The Effect of the Dreamer Spiritual Therapies on Saliva Cortisol Hormone and Pain Score Patients in the Intensive Care Unit: A True-experimental Study

Authors

  • Iwan Purnawan Department of Nursing, Faculty of Health Sciences, Jenderal Soedirman University, Purwokerto, Indonesia; Doctoral Program in Medical and Health Sciences, Faculty of Medicine, Public Health, and Nursing, Gadjah Mada University, Yogyakarta, Indonesia
  • Sri Setiyarini Department of Nursing, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia image/svg+xml
  • Probosuseno Probosuseno Department of Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia image/svg+xml
  • Yunita Widyastuti Department of Medicine, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia image/svg+xml

DOI:

https://doi.org/10.3889/oamjms.2021.7462

Keywords:

Critical patient, Cortisol, Post-operative pain, Stress, Psychological, Intensive care unit

Abstract

BACKGROUND: Patients’ conditions can worsen if stress and pain are not appropriately managed. Conventional therapy ignores psychological and spiritual aspects. Both influence the body’s response to various stimuli.

AIM: This study aimed to assess how Dreamer’s spiritual therapy can affect the cortisol and pain in the intensive care unit (ICU) patients.

METHODS: It involved 86 ICU patients in a true-experimental study. Respondents were divided into the intervention and the control group randomly. The intervention group received Dreamer spiritual therapy (DST) for 30 min but not for the control group. Saliva samples and pain scores were taken from both groups before and after treatment. The comparison of two groups cortisol decreases using Wilcoxon test. Differences in pre- and post-pain scores in each group were analyzed using paired t-test.

RESULTS: According to Levene’s test, the two groups were homogeneous (p > 0.05). The Wilcoxon test revealed a statistically significant difference in cortisol level reduction between the intervention (3.88 ng/mL) and control (3.82 ng/ml) groups (p = 0.024), with a large effect size (Cohen’s d value = 59.5). The paired t-test revealed a statistically significant decrease in the intervention group’s pain score from 2.6 to 1.95 (p = 0.001), with a moderate effect size (Cohen’s d value = 0.49). The control group’s pain score did not significantly decrease (p = 0.75).

CONCLUSIONS: A DST is effective in reducing salivary cortisol levels and pain scores of ICU patients.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Klein DG, Dumpe M, Katz E, Bena J. Pain assessment in the intensive care unit: Development and psychometric testing of the nonverbal pain assessment tool. Hear Lung J Acute Crit Care. 2010;39(6):521-8. https://doi.org/10.1016/j.hrtlng.2010.05.053 PMid:20888642 DOI: https://doi.org/10.1016/j.hrtlng.2010.05.053

Urden LD, Stacy KM, Lough ME. Critical Care Nursing : Diagnosis anda Management. 7th ed. Canada: Mosby; 2014.

Puntillo M. Pain. In: Pathophysiological Phenomena in Nursing: Human Responses to Illness. 3rd ed. Carrieri-Kohlman, Lindsey. St. Louis, Missouri: Saunders; 2003. p. 235-55.

Berntzen H, Bjørk IT, Wøien H. Pain relieved, but still struggling-critically ill patients experiences of pain and other discomforts during analgosedation. J Clin Nurs. 2018;2(1):223-34. https://doi.org/10.1111/jocn.13920 PMid:28618123 DOI: https://doi.org/10.1111/jocn.13920

Ristianingsih D, Septiwi C, Yuniar I. An overview of nursing motivation and actions in fulfilling patient spiritual needs in the ICU PKU muhammadiyah. Kesehatan. 2014;10(2):100-7.

Al-Kaheel A. Al Qur’an the Healing Book. Jakarta: Tarbawi Press; 2011.

Kozier B, Erb G, Berman A, Snyder S. Kozier and erb’s fundamentals of nursing: Concepts, process and practice. Nurse Educ Pract. 2012;12(2):e12. https://doi.org/10.1016/j.nepr.2011.09.002 DOI: https://doi.org/10.1016/j.nepr.2011.09.002

Alligood MR, editor. Nursing Theorist and Their Work. 8th ed. St. Louis, Missouri: Elsevier; 2014. p. 765.

