CLASSICAL INFLUENCES MENSTRUAL PAIN in THE TENTH-GRADE STUDENTS AT SMAN 1 Gedangan SIDOARJO

Firma Hidayanti1, R. Khairiyatul Afiyah2 Nursing Programme, Faculty of Health Science UNUSA

E-mail: Satu_37@ yahoo.co.id

ABSTRACT

Menstrual pain (Dysmenorrhea) can disturb the daily activities and cause the student’s absence at school. The incidence rate of Dysmenorrhea found in SMAN 1 Gedangan (State High School) shows that 83.13% of the tenth-grade female students had Dysmenorrhea. Therefore, this research was purposed to find out the relationship between the classical and Dysmenorrhea. The design of research was analytic-cross sectional. The population involved 88 tenth-grade female students experiencing Dysmenorrhea on day 1-3 without consuming any pain killers during menstrual period studying at the above-mentioned high school. 72 respondents were taken as the samples by using the simple random sampling technique. The independent variable was the therapy, whereas the dependent variable was Dysmenorrhea. Questionnaires were used to collect data which were finally analyzed by using Fisher’s Exact test with the significance level α = 0.05. The result of study done among 72 respondent show that, most 43(59,7%) respondent listening to Mozart’s classical music, and nearly all of them 64(88,9%) respondent did not have Dysmenorrhea after listening the classical music. Furthermore, Fisher’s Exact test showed that p = 0.164 > α = 0.05 so that H0 was accepted describing no relationship between the classical music therapy and Dysmenorrhea. In conclusion, the classical music from Mozart, Beethoven, and Vivaldi can relieve the menstrual pain. Therefore, the female students are expected to use classical music to relieve the menstrual pain to prevent the absence for school.

