The Influence of Dhikr on Anxiety in Acute Coronary Syndrome (ACS) Patients at Dr. Chasbullah Abdulmadjid Hospital, Bekasi City

ISSN 2354-8428 e-ISSN 2598-8727 JURNAL KEPERAWATAN KOMprEhEnsIF COMPREHENSIVE NURSING JOURNAL Vol. 10 No. 1, January 2024 Published by : Sekolah Tinggi Ilmu Keperawatan PPNI Jawa Barat JURNAL KEPERAWATAN KOMPREHENSIF VOL. 10 NO. 1 Bandung January 2024 ISSN 2354-8428 e-ISSN 2598-8727 11 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 Jurnal Keperawatan Komprehensif Volume 10 Issue 1 January 2024 Research Article The Influence of Dhikr on Anxiety in Acute Coronary Syndrome (ACS) Patients at Dr. Chasbullah Abdulmadjid Hospital, Bekasi City Heppy Sulistiyowati1* │ Wati Jumaiyah2 │ Dewi Purnamawati3 │ Yani Sofiani4 │ Budi Susanto5 │ Ashar Prima6 │ Hamdah Hamdah7 1,2,3,4Jakarta Muhammadiyah University 1,7Dr. Chasbullah Abdulmadjid Hospital, Bekasi City 5Harapan Kita Heart and Blood Vessel Hospital, Jakarta 6Department of Medical Surgical Nursing, Bani Saleh University *contact Received : 14/09/2023 Revised : 21/01/2024 Accepted : 22/01/2024 Online : 30/01/2024 Published : 30/01/2024 Abstract Aims: This study was to determine the effect of dhikr on anxiety in ACS patients at Dr. Chasbullah Abdulmadjid General Hospital, Bekasi City. Methods: The research method used pre- and post-quasy experiments in the control group and the intervention group. This study used the HARS questionnaire and family support for 76 respondents. Result: Data analysis using multiple logistic regression tests The results showed that the proportion in the control group with mildmoderate anxiety was 31.6% and severe anxiety was 18.4%; the proportion in the intervention group with mild-moderate anxiety was 46.1% and severe anxiety was 3.9%. Dhikr (p = 0.006) and history of heart disease (p = 0.023) significantly influence anxiety after being controlled by age (p = 0.244) (p = 0.001 omnimbus). The dominant factor that influences anxiety is dhikr (OR 10.674). Conclusions : Dhikr is an act of remembering Allah that can be used to reduce anxiety in SKA patients. This can be done independently by reading istigfar, tasbih, hauqalah, and takbir for 15 minutes in the morning and evening. Therefore, nursing services using dhikr as an effort to reduce anxiety in ACS patients. Keywords: Acute Coronary Syndrome, Anxiety, Dhikr INTRODUCTION Degenerative diseases, such as noncommunicable diseases, accounted for 71% of deaths in the world in 2016 and will increase in 2021 to 74% (1). The disease with the highest ranking is heart disease; its incidence in the United States (2019) occurs mostly in the elderly; in Southeast Asia (2) and in Indonesia (2019) (3). West Java is ranked 10th, and one of them is the city of Bekasi, namely Dr. Chasbullah Abdulmadjid Hospital, Bekasi City. Heart disease is ranked first, namely ACS. The incidence of https://doi.org/10.33755/jkk ACS in the ordinary cardiac ward was 61.2% and in the intensive care unit was 66.1% (4). ACS consists of STEMI, NSTEMI, and UAP (5), which are heart diseases that occur because the heart muscle lacks oxygen nutrition due to ruptured coronary artery atheroma plaques (6). ACS occurs due to biochemical and mechanical changes resulting from strenuous physical activity and emotional loads that can stimulate increased norepineprine, epineprine, and gamma-aminobutyric acid (GABA) so that This is an open access article under the CC BY-SA license 12 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 the cardiovascular system is disrupted, physiologically stimulating, and feelings of tension, unpleasantness, or anxiety. These things can aggravate ACS (7). The need for good management, namely with a holistic approach, in both aspects of medical services, pharmacy, and nursing care (8). Nursing care according to standards includes biochemical, physical, and psychological factors. One part of nursing actions is complementary actions such as dhikr (9). Dhikr means remembering and saying tayyibah words to Allah orally (10). Dhikr is a relaxation technique that stimulates endorphins, dopamine, and oxytocin (11), which work to provide a feeling of calm and reduce anxiety, lowering heart rate, lowering blood pressure, smoothing blood vessels, and increasing oxygen in the body (12). According to Somana, dhikr and murottal Al-Quran can reduce anxiety, with moderate anxiety at 76.9% and mild anxiety at 69.2%. According to Sulistyawati (13), there was a statistically significant difference in the anxiety level of patients in the intervention group and the control group (p = 0.001), indicating the effect of dhikr in reducing anxiety. Dhikr makes people feel calm and optimistic, increases immunity, accepts the conditions that happen to them, and believes that what happens is because of Allah's will (14). The purpose of this study was to determine the effect of dhikr on anxiety in ACS patients. METHODS This research design uses a quasiexperiment with pre- and post-intervention using two groups, namely the control group https://doi.org/10.33755/jkk Jurnal Keperawatan Komprehensif Volume 10 Issue 1 January 2024 and the intervention group. The population in this study were ACS patients in the cardiac care room. Sample calculations used the Lameshow formula with a total sample of 76 respondents. The sampling technique uses the purposive sampling technique. The inclusion criteria for this study were SKA sufferers who experienced anxiety and were Muslims. The exclusion criteria are ACS sufferers who are in an emergency condition and are currently taking mental medication. The instrument used is the HARS anxiety instrument in Indonesian, which has been translated and tested for reliability and validity by Ramdan (2019) (15). The HARS instrument contains 14 statements with a score of 0-4. Researchers divided into two score categories, namely a score of <25 for mild-moderate anxiety and ≥25 for severe anxiety, according to Rusanty (2016) (16). The research process will take place in April–May 2023 after passing the campus ethical review number 0259/F.9-UMJ/III/2023 on March 9, 2023, and the site ethical review number 010/KEPK/RSCAM/III/2023 on March 27, 2023, and receiving research permission on March 31, 2023. Researchers selected respondents in cardiac care rooms, both regular wards and intensive care rooms, and specialized in ACS. Instruments are distributed directly to respondents, who fill them in themselves without intervention from anyone. The intervention group was given dhikr in the form of leaflets with the reading of istighfar, tasbih, hauqalah, and takbir. Univariate data analysis uses the proportion test, bivariate uses the q square test, and multivariate uses the multiple logistic regression test. This is an open access article under the CC BY-SA license 13 p-ISSN : 2354 8428 | e-ISSN: 2598 8727 Jurnal Keperawatan Komprehensif Volume 10 Issue 1 January 2024 RESULTS Table 1. Distribution of Respondent Characteristics (n=76) No. Variable Category Group Total Control Intervention Total Percentage Total Percentage Total % 22 28,9 20 26,3 42 55,3 16 21,1 18 23,7 3 (...truncated)