The Effect of Cognitive Behavior Therapy on Self-Efficacy and Reducing Anxiety Levels in Hospitalized Patients
DOI:
https://doi.org/10.30829/jumantik.v10i2.24678Abstract
Self-efficacy refers to an individual's belief in their ability to successfully manage and overcome challenging situations. It is a key factor that can help patients effectively cope with anxiety. Anxiety is a common emotional response experienced by patients during hospitalization, and high levels of anxiety can negatively impact comfort, the healing process, and overall quality of life. Psychological interventions such as Cognitive Behavioral Therapy (CBT) have been shown to improve self-efficacy and significantly reduce anxiety. This study aimed to evaluate the effect of CBT in enhancing self-efficacy and reducing anxiety levels in hospitalized patients. A quasi-experimental design with a control group and pre-test post-test measurements was used. The study involved 45 respondents, selected through a saturated sampling technique, meaning all eligible participants who met the inclusion criteria were included. Data were analyzed using the Wilcoxon signed-rank test. The results showed that all respondents in the intervention group had consistently high self-efficacy before and after CBT. CBT significantly improved patients' confidence in managing their treatment period (p-value 0.000) and meaningfully reduced their anxiety levels (p-value 0.000). In contrast, the control group showed no change in self-efficacy (p-value 1.000) and experienced a slight increase in anxiety (p-value 0.257). These findings highlight the positive impact of CBT in helping patients feel stronger, calmer, and more in control during hospitalization. CBT is recommended as part of a holistic and compassionate approach to patient care in clinical settings.References
Abate, S. M., Chekol, Y. A., & Basu, B. (2020). Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. International Journal of Surgery Open, 25, 6-6. https://doi.org/10.1016/j.ijso.2020.05.010
Abdi, S. K., Syed, A. A., Butt, A., & Batool, S. (2023). A comparison of eidetic image therapy with cognitive behavior therapy for treating depressive and anxiety disorders in adults: A randomized controlled trial. JAIMC: Journal of Allama Iqbal Medical College, 20(3). https://doi.org/10.59058/jaimc.v20i3.67
Adi, S. (2024). Faktor yang mempengaruhi tingkat kecemasan pada pasien hemodialisa di RS PKU Muhammadiyah Sruweng. Universitas Muhammadiyah Gombong.
Afsharzada, M. S., Keshavarz, A., Keshavarz, A., & Saadat, S. (2023). Psychological interventions for decreasing anxiety in people with multiple sclerosis (MS): A systematic review. Romanian Medical Journal, 70(4), 199-204. https://doi.org/10.37897/RMJ.2023.4.7
Arif, S. H. H., & Listyaningrum, T. H. (2022). Faktor-faktor yang berhubungan dengan tingkat kecemasan pada pasien pre operasi: Literatur review [Universitas 'Aisyiyah]. https://digilib.unisayogya.ac.id/6423/1/NASKAH%20PUBLIKASI_SITI%20HUMAIRA%20HUSBA%20ARIF_1811604031_D4%20ANESTESIOLOGI%20-%20unisa_7_Siti%20Humaira.pdf
Badan Pusat Statistik. (2023). Profil statistik kesehatan 2023. Badan Pusat Statistik.
Bamijoko-Okungbaye, A. (2020). The lived experience of anxiety disorder patients: Narrative inquiry. Journal of Health Education, 5(2). https://doi.org/10.15294/jhe.v5i2.38348
Bentley, K. H., Bernstein, E. E., Wallace, B., & Mischoulon, D. (2021). Treatment for anxiety and comorbid depressive disorders: Transdiagnostic cognitive-behavioral strategies. Psychiatric Annals, 51(5). https://doi.org/10.3928/00485713-20210414-01
Brenninkmeijer, V., Lagerveld, S. E., Blonk, R. W. B., Schaufeli, W. B., & Wijngaards-de Meij, L. D. N. V. (2019). Predicting the effectiveness of work-focused CBT for common mental disorders: The influence of baseline self-efficacy, depression, and anxiety. Journal of Occupational Rehabilitation, 29(1), 31-41. https://doi.org/10.1007/s10926-018-9760-3
Budiman, R., Purwanto, E., & Murtadho, A. (2020). Cognitive Behavioral Therapy to improve self-efficacy and reduce academic procrastination. Jurnal Bimbingan Konseling, 9(3).
Carr, N. (2024). Self-efficacy and the perception of control in stress reduction. Mentalhealth.Com.
Chand, S. P., & Marwaha, R. (2024). Anxiety. StatPearls Publishing.
