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Study on Gamelan Degung As Music Therapy in an Active Labor Phase on the First Stage of Labor by Using Pain Intensity Rating Scale

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Study on Gamelan Degung As Music Therapy in an Active Labor Phase on the First Stage of Labor by Using Pain Intensity Rating Scale International Journal of Advances in Science Engineering and Technology, ISSN: 2321-9009, Vol-5, Iss-3, Spl. Issue-2 Sep.-2017 http://iraj.in STUDY ON GAMELAN DEGUNG AS MUSIC THERAPY IN AN ACTIVE LABOR PHASE ON THE FIRST STAGE OF LABOR BY USING PAIN INTENSITY RATING SCALE 1RIKSA WIBAWA RESNA, 2IMELDA YUSNIARSIH, 3PUPUT LENI YULIANI 1,2NursingDepartment STIKES BANTEN – Indonesia 3Public Health Department Universitas Indonesia – Indonesia E-mail: [email protected], [email protected], [email protected] Abstract- This research aims to prove different intensity of pain in an active labor phase before and after Music Therapy with Gamelan Degung,Sundanese Instrument, for 15 minutes. This research is one group pretesposttest design and the sample were taken by non probability sampling in Harapan Ibu Maternity Hospital. Study results shows that the mean intensity of pain on patient in an active labor phase is 7.50 (1.022) before heard Gamelan Degung Instruments while the mean after heard those instrument is 5.54 (0.977). Wilcoxon-Test shows thatp (0.000) < α (0.05), so Ho is rejected which means there are significant differences intensity of active labor pain scale in the first stage before and after 15 minutes of Gamelan Degung’sMusic Therapy.Thus, Music theraphy can be performed as one of the nursing action to reduce the mother’s labor pain. Keywords- Active Labor Phase, Music Therapy, Gamelan Degung, Javanese Instrument, Pain Intensity Rating Scale. I. INTRODUCTION parity, occupation, education profile, dwell location, etc. Naturally woman will have an experience in the labor These labor pain can not be avoided, but the sensation process. “The way we give birth to our young is that of pain in it can be minimize with therapies that can the muscular organ (the uterus) in which the offspring divert the mother's perception of pain. Music therapy has been nurtured for nine months begins to contract. also qualifies as one of the techniques in minimize The contractions work to open the neck of the uterus sensation of labor pain, which is easy and safe, (the cervix) and then expel the baby down the birth because it does not disturb the fetus's homeostasis canal and out through the vaginal opening. A short (Crisp, et al., 2012). time later the nourishing organ for the baby (the placenta) follows the same path out of the uterus and As we know Music-BasedInterventions in health care into the world. The process, which pushes the baby are generally considered low risk and palatable to out of its warm, wet, nearly dark and rhythmically patients of various ages from infants to elderly (Robb, rocking home is as complicated a physical drama we, et al., 2011). In the implementation of music therapy as humans, are likely to be able to witness” (Charles to control pain and improve comfort, also need to & Ann, 2015). We call its process as pain, stressful, consider the selection of music in accordance with the and a miracle moment at the same time. tastes of music, age and background of the mother(Potter, et al., 2006).Music has been proven Based on Data of World Health Organization that it has effects in lowering the heart rate, reducing (2014)shows that in 2012 more than 9,900 mothers anxiety and depression relieving pain, lowering die in Indonesia during pregnancy or childbirth.While bloodpressure, and changing the perceptionoftime the result of Indonesia Demographic and Health (Potter & Perry, 2009), thus can help women regulate Survey,called as SDKI, in 2013 maternal mortality breathing during the labor pain(Mander, 2004). rate in Indonesia is 359 per 100,000 of live birth, where it was most happen in the East of Nusa The Sundanese are Indonesia's second largest ethnic Tenggara, the West of Kalimantan, and in Java. group. They live in the province of West Java (also called "Sunda" by many foreigners), encompassing Contraction intens with multiple peaks can cause the interior highlands, the coastal areas, and Cirebon, intensity of pain and stressful that every mother's will a culturally distinct region(Williams, 2014).When the feel during the stages of labor and birth(University of Sundanese refer to their performing arts, they are Washington Medical Center, 2007). In 2005, Bobak careful to describe what they call khas Sunda -- that suggested that intensity of pain can be defferent and which is characteristically Sundanese -- a designation unique in each mother. Factors associated with pain that bears a sense of regional identity.A large in labor and childbirthincluded culture, fear, anxiety, proportion of Sundanese music is performed on previous labor experience, and support from the gamelans, sets of bronze or iron instruments family (Bobak, et al., 2005).However, Ye HJ and supported by carved wooden racks. team found that the labor pain of latent and active Gamelan music, in particular, teaches us much about phase were associated by the number of gravidity and Indonesian values and modern-day life. Gamelan Study on Gamelan Degung as Music Therapy in an Active Labor Phase on the first Stage of Labor by using Pain Intensity Rating Scale 87 International Journal of Advances in Science Engineering and Technology, ISSN: 2321-9009, Vol-5, Iss-3, Spl. Issue-2 Sep.