Smith MJ, Liehr P, editors. Middle Range Theory for Nursing. New York: Springer Publishing Company; 2014. p. 479. DOI: https://doi.org/10.1891/9780826195524

Hu R, Jiang X, Zeng Y, Chen X, Zhang Y. Effects of earplugs and eye masks on nocturnal sleep, melatonin and cortisol in a simulated intensive care unit environment. Crit Care. 2010;14(2):2-9. https://doi.org/10.1186/cc8965 PMid:20398302 DOI: https://doi.org/10.1186/cc8965

Wallace J, Robins J, Alvord LS, Walker JM. The effect of earplugs on sleeo measures during exposure to stimulated ICU noise. Am J Crit Care. 1999;8(4):210-9. https://doi.org/10.4037/ajcc1999.8.4.210 PMid:10392220 DOI: https://doi.org/10.4037/ajcc1999.8.4.210

Najafi Ghezeljeh T, Mohades Ardebili F, Rafii F. The effects of massage and music on pain, anxiety and relaxation in burn patients: Randomized controlled clinical trial. Burns. 2017;43(5):1034-43. https://doi.org/10.1016/j.burns.2017.01.011 PMid:28169080 DOI: https://doi.org/10.1016/j.burns.2017.01.011

Newberg AB, Wintering NA, Yaden DB, Waldman MR, Reddin J. A case series study of the neurophysiological effects of altered states of mind during intense Islamic prayer. J Physiol Paris. 2015;109(4-6):214-20. https://doi.org/10.1016/j.jphysparis.2015.08.001 PMid:26296991 DOI: https://doi.org/10.1016/j.jphysparis.2015.08.001

Syarif M. Peranan do’a dan zikir dalam menghadapi trauma yang dialami pasien di rumah sakit 1. In: Seminar and Workshop Post Traumatic Counseling. Padang; EST; 2012. p. 147-55.

Wahida S, Nooryanto M, Andarini S. Al Qur’an Surah arrahman recital therapy increase β-endorphin levels and reduce childbirth pain. J Kedokt Brawijaya. 2015;28(3):213-6. https://doi.org/10.21776/ub.jkb.2015.028.03.9 DOI: https://doi.org/10.21776/ub.jkb.2015.028.03.9

Misnawati W, Ropyanto CB. In: Utami RS, editor. The Effect of Dzikir Concerning to Pain Level After Surgical Operation Reduction Internal Fixation (ORIF). Semarang: Harmony of Caring and Heali; 2015.

Rahman FS, Yahya N, Din NM, Izaham A, Mat WR. The comparative effects of listening to prayer recitation and music therapy intraoperatively on postoperative pain. Int Med J Malaysia. 2018;17(2):107-15. https://doi.org/10.31436/imjm.v17i2.277 DOI: https://doi.org/10.31436/imjm.v17i2.277

Sulistyawati RA, Probosuseno, Setiyarini S. Dhikr therapy for reducing anxiety in cancer patients. Asia Pac J Oncol Nurs. 2017;4(2):95-7. https://doi.org/10.4103/apjon.apjon_33_19 DOI: https://doi.org/10.4103/apjon.apjon_33_19

Sukarni S, Mardiyono M, Parwati MD. 4T Zikr in anxiety reduction in acute coronary syndrome patients. J Ris Kesehat. 2014;3(2):567-75.

Jafari H, Zeydi AE, Khani S, Esmaeili R, Soleimani A. The effects of listening to preferred music on pain intensity after open heart surgery. Iran J Nurs Midwifery Res. 2012;17(1):1-6. PMid:23493927

Oktora SP, Purnawan I, Achiriyati D. The effect of murottal Al Qur’an therapy on sleep quality in the social rehabilitation unit of the dewanata cilacap. J Keperawatan Soedirman. 2016;11(3):168-73. https://doi.org/10.20884/1.jks.2016.11.3.710 DOI: https://doi.org/10.20884/1.jks.2016.11.3.710

Atiyaningsih N, Wulandari I. Dhikr Therapy to Improving Sleep Quality for Post Surgery Patient at Banten Indonesia. Indonesia: The 5th AASIC; 2017.