Chen, S. (2024). Cognitive behavior therapy for social anxiety disorder. Lecture Notes in Education Psychology and Public Media, 37(1). https://doi.org/10.54254/2753-7048/37/20240506
Chiș, R., Ignat, S., Roman, R., Demeter, E., Chiș, S., Rad, D., & Arion, F. (2024). The Influence of educational level on self-efficacy, introversion, and agreeableness: An interpersonal difference analysis. Revista Romaneasca Pentru Educatie Multidimensionala, 16(2), 569-580. https://doi.org/10.18662/rrem/16.2/872
Cludius, B., Landmann, S., Rose, N., Heidenreich, T., Hottenrott, B., Schröder, J., Jelinek, L., Voderholzer, U., Külz, A. K., & Moritz, S. (2020). Long-term effects of mindfulness-based cognitive therapy in patients with obsessive-compulsive disorder and residual symptoms after cognitive behavioral therapy: Twelve-month follow-up of a randomized controlled trial. Psychiatry Research, 291. https://doi.org/10.1016/j.psychres.2020.113119
Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. Focus (Am Psychiatr Publ), 19(2), 184-189. https://doi.org/10.1176/appi.focus.20200045
Damanik, H. (2020). Tingkat kecemasan pasien gagal ginjal kronik dalam menjalani hemodialisa di Rumah Sakit Imelda Pekerja Indonesia. Jurnal Ilmiah Keperawatan Imelda, 6(1), 80-85. https://doi.org/10.52943/jikeperawatan.v6i1.365
Domhardt, M., Geßlein, H., von Rezori, R. E., & Baumeister, H. (2019). Internet- and mobile-based interventions for anxiety disorders: A meta-analytic review of intervention components. In Depression and Anxiety (Vol. 36, Issue 3). https://doi.org/10.1002/da.22860
Donahue, S., Quinn, D. K., Cukor, D., & Kimmel, P. L. (2021). Anxiety Presentations and Treatments in Populations With Kidney Disease. Seminars in Nephrology, 41(6). https://doi.org/10.1016/j.semnephrol.2021.10.004
Fauziah, J., & Kesumawati, F. (2021). Terapi kognitif perilaku dapat menurunkan kecemasan sosial pada pasien waham: Literature review. Jurnal Borneo Cendekia, 5(1).
Fürtjes, S., Voss, C., Rückert, F., Peschel, S. K. V., Kische, H., Ollmann, T. M., Berwanger, J., & Beesdo-Baum, K. (2023). Self-efficacy, stress, and symptoms of depression and anxiety in adolescents: An epidemiological cohort study with ecological momentary assessment. Journal of Mood & Anxiety Disorders, 4. https://doi.org/10.1016/j.xjmad.2023.100039
Haikal, M. (2022). Terapi kognitif perilaku untuk mengurangi gejala kecemasan. Procedia: Studi Kasus Dan Intervensi Psikologi, 10(2). https://doi.org/10.22219/procedia.v10i2.19215
Hendriks, G. J., van Zelst, W. H., van Balkom, A. J., Uphoff, E., Robertson, L., Keijsers, G. P. J., & Oude Voshaar, R. C. (2021). Cognitive behavioral therapy and third wave approaches for anxiety and related disorders in older people. Cochrane Database of Systematic Reviews, 2021(1). https://doi.org/10.1002/14651858.CD007674.pub2
Hidayat, A. A. (2021). Metodologi keperawatan untuk pendidikan vokasi. Health Books Publishing.
Jumain, Bakar, A., & Hargono, R. (2020). Self-efficacy pasien stroke di instalasi rawat inap Rumah Sakit Umum Haji Surabaya. Jurnal Penelitian Kesehatan "SUARA FORIKES" (Journal of Health Research "Forikes Voice"), 11. https://doi.org/10.33846/sf.v11i0.521
Karno, Y. M., & Thalib, A. (2023). Faktor-faktor yang berhubungan dengan tingkat kecemasan pasien di intalasi gawat darurat puskesmas dokobarat kepulauan aru. Jurnal Online STIKES Nani Hasanuddin Makassar.
Kementerian Kesehatan RI. (2021). Pedoman Indonesian Case Base Groups (INA-CBG) dalam pelaksanaan jaminan kesehatan. Perhimpunan Rumah Sakit Seluruh Indonesia (PERSI).
Kreuze, L. J., Pijnenborg, G. H. M., de Jonge, Y. B., & Nauta, M. H. (2018). Cognitive-behavior therapy for children and adolescents with anxiety disorders: A meta-analysis of secondary outcomes. Journal of Anxiety Disorders, 60. https://doi.org/10.1016/j.janxdis.2018.10.005
Kurniawan Purba, A., Girsang, E., & Silaen, M. (2023). The effect of cognitive behavioral therapy (CBT) application on lifestyle in hypertension patients at Royal Prima Marelan Hospital 2022. International Journal of Health and Pharmaceutical (IJHP), 3(3). https://doi.org/10.51601/ijhp.v3i3.187
Kusol, K., & Kaewpawong, P. (2023). Perceived self-efficacy, preventive health behaviors, and quality of life among nursing students in Nakhon Si Thammarat Province, Thailand during the COVID-19 pandemic. Patient Preference and Adherence, 17. https://doi.org/10.2147/PPA.S424611
Larasati, R. (2018). Hubungan dukungan keluarga dengan tingkat kecemasan pasien gagal ginjal kronik yang menjalani hemodialisa. Universitas Muhammadiyah Surakarta.
