International Journal of Community Medicine and Public Health

Rahmi D et al. Int J Community Med Public Health. 2020 Nov;7(11):4323-4326

http://www.ijcmph.com pISSN 2394-6032 | eISSN 2394-6040

DOI: https://dx.doi.org/10.18203/2394-6040.ijcmph20204724
Original Research Article

Effectiveness of counselling to increase the family of soul patients

about drug compliance
Dian Rahmi*, Rikayoni

Department of Nursing, Nursing Academy of Baiturrahmah, West Sumatera, Indonesia

Received: 06 August 2020

Accepted: 01 October 2020

*Correspondence:
Dr. Dian Rahmi,
E-mail: dian_rahmi90@yahoo.co.id

Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background: According to WHO it is known that around 21 million people in the world are affected by
schizophrenia and have psychiatric disorders. From the results of Riskesdas 2018 the prevalence of mental disorders
in Indonesia is as much as 7%, and around 9.8% of the population experiences mental and emotional disorders. For
the coverage of the treatment of people with mental disorders, data obtained by clients who went for treatment 48.9%
for routine treatment and 51.1% for no routine treatment. The purpose of this research is to determine the effect of
health promotion using counseling methods to increase the knowledge of mental patients' families about taking
medication in the Adult Outpatient Polyclinic at the RSJ Prof. Hb Saanin Padang.
Methods: This type of research is quasi-experimental (Quasi Experimental, Design uses One Group Pretest Postest
design model. This research was conducted at RSB Haan Saanin Padang. The population in this study was the
families of mental patients who visited the Polyclinic as many as 649 people with the number of respondents as many
as 87 people, the sampling technique was by accidental sampling Statistical tests using the Non-Parametric Test
(Wilcoxon Test).
Results: Research results show that the mean range of Pre-Test knowledge is 8.48±1,982 and Postest knowledge is
17.13±1,641, with a p value p=0,000 (p≤0.05).
Conclusions: Health promotion using counseling methods has a significant effect in increasing the family knowledge
of mental patients about medication adherence.

Keywords: Counseling, Compliance with taking medication, Knowledge

INTRODUCTION Some researchers report that the biggest mental disorder

is schizophrenia.2 From the results of the 2018 Riskesdas,
In RI Law No. 18 of 2014 Chapter I Article 3 on Mental there was an increase in the prevalence of mental
Health, explained that mental health efforts aimed at disorders, from 1.7% in 2013 to 7% in 2018. The increase
ensuring everyone can achieve a good quality of life, in mental disorders also experienced an increase in West
enjoy a healthy mental life, free from fear, pressure and Sumatra. In 2018 it can be seen that West Sumatra which
other disorders that can interfere with mental health.1. was previously ranked 9th in 2013 rose to 7th place with
the population prevalence of the most mental disorders.3
According to WHO (2016) there are around 35 million Mental disorders according to the American Psychiatric
people affected by depression, 60 million people affected Association (APA) are syndromes or patterns of behavior
by bipolar disorder, 21 million people affected by that are clinically important, which occur in individuals
schizophrenia, and 47.5 million affected by dementia. and the syndrome is associated with distress or disability

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 Rahmi D et al. Int J Community Med Public Health. 2020 Nov;7(11):4323-4326