Steptoe A, Serwinski B. Cortisol Awakening Response. Stress: Concepts, Cognition, Emotion, and Behavior: Handbook of Stress. Netherlands: Elsevier Inc.; 2016. p. 277-83. https://doi.org/10.1016/b978-0-12-800951-2.00034-0 DOI: https://doi.org/10.1016/B978-0-12-800951-2.00034-0

Sussex R. How Different Cultures Experience and Talk about Pain. The Conersation; 2015. p. 11-3. Available from: https:// www.theconversation.com/how-different-cultures-experience-and-talk-about-pain-49046. [Last Accessed on 2021 Aug 25].

Riley JL, Cruz-Almeida Y, Glover TL, King CD, Goodin BR, Sibille KT, et al. Age and race effects on pain sensitivity and modulation among middle-aged and older adults. J Pain. 2014;15(3):272-82. https://doi.org/10.1016/j.jpain.2013.10.015 PMid:24239561 DOI: https://doi.org/10.1016/j.jpain.2013.10.015

El Tumi H, Johnson MI, Dantas PB, Maynard MJ, Tashani OA. Age-related changes in pain sensitivity in healthy humans: A systematic review with meta-analysis. Eur J Pain (United Kingdom). 2017;21(6):955-64. https://doi.org/10.1002/ejp.1011 PMid:28230292 DOI: https://doi.org/10.1002/ejp.1011

Vellyana D, Lestari A, Rahmawati A. Faktor-Faktor yang Berhubungan dengan Tingkat Kecemasan pada Pasien Preoperative di RS Mitra Husada Pringsewu. J Kesehat. 2017;8(1):108. https://doi.org/10.26630/jk.v8i1.403 DOI: https://doi.org/10.26630/jk.v8i1.403

Jacq G, Melot K, Bezou M, Foucault L, Courau-Courtois J, Cavelot S, et al. Music for pain relief during bed bathing of mechanically ventilated patients: A pilot study. PLoS One. 2018;13(11):e0207174. DOI: https://doi.org/10.1371/journal.pone.0207174

Annesi SM, Brooks-Brunn JA, Byers JF, Casey PE, Cash J, Corbin J. Brunner and Suddarth’s Textbook of Medical-surgical Nursing. 14th ed., Vol. 79. United States: Lippincott Williams & Wilkins; 2017. p. 151.

Youssef NA, Abdelmalek MF, Binks M, Guy CD, Omenetti A, Smith AD, et al. Associations of depression, anxiety and antidepressants with histological severity of nonalcoholic fatty liver disease. Liver Int. 2013;33(7):1062-70. https://doi.org/10.1111/liv.12165 PMid:23560860 DOI: https://doi.org/10.1111/liv.12165

Trevor AJ, White PF. Anestetik umum. In: Katzung BG, editor. Farmakologi Dasar dan Klinik. 10th ed. Jakarta: EGC; 2010. p. 405-85.

Hsu CC, Chen WM, Chen SR, Tseng YT, Lin PC. Effectiveness of music listening in patients with total knee replacement during CPM rehabilitation. Biol Res Nurs. 2016;18(1):68-75. https://doi.org/10.1177/1099800415572147 PMid:25693577 DOI: https://doi.org/10.1177/1099800415572147

Waldron NH, Jones CA, Gan TJ, Allen TK, Habib AS. Impact of perioperative dexamethasone on postoperative analgesia and side-effects: Systematic review and meta-analysis. Br J Anaesth. 2013;110(2):191-200. https://doi.org/10.1093/bja/aes431 PMid:23220857 DOI: https://doi.org/10.1093/bja/aes431

