ICHT 2019

Selection and Peer-review under the responsibility of the ICHT Conference

Committee
Volume 2019

Conference Paper

Effectiveness of Progressive Relaxation

Therapy among Clients with Risk of Violence
Behavior in Indonesia
Vita Lucya, Wini Hadiyani, and Lia Juniarni
West Java PPNI Nursing College

Abstract
Objective: Clients diagnosed with risk of violent behavior might affect the surrounding
environment. A therapy is necessary to control the behavior and reduce clients
[Link] muscle relaxation is one of therapy aims to reduce tension
and anxiety by relaxing the muscles of the body with rhythmrelaxation exercises of
muscle from head to toe. (a) The purpose of this study was to identify the effect of
progressive relaxation therapy in decreasing signs and symptom of aggression among
clients with risk of violent behavior. Method: A quasi-experimental study was used
with pre and post-test one group design. The samples used were 16 respondents and
Corresponding Author: resulted in 50% of patients had red face signs and sharp eyes before intervention.
Vita Lucya Results:research results shows that (b). P value 0,017 was obtained showing the
vitalucyavita@[Link] influence of progressive relaxation therapy on clients with risk of violent behavior
Conclusion: It was concluded that progressive relaxation can be recommended for
Received: 22 September 2019
health care providers as one strategy action in managing client with violent behavior or
Accepted: 4 October 2019
Published: 10 October 2019
risk of violent behavior, especially to control anger and aggression. This therapycould
be suggested as one of patients’ preparation for discharge from hospital.
Publishing services provided by
Knowledge E Keywords: Relaxation Therapy, Nursing Problem, Violence BehaviorRisk
Vita Lucya et al. This article is
distributed under the terms of
the Creative Commons
Attribution License, which
permits unrestricted use and
redistribution provided that the
original author and source are 1. Introduction
credited.

Selection and Peer-review under

Advanced stages of mental disorder induce aggressive behavior which might harmful
the responsibility of the ICHT for both the sufferer and the closest social environment. Schizophrenia is one of severe
2019 Conference Committee.
mental disorder, which affects client perceptions, intellectualfunction, language, emotion
and social behavior (Hermann, 2008). Patient with schizophrenia have higher risk to
behave aggressively in which dramatically behavior changes occurs within days or
weeks. In some cases, attacks can increase when the disease become severe(chronic
schizophrenia). At this condition, client becomes savage, loses character as a human
in social life, has no motivation at all, depressed, and has no sensitivity to their own
feelings [1]. Positive symptoms often appear at the beginning of the schizophrenic phase

How to cite this article: Vita Lucya, Wini Hadiyani, and Lia Juniarni, (2019), “Effectiveness of Progressive Relaxation Therapy among Clients with
Risk of Violence Behavior in Indonesia” in Selection and Peer-review under the responsibility of the ICHT Conference Committee, KnE Life Sciences, Page 342
pages 342–348. DOI 10.18502/kls.v4i13.5264
 ICHT 2019

and violent behaviorbecome the main cause of patients hospitalization. The National
Institute of Mental Nursing Health’s Epidemiologic Catchment Area [2].
Progressive muscle relaxation (PMR) isone form of relaxation therapy that can be used
as therapeutic choice in patients who experience anxiety or the psychologic conditions
that often manifests to the existence of muscle tension (Sustrani, Alam and Hadibroto,
2004; Lilik, 2010). The mechanism of this therapy involving deep muscle relaxation
technique by repeatedly stretching and relaxing muscle [3]. The goal of this therapy is
reduce tension and anxiety through relaxation by targeting autonomic nerves (Utami,
2007). Previous studies using this therapy for violent prevention showing the significant
decrease of anger and the feeling ability to control violent behavior among intervention
group compare to the control group ( Jewell and Elliff’s, 2013).

2. Methods
2.1. Design

A quasi-experimental study was conducted using pre and post-test one group design.

2.2. Participant and Setting

The study was carried out in west java province hospital, (name of city), Indonesia. In
total, 20 participants were involved in this study. Subjects were recruited….

2.3. Measurement

(State your variable and how to measure it such as demographic and clinical character-
istics and etc.)

2.4. Intervention

2.4.1. Data collection procedure

(Statehow you collect data)

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2.5. Data analysis

(Example: Statistical analysis was carried out using the SPSS statistical program) version
… Characteristic of the sample were described using mean and standard deviation …

2.6. Ethical considerations

Approval for this study was obtained from …

3. Results
3.1. Population characteristics

3.1.1. Signs or symptoms of violent behavior before progressive relax-

ation therapy is carried out.

Signs or symptoms of violent behavior that are often shown by clients can be seen from
the following table:

Table 1: Frequency distribution of signs and symptoms of violent behavior before progressive relaxation
therapy is carried out.

Signs and symptoms of PK Yes No Total

f (%) f (%) f (%)
Red / Tense 8 50 8 50 16 100
Eyes bulging / sharp eyes 8 50 8 50 16 100
Rigid body posture 5 31,2 11 68,8 16 100
Jaws closed 2 12,5 14 87,5 16 100
High voice 5 31,2 11 68,8 16 100
Walk back and forth 5 31,2 11 68,8 16 100
Speak roughly 3 18,7 13 81,3 16 100
ketus 2 12,5 14 87,5 16 100
Distance yourself 3 18,7 13 81,3 16 100
Dominate 3 18,7 13 81,3 16 100
Emotional labile 2 12,5 14 87,5 16 100
Etc 6 37,5 10 62,5 16 100

Based on the table above shows that the dominant symptoms of clients with a risk
of violent behavior are red / tense face and 8 eyes (50%) glaring / sharp eyes.