Keywords: Classical music, Menstrual pain

Introduction and menstruation (Proverawati and Misaroh, Adolescence or puberty links childhood with 2009). For some women, the presence of adulthood. Both physical and psychological menstruation causes anxiety and pain growth and development in adolescence (Proverawati and Misaroh, 2009). happen very fast. Girls reach maturity faster Dysmenorrhea is a menstrual pain than boys do. One of puberty signs in girls is occurring before and during menstruation, the occurrence of menstruation (Proverawati making women unable to work and forcing and Misaroh, 2009). them to take a rest, which results in degraded Menstruation is the periodic discharge of performance and a reduction in daily activities blood from the uterus caused by the (Anurogo, 2011; Proverawati and Misaroh, endometrial shedding (Hamilton, 1995). The 2009). Painful menstruation causes disruption process of menstruation happens in four stages of daily activities, reduces the quality of life of namely the proliferation, ovulation, secretion, individuals and is the leading cause of absenteeism in adolescent women because this music is capable of producing a (Widjanarko, 2006). change of consciousness status through sound, The incidence rate of menstrual pain in the silence, space, and time (Potter and Perry, world is very high for more than 50% of 2005). Music can stimulate the increase of women in every country suffer from menstrual endorphin hormones categorized as the pain. An epidemiological study on adolescent morphine-typed substance supplied by the population (12-17 years) in the United States body. Therefore, at the time when peripheral reported 59.7 % prevalence of menstrual pain. neurons send pain signals to the synapse, the Among those complaining of pain, 12 % had synapses occur between peripheral pain severe pain, 37 % had moderate pain, and 49 neurons and neurons of the brain in which P % experienced mild pain. This incident cause substance sends impulses. At that point, 14 % of teenagers often do not attend school. endorphin will block the detached P substance Almost two thirds of post menarche teens in from sensory neurons, so transmission of pain the United States suffer from menstrual pain; impulses in the spinal medulla will be blocked, 10 % of them when beginning to suffer can not then reduce menstrual pain sensation go to school (Anurogo, 2011 ). The incidence (Proverawati and Misaroh, 2009). Music rate of primary menstrual pain in Indonesia therapy, as one of non-pharmacological reached 54.89 %, while the rest experienced therapies, can be used by high school students the secondary type (Proverawati and Misaroh, to reduce menstrual pain. When complaints of 2009). pain can be eliminated by using a simple way, Based on the preliminary studiy performed it is much better for them to do so than using by the researcher by spreading questionnaires drugs because drugs will cause dependency on in January 2013 to 166 female students of pain reliever effects and cause unwanted side SMA Negeri 1 Sidoarjo Palmares (State High effects. The role of the nurse in handling School) who were having periods, 138 (83.13 complaints of menstrual pain is to provide %) have experienced menstrual pain, whereas schools with counseling about non- the remaining of 28 (16.87 %) have never pharmacologic therapy to reduce menstrual experienced any menstrual pain. The female pain until the students can find an alternative students having experienced menstrual pain solution for the reproductive health problems, totaling 62 (44.93 %) managed the menstrual especially for menstrual pain, which has pain by letting the pain get away, 22 (15.94 %) become their problems. required total rest, 33 (23.91 %) took medication to relieve pain, 17 (12.32 %) drank Research Methods herbal medicine, and the remaining of 4 (4.35 The type of research is an analytic %) handled it by doing exercise and applying survey done with a cross-sectional design. The eucalyptus oil to the stomach where pain population involves the tenth-grade students of occurred. SMA Negeri 1 Gedangan, Sidoarjo having According to Guzetta (1989) in Potter and menstrual pain during menstruation on day 1-3 Perry (2005), the most distraction technique is and not taking anti-pain medication during to listen to music because music can decrease menstrual pain, totaling 88 students. 72 the physiology of pain, stress, and anxiety by students are taken as the samples of research diverting one's attention from the pain. Music by using probability sampling, namely simple is proven to give the effects of decreasing the random sampling technique. The research frequency of the heartbeat, reducing anxiety done in March 2013 is located at SMAN 1 and depression, relieving pain, decreasing Gedangan, Sidoarjo. blood pressure, and changing the time perception. Classical music (music without vocals, quiet period) is used in music therapy Results, Discussion, and Conclusion No Classical Menstrual pain Total Table 5.7. Cross tabulation of classical music music No pain Menstrual therapy with menstrual pain in the tenth-grade pain students at SMAN 1 Gedangan, Sidoarjo N % N % n % Source: Primary data 2013 1 Mozart 40 93,0 3 7,0 43 100,0 According to Table 5.7. it can be seen 2 Other 24 82,8 5 17,2 29 100,0 classical that among 72 respondents, nearly all (93,0%), music totaling 43 respondents listening to classical Total 64 88,9 8 11,1 72 100,0 music of Mozart did not feel menstrual pain. a. Types of classical music Among 29 respondents listening to other Table 5.5. The frequency distribution of classical music, nearly all (82.8 %) did not feel respondents by type of classical music used in any menstrual pain. the tenth-grade students at SMAN 1 The results of statistical test using Gedangan, Sidoarjo Fisher's Exact Test done to determine the correlation of classical music therapy and No Classical Music Total Percentage menstrual pain in the tenth-grade students at 1 Mozart 43 59,7 SMAN 1 Gedangan, Sidoarjo with the 2 Other classical 29 40,3 significance level (α = 0.05) and manual