see which
groups give the right results, it is also done with trials.

2) WILCOXON TEST
Wilcoxon test to test whether there is a difference between the pre test in the
control group and the post test in the experimental group. Table 1.4. Wilcoxon Control
Group test results.
Depression Level Pre Depression Level Post Test
Test Total
No depression Mild Moderate Ρ
depressio depressio
n n
No depression 0 0 0 0 0,157
Mild 13 2 15
Moderate 0 0 1 1
Total 0 13 3 16
Wilcoxon Test

(a) Pre test control group data.

There is no overall difference (p = 0,157, p > 0,05).
Table 4.9 Experimental Group Wilcoxon Test Results.
Depresi level Pre Test Depression level Post Test
No Depression Mild Moderate Total Ρ
No depression 0 0 0 0 0,003
Mild 8 7 0 15
Moderate 0 1 0 1
Total 8 8 0 16
Wilcoxon Test
(b) Post test experiment group data.

There are differences overall (p = 0,003, p < 0,05).

Based on the statistical test with the Kolmogorov Smirnov test, the level of error of the
respondents before the TAK Psychodrama model showed no significant results (p = 1,000, p> 0.05)
in the treatment and intervention groups, and TAK Psychodrama intervention in the elderly,
obtained results there were differences in the control group and the experimental group (p = 0.037,
p <0.05).

Meanwhile, to see which groups gave the right results, it was carried out by the Wilcoxon test in
the control and experimental groups. The calculation results using the Wilcoxon test showed that in
the control group there were no differences at the beginning and end of the treatment (p = 0.157,
p> 0.05), in the experimental group there were differences between pre and post trauma (p =
0.003, p <0.05). Determine the Psychodrama Model ICT Model so that the results obtained
significantly p = 0.003 (p <0.05).

DISCUSSION

The psychodrama therapy model was carried out during the study of MOH respondents in the Taman
Seruni neighborhood of Taman Sari Village who were given 40 minutes of care to 16 respondents by
observing the respondent's beliefs and the ability of respondents to express their feelings in order
to socialize with others.

Based on the results of statistical tests using the Kolmogorov Smirnov test, the level of error of the
respondents before the TAK Psychodrama model showed no significant results (p = 1,000, p> 0.05)
between the control group and the experimental group, and the TAK intervention period
Psychodrama Model on the elderly, the results obtained were differences between the two groups
(p = 0.037, p <0.05).

CONCLUSION

In the experimental group 15 respondents (93.75%) had mild depression and 1 (6.25%) moderate
depression. While in the control group, 15 respondents (93.75%) had mild depression and 1
respondent (6.25%) had moderate depression. In the experimental group there were 8 respondents
(50%) who did not experience depression, and 8 respondents (50%) who experienced mild
depression. While in the control group 13 respondents (81.25%) experienced mild depression and 3
(18.75%) moderate depression. There is a significant influence from the TAK Psychodrama model on
the mortality rate at the Seruni Park Taman Sari Village in the Tanjung Karang City Public Health
Center in Mataram. (p = 0.003, p <0.05; Wilcoxon test in the experimental group).
CONFLICT OF INTEREST

The author declared no potential conflicts of interest with respect to the research authorship, and
publication of this article.

ACKNOWLEDGEMENTS

I express my deepest gratitude to the lecturers, friends, big family who motivated and gave
enthusiasm in compiling this paper, the first time I sent a thank you to experts and other parties
who contributed greatly to the paper this paper.