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3.1.2. Signs or symptoms of violent behavior after progressive relaxation

therapy

Signs or symptoms of violent behavior that are still shown by the client after progressive
relaxation therapy can be seen from the following table:

Table 2: Frequency Distribution of signs and symptoms shown by the client at risk of violent behavior after
progressive relaxation therapy 2017.

Signs and symptoms of PK Yes No Total

f (%) f (%) f (%)
Red / Tense 7 43,7 9 56,3 16 100
Eyes bulging / sharp eyes 4 25 12 75 16 100
Rigid body posture 2 12,5 14 87,5 16 100
Jaws closed 1 6,2 15 97,8 16 100
High voice 1 6,2 15 97,8 16 100
Walk back and forth 2 12,5 14 87,5 16 100
Speak roughly 1 6,2 15 97,8 16 100
Ketus 2 12,5 14 87,5 16 100
Distance yourself 2 12,5 14 87,5 16 100
Dominate 2 12,5 14 87,5 16 100
Emotional labile 0 0 16 100 16 100
Etc 6 37,5 10 62,5 16 100

Based on the table above shows that the symptoms that are still often shown to
clients with a risk of violent behavior after progressive relaxation therapy is a red /
tense face of 7 clients (56.3%).

3.1.3. Effectiveness of progressive relaxation therapy on clients at risk

of violent behavior

Table 3: Effectiveness of progressive therapy for clients with a risk of 2017 violent behavior.

Variable P value
Before 0,017
After

Based on the table above shows the results of the analysis which has a value of p
value <α (0.05) which can be interpreted to be different signs or symptoms of violent
behavior on clients the risk of violent behavior before and after progressive relaxation
therapy.

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4. Discussion

Start with univariate findings that important to be discussed, then bivariate. Do NOT
repeated the results of this study in discussion section, paraphrase the results of this
study that you would like to discuss then compare with supporting literature.
Clients with a risk of violent behavior based on the results of the study obtained
from 20 clients there were 16 clients who showed some signs or symptoms of violent
behavior, most of which were red / tense and 8 clients (50%), while other symptoms
such as rigid body posture, high voice, pacing back and forth. This can still show that
clients are still at risk of committing violent behavior. Anger is a normal response, but if
it is expressed poorly it can lead to aggression and hostility [2]. Clients with experience
of committing violent behavior of course have entered a maladaptive response that
is aggressive to rampage in the range of their anger response. [1] considers violent
behavior as an extreme result of anger or fear (panic). Aggressive behavior and violent
behavior itself are often seen as a range, where aggressive verbal side and violence
on the other.

4.1. Signs or symptoms of violent behavior after progressive relax-

ation therapy

Progressive relaxation therapy is carried out on 20 clients who have experienced violent
behavior. After two days of therapy, 16 clients who previously showed signs or symptoms
of violent behavior that often appeared to clients such as red / tense face, glaring eyes
/ sharp vision, pacing back and forth decreased to 43.7%, 25%, 12.5%. But there are
also those who do not experience a decrease or reduction in signs or symptoms that
were previously shown. Whereas in 4 clients who before the therapy showed no signs
or symptoms we still gave therapeutic exercises to add ways to control their violent
behavior. (Add supporting literature)

4.2. Effectiveness of progressive relaxation therapy on clients at

risk of violent behavior

The results of the analysis p value <0.05 indicate that there are differences in signs or
symptoms of violent behavior shown by the client before or after progressive relaxation
therapy. so that this therapy can be said to be effectively done to clients with the
risk of violent behavior with a decrease in signs or symptoms of violent behavior.

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This supports the research conducted by Jewell and Elliff (2013) where progressive
relaxation therapy can improve anger control ability, this therapy is included in one of
the interventions of the violence prevention relaxation skills program. Although in the
evaluation of management the therapy that has been carried out still has shortcomings
so that the results obtained are less than optimal such as observation of the evaluation
results carried out one time not for 24 hours, the presence of external factors by
providing pharmacological therapy, and sampling that shows no signs or symptoms
of violent behavior.
The ability to know or feel tension and stretching muscles can help clients realize
when they feel angry and reduce anxiety and stress experienced by clients when they
get problems that are adaptive coping for clients. The statement was supported by
research conducted by Goergiev (2012) aimed at providing evidence about the efficacy
of Progressive Muscle Relaxation (PMR) as a way to reduce anxiety and psychological
distress as well as ways to improve subjective well-being in chronic patients with
schizophrenia. Goergiev’s research proves that this study provides scientific evidence
for the usefulness of PMR in chronic psychiatric settings for patients with schizophrenia.

5. Conclusion

Progressive muscle relaxation therapy on the client with the risk of violent behavior is
one of management strategies to control anger. It can also be usedto preparing care
client in home. It would be better if health workers and families in support of progressive
relaxation therapy so that families have more alternative ways of caring on the client
with the risk of violent.

Acknowledgement

The authors would like to thank their colleague for their contribution and support to the
research. They are also thankful to all the reviewers who gave their valuable inputs to
the manuscript and helped in completing the paper.

References

[1] Yosep, Iyus. (2007). KeperawatanJiwa. Cetakan I. Jakarta:RefikaAditama

[2] Videbeck, S.L (2008). Buku Ajar KeperawatanJiwa. Jakarta: EGC

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[3] Gemilang, J. (2013). BukuPintarManajemenstresdanEmosi. Yogyakarta Mantra

Books

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