-2017 http://iraj.in music provides values of historical and philosophical Women now dominate the performance of gamelan Indonesia, especially for Javanese. Javanese Gamelan degung, with the exception of the kendang (drum) also has an aesthetic function related to social, moral and suling (bamboo flute), which are still always and spritual values (Spiller, 2008). played by men.(Williams, 2014). In addition, Gamelam music has other benefits in II. DETAILS EXPERIMENTAL lowering stress level (Loth, 2006). This suggested also concurred by Abdul Rokhman who founf that This study used pre-experimental design with one Gamelan Music has decrease the stress level of group pretest and posttest with crosssectional elderly (Rokhman, 2016). approach. The population in this studywas mothers who will doing a normal delivery in Harapan Ibu Gamelan degung is the other primary Sundanese Maternity Hospital. Besides,the sample used was 24 gamelan; in addition to the usual instruments, it also mother who on an active labor phase inHarapan Ibu includes a set of six hanging gongs (degung or Maternity Hospital who met the inclusion criteria jenglong), which gives the ensemble its name. usingsimple non probability technique. study was Numerical Rating Scale-Pain Scale (NRS). The symbolic represetation of the reaserch design can The intensity of pain was divided into 4 stage, 0 is be represented in none pain, 1-3 is mild pain, 4-6 moderate pain, and 7- 10 is the severe or worst pain imaginable. All the data will computed and tabulated. After beingtabulated, the data were analyzed using Wilcoxon Rank Signal Test with significance level p =<0.05. III. RESULT AND DISCUSSION Figure 1.The interpretations of the symbols in The results shows that from 24 mothers when faced active labor phase on the first stage of labor in Harapan Ibu Maternity Hospital, most of them experiencing pain intensity in severe pain (scale 7 to 10) before being given gamelan degung music therapy. While, 16.7% spent labor pain intensity in moderate pain scale (scale 4 to 6). All of these data showed in Figure 1 are as follows: Table 1. Figure 1. Symbolic Representation of The Research Design The researcher pretests the respondents by showing the NRS pain scale to inquire the intensity of the labor pain scale currently being felt.The rating labor pain scale which shown by the respondent is documented in the pretest observation sheet Table 1. The Distribution of Mothers by Their Labor Pain provided.Then, Gamelan Degung Music Therapy is Intensity Rating Scale before being Treated using Gamelan given to the respondent for 15minutes,after Degung Music Therapy completion of music therapy, the research measured again the rating labor pain scale which shown by the The results after the experimental group receive respondent using the same measuring instrument, and Gamelan Degung Music Therapy are shown in the results are documented in the posttest observation sheet that has been provided. Thisresearch was conducted in Parung Panjang on July 2014 to August 2014. The instrumentused for data collection in this Study on Gamelan Degung as Music Therapy in an Active Labor Phase on the first Stage of Labor by using Pain Intensity Rating Scale 88 International Journal of Advances in Science Engineering and Technology, ISSN: 2321-9009, Vol-5, Iss-3, Spl. Issue-2 Sep.-2017 http://iraj.in Table 2. From the tabulation, most of them experiencing the decrease pain intensity, from severese to be moderate pain scale (scale 4 to 6) after being given gamelan degung music therapy for 15 minutes. Beside that only 12.5% spent labor pain Table 2. The Distribution of Mothers by Their Labor Pain intensity in severe pain scale (scale 7 to 10). Intensity Rating Scale after being Treated using Gamelan Degung Music Therapy Evalation of effectiveness of Gamelan Degung Music Therapy in terms of pain intensity score of primapara mother during the first stage of labor was carried out. Pain perception was tested by using NRS Pain Scale with scale from 0 to 10. As explained before, pain perception was recorded twice i.e in the active phase of labor before starting and after completion of the music therapy. In order to compare the difference between the means of pretest and posttest pain intensity score of experimental group, ‘t’ test was computed. The data is given in Table 3. Table 3. Mean, Median, Standard Deviation and Range of Score of the Pretest and Postest Pain Scale of Primapara Mothers in the Experimental Group After being tabulated, before tests of hypothesis for public/pdf/labor-delivery-maternity-stanford- continuous, the researcher has to observed whetear childrens.pdf.
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