accompanied by a significantly increased risk for death, sample selection are the families of patients who were
illness, disability, or loss of freedom.4 visiting during the study in the continuation of drug
therapy at the Adult Hospitalization Outpatient Clinic.
Schizophrenia is also a recurring chronic mental disorder. Saanin Padang and Criteria for Respondents who did not
Recurrence is a recurrence of the client's disease participate in one of the activities undertaken by
condition. Recurrence can occur due to failure in the researchers (pre-test, counseling and post-test). In order to
treatment process, get violent behavior, pressure, poverty, avoid errors in interpreting data and to obtain valid data,
stigma, discrimination, lack of support from others, the data collection was carried out by distributing
especially caregivers, and substance abuse (alcohol and questionnaires in the form of objective questions totaling
drugs). But what most influences the recurrence rate is 20 questions before and after counseling, questions about
the failure of the treatment process for schizophrenic the knowledge of mental patients' families about
clients.5 medication, medication adherence and family support for
clients in monitoring clients taking appropriate
From some research conducted in Indonesia proving that medication. Knowledge is measured using a Guutment
family support has a positive effect on healing patients of Scale
their illnesses. Large family support for the healing
process of chronic diseases including schizophrenia. Analysis of the research to be conducted is the Paired-
Family support can reduce 50% of patient recurrence.6 Sample t-Test to see the effect of the intervention group
before and after the health promotion is given using
The family as a person who is close to the patient, must counseling methods with a 95% confidence level
know the principle of five correct in taking medicine, that (α=0.05). After conducting research, the Paired Sample t-
is the correct patient, the correct medicine, the correct Test cannot be used because when data processing is
dosage, the correct method and time of administration performed, it shows that the data distribution is not
where compliance occurs when the rules of use in normal so that the proper data analysis used is the Non-
prescribed drugs and their administration in hospital Parametric Test (Wilcoxon Test).
followed correctly. This is very important especially in
chronic diseases, including one of them is a mental RESULTS
illness.
Table 1 shows that the average family knowledge of
The incidence of recurrence has increased if you do not mental patients about medication adherence before
have knowledge about schizophrenia, are not compliant counseling is 8.48 with a standard deviation of 1.982 and
in taking medication and do not have family support. an error standard of 0.212, the statistical test results
Schizophrenia and Caregiver clients are considered less obtained p=0.000.
adherent to psychotic treatment as a major risk of
recurrence. Table 1: Average value of respondents' knowledge
about compliance with taking medication before doing
The purpose of the research is to determine the effect of counseling at the adult outpatient polyclinic of RSJ.
health promotion using counseling methods to increase Prof. HB. Saanin Padang.
the mental knowledge of patients about medication
adherence. Std. Std.
Variable Mean N
Deviation Error
METHODS Pre 8.48 1.982 0.212 87

The research was conducted at the Adult Outpatient Table 2: Average Value of Respondents Knowledge
Polyclinic at Prof. Mental Hospital. Hb. Saanin Padang, about Compliance with Taking Medication After
and has been carried out from 27 to 30 July 2020. This Counseling in Adult Outpatient Polyclinic RSJ. Prof.
study uses a quasi-experimental design using the One HB. Saanin Padang.
Group Pretest Postest design model. That is before
counseling is given first (pre-test) family knowledge Std. Std.
about compliance taking medication then given treatment Variable Mean N
Deviasi Eror
(counseling about medication adherence) and carried out Post 17.13 1.641 0.176 87
another post test (family knowledge after being given
counseling) to find out the family's knowledge about Table 2 results of the study found that the average family
medication adherence. knowledge of mental patients about adherence to taking
medication after counseling is 17.13 with a standard
Stages of the study began from the initial survey looking deviation of 1.641 and an error standard of 0.176, the
at data from a mental hospital about patients experiencing statistical test results obtained p=0,000. Table 3 shows the
recurrence due to lack of family knowledge about difference in the average value of respondents' knowledge
medication adherence. Then the family is chosen as the (family of mental patients) before and after treatment
respondent to be the research sample. The criteria for with the counseling method, the average value obtained

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 Rahmi D et al. Int J Community Med Public Health. 2020 Nov;7(11):4323-4326