music calculation, the results obtained that ρ = 0.164 Total 72 100 so that ρ > α. Therefore, Ho was accepted Source: Primary data 2013 showing that there was no correlation between the type of classical music and menstrual pain According to table 5.5 above shows that in the tenth-grade students at SMAN 1 among 72 respondents, most of them (59.7%) Gedangan, Sidoarjo. It also meant that any of use Mozart’s classical music to relieve classical music has a soft rhythm, relaxing, menstrual pain. and can reduce menstrual pain when being heard. So, not only classical music of Mozart, b. Menstrual pain but also Beethoven and Vivaldi can eliminate Table 5.6. The frequency distribution of menstrual pain on the tenth graders studying at respondents according to the frequency of SMA Negeri 1 Gedangan, Sidoarjo. menstrual pain felt after listening to classical music in the tenth-grade students at SMAN 1 Discussion Gedangan, Sidoarjo 1. Correlation between classical music therapy and menstrual pain No Menstrual Total Percentage The correlation between classical pain music therapy and menstrual pain can be seen 1 No pain 64 88,9 from the result of statistical test using Fisher's 2 Menstrual 8 11,1 Exact Test with significance level (α = 0.05) pain and manual calculation that ρ = 0.164 so that ρ Total 72 100 > α, Therefore, Ho was accepted showing that Source: Primary data 2013 there was no correlation between the type of classical music and menstrual pain in the According to Table 5.6 above shows that tenth-grade students at SMAN 1 Gedangan, among 72 respondents, nearly all (88.9%) have Sidoarjo. no menstrual pain after listening to classical According to table 5.7, it can be seen music. from both respondents listening to classical music of Mozart or other classical music, c. Correlation between classical music almost all experienced painless menstruation. therapy and menstrual pain This proved that there was no correlation between the type of classical music and Another study done by Satiadarma menstrual pain because classical music of (1990), done by measuring the temperature of Mozart or other classical music (Beethoven the skin using Galvanic Skin Response (GSR). and Vivaldi) can eliminate menstrual pain. When the subjects listen to loud music, the Any of the classical music are known with its skin temperature is lower than the basal soft sound and easy listening music. Typical temperature (the temperature of normal melody in classical music makes this music individuals without music). On the other hand, feels comfortable and provides relaxing effects when the soft music heard, skin temperature for anyone listening to it, unlike dangdut or rises than usual. This proves the existence of a , which has the opposite rhythm stress hormone released by the brain, namely with the heartbeat. Music which has a rhythm adrenaline, which can affect the blood vessels opposing to the heartbeat may make the heart in the skin to have vasoconstriction beats faster than usual. It may result in blood (narrowed). In condition of stress, adrenaline vessels throughout the body become narrowed is discharged much causing blood vessels in or vasoconstriction so that blood flow to the skin narrowed, until the skin temperature to uterus becomes obstructed, and aggravate drop. It concludes that the type of loud music menstrual pain. can cause stress, while soft music has a Music therapy is a therapy that can be calming effect (Aemilia, 2006). accepted by everyone because the brain does Classical music has the same rhythm not require hard work to interpret the music. with the rhythm of the heart and respiration, Music therapy is very easy to be accepted by and soft and soothing melodies. O'Sullivan the organ of hearing and then funneled through (1991) suggests that classical music influences the auditory nerve in the brain to the pituitary imagination, intelligence and memory. Besides to release endorphin hormones. The endorphin it also affects the Pituitary gland in the brain to hormones, which will block pain impulses to release endorphins. We know that endorphin the brain, so menstrual pain sensory decreases. can reduce pain, as to reduce the use of Yet, not all music can be used for therapy. analgesics (Aemilia, 2006). Music that has a soft and relaxing melodies Proverawati and Misaroh (2009) and rhythms flowing the same with the rhythm suggests that Mozart's music can also stimulate of the heart and breathing can lower heart rate the increase of endorphin hormone which will and catecholamine levels in the blood, so the block P substance from sensory neurons, so blood vessels dilate (vasodilatation) and blood the transmission of pain impulses in the spinal supply to the uterus becomes smooth. As a medulla becomes obstructed, finally menstrual result, menstrual pain can be reduced and even pain sensation reduced. disappear. Classical music has a sort of rhythm Conclusion that is light, soft , easier and less confusing, Based on the results of research and has a texture that is far clearer (Smith, conducted at SMAN 1 Gedangan, Sidoarjo 2011). Mornhinweg (1992) in Aemelia (2006) about the correlation between classical music examined 58 healthy subjects to assess the therapy and menstrual pain in the tenth-grade type of music which reduce stress. Classical students obtained the following conclusions: music appears to provide a relaxing effect that 1. The tenth-grade students of SMAN 1 can be proved statistically compared with the Gedangan, Sidoarjo mostly used Mozart’s "new age" music. Soothing music is also used classical music as a therapy to reduce in the treatment of patients with myocardial menstrual pain. infarction (heart attack) before surgery, even 2. Nearly all of the female students of tenth- to reduce patient’s stress while waiting in the grade students of experienced no menstrual waiting room pain after listening to classical music (Mozart, Nursalam (2011). Konsep dan Penerapan Beethoven, and Vivaldi). Metodologi Penelitian Ilmu Keperawatan : Pedoman Skripsi, Tesis, 3. 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