Li, J., Cai, Z., Li, X., Du, R., Shi, Z., Hua, Q., Zhang, M., Zhu, C., Zhang, L., & Zhan, X. (2021). Mindfulness-based therapy versus cognitive behavioral therapy for people with anxiety symptoms: A systematic review and meta-analysis of random controlled trials. Annals of Palliative Medicine, 10(7). https://doi.org/10.21037/apm-21-1212
Lianto, L. (2019). Self-efficacy: A brief literature review. Jurnal Manajemen Motivasi, 15(2). https://doi.org/10.29406/jmm.v15i2.1409
Liao, J., Rosenheck, R., Sun, B., Liu, J., Shen, Y., Yuan, S., Ma, Y., Zhang, J., Zhang, R., Zheng, L., Chen, H., Feng, H., & He, H. (2024). Prevalence and correlates of suicide risk among non-psychiatric inpatients in a general hospital in China. Journal of Affective Disorders, 347. https://doi.org/10.1016/j.jad.2023.11.072
Masnur, A. D. A., Wibowo, M. E., & Purwanto, E. (2022). The Effectiveness of CBT group counseling with self-instruction technique to improve students' self-efficacy. Jurnal Bimbingan Konseling, 11(1).
Mukhtar, S., Mukhtar, S., Naeem, F., & Rana, W. (2024). Efficacy of cognitive-behavioral therapy in optimizing counseling outcomes for fast remission of social anxiety with panic attacks. Journal of Clinical Medicine of Kazakhstan, 21(5), 50-55.
Palmer, P. K., Wehrmeyer, K., Florian, M. P., Raison, C., Idler, E., & Mascaro, J. S. (2021). The prevalence, grouping, and distribution of stressors and their association with anxiety among hospitalized patients. PLoS ONE, 16(12 December). https://doi.org/10.1371/journal.pone.0260921
Pereira, A. S., Willhelm, A. R., Koller, S. H., & de Almeida, R. M. M. (2018). Risk and protective factors for suicide attempt in emerging adulthood. Ciencia e Saude Coletiva, 23(11). https://doi.org/10.1590/1413-812320182311.29112016
Polit, D. F., & Beck, C. T. (2020). Nursing research: Generating and assessing evidence for nursing practice (11th ed.). Wolters Kluwer.
Rahmadiani, N. D. (2020). Cognitive Behavior Therapy untuk mengurangi kecemasan sosial pada remaja. Procedia, 8(1).
Rahmi. (2020). Self efficacy modifikasi gaya hidup pada pasien hipertensi di Banda Aceh. JIM FKep, 4(3).
Rustandi, B., & Gumilang, R. (2020). Hubungan self efficacy dengan tingkat kecemasan pada pasien infark miokard. Jurnal Kesehatan Rajawali, 10(1), 11-25. https://ojs.rajawali.ac.id/index.php/JKR/article/view/56
Salartash, V., Yekta, M. A., & Zabihi, R. (2022). The effectiveness of cognitive behavior therapy on anxiety, physical symptoms, worry, and attention deficit in women with generalized anxiety disorder. The Open Public Health Journal, 15(1), 1-8. https://doi.org/10.2174/18749445-v15-e2209080
Sherly, F. (2020). Pengaruh Cognitive Behavior Therapy terhadap kecemasan remaja di Panti Asuhan Kota Pekanbaru [Universitas Andalas]. http://scholar.unand.ac.id/64471/
Sundari, R. K., Irawan, A., & Palimbo, A. (2023). Analisis faktor berhubungan dengan self efficacy pengobatan pada pasien hipertensi. Jurnal Keperawatan, 15(4), 1709-1718. https://doi.org/10.32583/keperawatan.v15i4.1269
Tanaya, V. Y., & Yuniartika, W. (2023). Cognitive Behavior Therapy (CBT) sebagai Terapi Tingkat Kecemasan pada Lansia. Jurnal Keperawatan Silampari, 6(2). https://doi.org/10.31539/jks.v6i2.5422
Wang, S., Wei, J., Zhang, P., Song, J., Chen, J., & Li, G. (2025). The chain mediating effect of self-efficacy and health literacy between proactive personality and health-promoting behaviors among Chinese college students. Scientific Reports, 15, 16101. https://doi.org/10.1038/s41598-025-00936-0
Wardhani, A., Maria, I., & Murdiany, A. N. (2019). Hubungan self-efficacy dengan penatalaksanaan pencegahan kekambuhan hipertensi di Wilayah Kerja Puskesmas Martapura II, Kalimantan Selatan. Jurnal Keperawatan Suaka Insan (JKSI), 4(2), 70-77. https://doi.org/10.51143/jksi.v4i2.181
Whisman, M. A. (1993). Mediators and moderators of change in cognitive therapy of depression. Psychological Bulletin, 114(2). https://doi.org/10.1037/0033-2909.114.2.248
Yang, J., Lo, W. L. A., Zheng, F., Cheng, X., Yu, Q., & Wang, C. (2022). Evaluation of Cognitive Behavioral Therapy on improving pain, fear avoidance, and self-efficacy in patients with chronic low back pain: A systematic review and meta-analysis. Pain Research and Management, 2022, 1-15. https://doi.org/10.1155/2022/4276175
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