Koh IJ, Chang CB, Lee JH, Jeon YT, Kim TK. Preemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: A randomized controlled study. Clin Orthop Relat Res. 2013;471(9):3010-20. https://doi.org/10.1007/s11999-013-3032-5 PMid:23645340 DOI: https://doi.org/10.1007/s11999-013-3032-5

Irawan H. Perbandingan kadar kortisol dan efek analgesia pascabedah anestesi spinal kombinasi bupivakain hiperbarik 0, 5% 8 mg dan klonidin 30 μg dengan bupivakain hiperbarik 0, 5% 8 mg dan Morfin 0, 1 mg pada pasien yang menjalani prosedur seksio sesaria. Maj Anest dan Crit Care. 2017;32(2):111-7. https://doi.org/10.47507/obstetri.v3i2.45 DOI: https://doi.org/10.47507/obstetri.v3i2.45

Ozgocer T, Ucar C, Yildiz S. Cortisol awakening response is blunted and pain perception is increased during menses in cyclic women. Psychoneuroendocrinology. 2017;77:158-64. https://doi.org/10.1016/j.psyneuen.2016.12.011 PMid:28064085 DOI: https://doi.org/10.1016/j.psyneuen.2016.12.011

Liu Y, Petrini MA. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery. Complement Ther Med. 2015;23(5):714-8. https://doi.org/10.1016/j.ctim.2015.08.002 PMid:26365452 DOI: https://doi.org/10.1016/j.ctim.2015.08.002

Dossey BM, Keegan L, Guzzetta CE. Holistic Nursing: A handbook for Practice. 4th ed. London: Jones And Bartlett Publishers; 2013.

Mejía Rubalcava C, Alanís Tavira J, Mendieta Zerón H, Sánchez Pérez L. Changes induced by music therapy to physiologic parameters in patients with dental anxiety. Complement Ther Clin Pract. 2015;21(4):282-6. https://doi.org/10.1016/j.ctcp.2015.10.005 PMid:26573456 DOI: https://doi.org/10.1016/j.ctcp.2015.10.005

Rokade PB. Release of endomorphin hormone and its effects on our body and moods : A review. Int Conf Chem Biol Environ Sci. 2011;431127(215):436-8.

Mulyani NS, Purnawan I, Upoyo AS. Differences in effects of murottal therapy for 15 minutes and 25 minutes on reduction of pain scale in post-surgery cancer patients. J Bionurs. 2019;1(1):77-88.

Bayrami R, Ebrahimipour H. Effect of the Quran sound on labor pain and other maternal and neonatal factors in nulliparous women. J Res Health Soc Dev Heal Promot Res Cent. 2014;4(4):898-902.

Wirakhmi IN, Novitasari D, Purnawan I. Comparison of influence of listening mozart music with murotal al quran on pain in hypertension patients. J Keperawatan Soedirman. 2018;13(3):100-6. https://doi.org/10.20884/1.jks.2018.13.3.813 DOI: https://doi.org/10.20884/1.jks.2018.13.3.813

Alivian GN, Purnawan I, Setiyono D. The effectiveness of listening to murottal and prayer to reduce anxiety in hemodialysis patients. J Keperawatan Sriwij. 2019;6(2):13-7.

Ahsan A, Khan M. The healing power of prayer in Islam. Indian J Posit Psychol. 2012;3(2):2012.

Downloads

Published

2021-12-01

How to Cite

1.
Purnawan I, Setiyarini S, Probosuseno P, Widyastuti Y. The Effect of the Dreamer Spiritual Therapies on Saliva Cortisol Hormone and Pain Score Patients in the Intensive Care Unit: A True-experimental Study. Open Access Maced J Med Sci [Internet]. 2021 Dec. 1 [cited 2024 Apr. 19];9(G):281-7. Available from: https://oamjms.eu/index.php/mjms/article/view/7462

Issue

Section

Emergency Nursing

Categories

Most read articles by the same author(s)