REFERENCES
1. Agustin., Ulliya. 2008. Differences in Depression Rate in the Elderly Before and After Active
Gymnastics Fit the Elderly at the Wening Ward, Wardo Ungaran. Semarang: PSIK Diponegoro
University and PPNI Semarang.
2. Ahmad, D. 2012. Model of Role Playing in Learning (online). (http: // www. blogspot.com,
accessed on January 12, 2012).
3. Arikunto, S. 2010. Research Procedure for a Practice Approach. Jakarta: Rineka Cipta.
4. Azizah, LM. 2011. Elderly Nursing. Jakarta: Graha Ilmu
5. Dalami, E. 2010. Basic Concepts of Mental Health Nursing. Jakarta: CV Trans Info Media
6. Darmojo and Martono. 2004. Geriatric Textbook (Elderly Health Sciences) edition 3.
Jakarta: Balai Pustaka FKUI.
7. Direja, AHS. 2011. Soul Nursing Care Books. Jakarta: Muha Medika.
8. Hawari, D. 2008. Stress Management, Anxiety and Depression. Jakarta: FKUI.
9. Hidayat, AAA. 2009. Nursing Research Methods and Data Analysis Techniques. Jakarta:
Salemba Medika.
10. Hutapea, R. 2005. Healthy and cheerful at dusk. Jakarta: Rineka Cipta.
11. Kaplan HI and Shadock BJ. 1997. Deep Pathological Anxiety: Psychiatric Synopsis. Seventh
edition. Jakarta: Binarupa Aksara
12. Keliat,, BA., Akemat. 2004. Soul Nursing Group Accessibility Therapy. Jakarta: EGC.
13. Kusumawati., Hartono. 2011. Soul Nursing Care Books. Jakarta: Salemba Medika.
14. Report Population Reference Bureau (PRB - WHO). 2012
15. Basic Health Research Reports. 2007
16. BKKBN RI Annual Report on Population. 2011
17. NTB Province BPS Population Annual Report. 2012
18. Annual Population Report of Taman Sari Village. 2012
19. Latifah, LH. 2006. Edinburgh Scale Effectiveness and Beck Scale in Detecting the Risk of
Post Partum Depression at the Regional General Hospital Prof. Dr. Margono Soekarjo
Purwokerto. Purwokerto: FK Sudirman University.
20. Lueckkeenotte. SG. 1996. Gerontology Nursing. Jakarta: Moesby Phladhelphia.
21. Maryam, RS. et al. 2011. Get to know old age and care. Jakarta: Salemba Medika.
 22. Mubarak WI. et al. 2009. Community Nursing Concepts and Applications. Jakarta: Salemba
Medika.
23. Notoatmodjo, S. 2010. Health Research Methodology, Jakarta: Rineka Cipta.
24. Nugroho, W. 2000. Elderly Nursing. Jakarta: EGC.
25. Nursalam. 2011. Concept and Application of Research Methodology in Nursing, Thesis
Guidelines, Thesis and Research Instruments. Jakarta: Salemba Medika.
26. Purnomo, L. 2008. Effect of Giving Therapy for Group Activities (TAK) Dissemination of
Behavior Changes in Depression in the Surakarta Mental Hospital, Central Java Province.
Surakarta: Surakarta Mental Hospital.
27. Setiadi. 2007. Concept & Writing of Nursing Research. Jakarta: Graha Ilmu.
28. Shaftel. 2007. Psychodrama (online) model. (http: // www. Scribd. Com, accessed on 12
February 2012).
29. Smeltzer, SC and Bare, BG. 1996. Textbook on Medical Surgical Nursing Issue 8 Vol. 3.
Jakarta: EGC.
30. Stuart and Laraia, 1998. Principles and practices of psychiatric nursing. Jakarta: CV Moesby
Company.
31. Sugiyono. 2012. Quantitative, Qualitative Research Methods and R & D Bandung: Alfabeta.
32. . 2012. Statistics for Research. Contents: Alfabeta.
33. Suparyanto. 2012. Relationship between Levels of Daily Life Activity (ADL) and Depression
Levels in Stroke Patients at the Flamboyan Pavilion in Jombang Hospital. Jombang: PSIK of
STIKES of Jombang Regency Government and BPPKB of Jombang.
34. Surini S and Utomo B. 2003. Physiotherapy in the elderly. Jakarta: EGC
35. Yusuf, A. et al. 2012. Cognitive Therapy Reduces the Rate of Elderly Depression. Surabaya:
FK Airlangga University.

Corresponding Author
Arif Munandar
Master of Nursing
University Muhammadiyah Yogyakarta
P.O. Box 84161, Bolo Bima,
Nusa Tenggara Barat, Indonesia
Adress : Health street, number 18 RT 03 RW 01, 84161, Rato, Bolo, Bima, West Nusa Tenggara,
Indonesia
Tel : +6285 253 708 078
Fax :-
Email : arifm96553@gmail.com