before the treatment was 8.48±1.982 and increased after From the analysis of the results of the comparison of the
the treatment, namely 17.13±1,641. mean range between pre-test and post-test that has been
done, the researcher believes that the increase in
Table 3: Difference in the Average Values of respondents' knowledge occurs because counseling is
Respondents' Knowledge about Compliance in Taking conducted in a structured manner and uses lecture and
Medication before and After Conducting Counseling question and answer techniques by fostering a
at the Polyclinic Adult Outpatient RSJ. Prof. HB. relationship of trust between the respondent and the
Saanin Padang. researcher. Before counseling is done, the researcher
makes guidance on the implementation of counseling, in
Counseling this guide the researcher compiles the objectives,
Variable Mean SD N SE P materials, and timing of counselling.9-11
Knowledge
17.13 1.641 0,176 This is in accordance with the theory put forward by
Post - Test
Knowledge 87 0.000 Notoatmodjo, 2010 that health promotion will succeed if
8.48 1.982 0,212 the message (massage) to be conveyed to the
Pre – Test
Difference 8,65 communicant is arranged in a planned and structured,
effective and efficient manner by selecting the right
Dependent test results of the T-Test sample shows the method.12
average difference between pre-test and post-test is 8.65
In addition, researchers also assume that the increase in
with the meaning of the word knowledge post-test is
higher than the pre-test that is found that there is a respondent knowledge is also influenced by hospital
meaningful difference between a person's level of programs and facilities and infrastructure provided by
hospitals to provide health promotion both using monthly
knowledge before and after getting counseling with a
extension methods, as well as displaying health
value of p=0,000 (p<0.05).
information related to mental health on the television
monitor screen contained in the Adult Outpatient
DISCUSSION
Polyclinic at Hb Saanin Hospital, Padang.
The effectiveness of increasing the knowledge of mental
CONCLUSION
patients 'families about medication adherence Based on
the results of the study found that an increase in the
Effective counseling to increase the knowledge of mental
average value of respondents' knowledge after being
given counseling. The average value before counseling patients' families about medication adherence.
was 8.48±1.641 and after giving counseling obtained an
average knowledge of respondents as much as ACKNOWLEDGEMENTS
17.13±1.641 and obtained a value of p=0,000 (p≤0.05) it
can be concluded that the average value of the post-test We would like to thank the mental hospital Prof. Hb
was more higher than the pre-test. From the results of the Saanin Padang, and all those who have helped carry out
Non-Parametric Test using the Wilcoxon Test the average this research.
difference between the pre-test and post-test was 8.65, in
Funding: Kemenristekbrind
this study it can be concluded that counseling has a very
Conflict of interest: None declared
good effect on the level of respondents' knowledge about
Ethical approval: The study was approved by the
compliance with medication taken by the researcher.
Institutional Ethics Committee
This is in line with research conducted by Misnan (2014)
on the effect of health education about drugs on REFERENCES
medication adherence for psychiatric patients in Desa
1. Mental Health. Directorate General of PP. 2014
Banaran Kulon Progo Yogyakarta to 20 respondents Accessed 20 June 2020. Available at:
showing data analysis using the Wilcoxon Man-Whitney ditjenpp.kemenkumham.go.id.
test showing that health education about drugs has
2. Ministry of Health. health-promotion-pdf. The RI
Significant influence to improve medication adherence in Ministry of Health was 2011 accessed on 12 June
patients with mental disorders with p value 0.42 (p<0.5).7 2020. Available at: www.depkes.gi.id.
3. Basic Health Research (Riskesdas). Data Collection
Notoatmodjo, (2012) states that knowledge is the result of Officer Interviewer Guidelines. Jakarta: National
knowing, and this happens after someone senses a certain Research and Development Agency. Accessed 5
object. Sensing, hearing, smell, taste and touch. Most of
June 2019.
human knowledge is obtained through the eyes and ears. 4. Prabowo E. Concepts & Applications of Psychiatric
Knowledge or cognitive domain is a very important
Nursing Care. Yogyakarta: Nuha Medika.
domain to shape one's actions.8
2014;69:78.

International Journal of Community Medicine and Public Health | November 2020 | Vol 7 | Issue 11 Page 4325
 Rahmi D et al. Int J Community Med Public Health. 2020 Nov;7(11):4323-4326

5. Arizanudin P. Relationship of Family Knowledge 10. Basuki ES. Medical Communication: The Key to
about Mental Disorders, Family Support and Patient Compliance, (online) Available at:
Compliance in Taking Medication in Schizophrenia (http://jurnal.pdii.lipi.go.id/index.php/Search.html?a
Patients in the Gamping 1 Puskesmas Sleman ct=view&id= 37601 & idc 2009, accessed 27 May
Yogyakarta. 2015;3(2):34-8. 2020.
6. Pudji H. The Effect of Health Education on Drugs 11. Jelly. Factors Related to Compliance with Taking
on the Compliance of Taking Medicines in the Medicines in Schizophrenic Patients at RSJ Prof.
Psychiatric Nursing Clinic of the Yogyakarta Dr. V. L. Ratumbusangrov. South Sulawesi'. In e-
Special Province Grhasia Hospita. 2010;4(1):123-8. Journal Nursing (e-Kp). 2017;3(2):78-80.
7. Misnan. The Influence of Health Education on 12. Soekidjo N. Health Behavioral Sciences. Jakarta:
Drugs on the Compliance of Taking Medication in Rineka Cipta. 2010;25:30.
Mental Disorders Patients in Banaran Kulon Progo
Village, Yogyakarta. 2014;5(1):345-56.
8. Notoatmodjo S. Health Research Methodology.
Jakarta: Rineka Cipta. 2012;345-350 Cite this article as: Rahmi D, Rikayoni.
9. Ananda MN. Compliance with Taking Medicines Effectiveness of counseling to increase the family of
for Schizophrenic Outpatients at Prof. Mental soul patients about drug compliance. Int J
Hospital DR. Soerojo Magelang "in Kartika J Sci Community Med Public Health 2020;7:4323-6.
Pharm. 2016;4(2):7-12.

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