PENERAPAN GRATITUDE JOURNAL UNTUK MENURUNKAN GEJALA DEPRESIF PADA PENDERITA KANKER: STUDI DENGAN ECOLOGICAL MOMENTARY ASSESSMENT

Main Article Content

Eric Sucitra
Samsunuwijati Mar’at
Sri Tiatri

Abstract

Kanker adalah sebuah masalah medis serius yang memiliki dampak yang signifikan terhadap kualitas hidup penderita secara holistik, termasuk masalah kejiwaan yang mengarah pada gejala depresif. Negative inferential style, yakni sebuah gaya pikir yang cenderung memproses peristiwa hidup secara lebih negatif dari biasanya, diduga sebagai salah satu faktor yang memicu penderita kanker untuk mengembangkan gejala depresif. Studi ini bertujuan untuk memeriksa penerapan intervensi yang berfokus pada aspek kognitif individu dalam bentuk aktivitas gratitude journal untuk mengurangi gejala depresif partisipan. Penelitian ini juga menggunakan ecological momentary assessment untuk memeriksa fluktuasi mood depresif dalam partisipan. Enam partisipan wanita dengan berusia antara 35 sampai 56 tahun (x? = 44.83) dengan diagnosis kanker dan gejala depresif (skor BDI-II > 0) direkrut dan menyelesaikan aktivitas gratitude journal selama dua minggu. Uji statistik non-parametrik Wilcoxon Signed Rank Test dan Kruskall-Wallis Test dilakukan untuk menganalisis data. Studi ini juga melakukan analisis tematik dalam bentuk coding untuk menemukan protective factors terhadap depresi yang terkandung dalam gratitude journal. Studi ini tidak menemukan perbedaan bermakna pada skor pretest-posttest trait gratitude, namun menemukan penurunan skor yang signifikan pada gejala depresif. Terakhir, peneliti tidak menemukan adanya perbedaan bermakna dalam gejala depresif pada tiga kondisi waktu yang berbeda. Studi ini menunjukkan bahwa gratitude journal dapat digunakan sebagai jenis intervensi yang dapat mendampingi intervensi lain karena karakteristik aktivitasnya yang sederhana. Akan tetapi, masih dibutuhkan penelitian lebih lanjut yang memeriksa penerapan gratitude journal terhadap penderita depresi klinis sebelum konklusi mengenai efektivitas dari aktivitas gratitude journal dapat ditegakkan.

 

Cancer is a group of medical diseases that has detrimental impacts on the sufferers’ quality of life holistically, which includes psychological issues that may lead them to heightened depressive symptoms. Negative inferential style, defined as the tendency to interpret or attribute negative life events in maladaptive ways, has been suggested to be a risk factor contributing to the development of depressive symptoms. The current study aimed to investigate the application of cognitive-based intervention in the form of gratitude journal to reduce depressive symptoms. In addition, the study was designed to explore the fluctuative depressive mood among cancer sufferers by utilizing ecological momentary assessment. Six partisipants with age range from 35 to 56 years old (x? = 44.83), with cancer diagnosis and depressive symptoms (BDI-II > 0) were recruited and completed gratitude journal activity for two weeks. Non-parametric statistical analyses in the form of Wilcoxon Signed Rank Test and Kruskall-Wallis Test were conducted to analyse the data. Findings showed no significant differences between gratitude trait pretest-posttest scores. In contrast, there were significant differences among depressive scores, indicating that the intervention helps to reduce depressive symptoms among cancer sufferers. It was further revealed that the analyses failed to find significant depressive symptoms’ differences among three different time points. The findings suggest that gratitude journal can be used as an effective side-intervention that complements other type of intervention to reduce depressive symptoms due to its “easy-to-do” nature. However, future research is necessary to establish its efficacy to treat individuals with more serious depressive symptoms.

 

Article Details

Section
Articles

References

Abramson, L. Y., Metalsky, G. I., & Alloy, L. B. (1989). Hopelessness depression: A theory-based subtype of depression. Psychological Review, 96(2), 358-372.

Atchley, R. C. (2006). Continuity, spiritual growth, and coping in later adulthood. Journal of Religion, Spirituality and Aging, 18(2-3), 19-29.

Barlow, D. H., & Durand, V. M. (2015). Abnormal psychology: An integrative approach., 7th ed. Belmont, CA, US: Cengage Learning.

Beck, A. T. (1967). Depression: Clinical, experimental and theoretical aspects. New York: Harper & Row

Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18, 211–237. doi:10.1080/10478400701598298

Chintamani, Gogne, A., Khandelwal, R., Tandon, M., Jain, S., Kumar, Y., & ... Saxena, S. (2011). The correlation of anxiety and depression levels with response to neoadjuvant chemotherapy in patients with breast cancer. JRSM Short Reports, 2(3), 15. doi:10.1258/shorts.2010.010072

Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches (3rd ed.). Los Angeles: Sage Publications, Inc.

Effendy, C., Vissers, K., Osse, B. P., Tejawinata, S., Vernooij-Dassen, M., & Engels, Y. (2014). Comparison of problems and unmet needs of patients with advanced cancer in a European country and an Asian country. Pain Practice: The Official Journal of World Institute of Pain, 15(5), 433-440. doi:10.1111/papr.12196

Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389.

Emmons, R. A., & Stern, R. (2013). Gratitude as a psychotherapeutic intervention. Journal of Clinical Psychology, 69(8), 846–855. https://doi.org/10.1002/jclp.22020

Feros, D. L., Lane, L., Ciarrochi, J., & Blackledge, J. T. (2013). Acceptance and Commitment Therapy (ACT) for improving the lives of cancer patients: a preliminary study. Psycho-Oncology, 22(2), 459-464.

Grunebaum, M. F., Galfalvy, H. C., Mortenson, L. Y., Burke, A. K., Oquendo, M. A., & Mann, J. J. (2010). Attachment and social adjustment: relationships to suicide attempt and major depressive episode in a prospective study. Journal of Affective Disorders, 123(1–3), 123–13

Mac Giollabhui, N., Hamilton, J. L., Nielsen, J., Connolly, S. L., Stange, J. P., Varga, S., & ... Alloy, L. B. (2018). Negative cognitive style interacts with negative life events to predict first onset of a major depressive episode in adolescence via hopelessness. Journal of Abnormal Psychology, 127(1), 1-11. doi:10.1037/abn0000301

Hankin, B., Abramson, L., & Siler, M. (2001). A Prospective Test of the Hopelessness Theory of Depression in Adolescence. Cognitive Therapy and Research, 25(5), 607–632.

Himelhoch, S., & Njie-Carr, V. (2016). “God loves me no matter how I am”: a phenomenological analysis of the religious and spiritual experiences of HIV-infected African-American women with depression. Mental Health, Religion & Culture, 19(2), 178–191.

International Agency for Research on Cancer (IARC). (2013). Latest world cancer statistics. Retrieved from https://www.iarc.fr/en/media-centre/pr/2013/pdfs/pr223_E.pdf

Kementerian Kesehatan Republik Indonesia. (2013). Riset Kesehatan Dasar 2013 (Riskesdas). Retrieved from http://www.depkes.go.id/resources/download/general/Hasil%20Riskesdas%202013.pdf

Khalil, A. A., & Abed, M. A. (2014). Perceived Social Support is a Partial Mediator of the Relationship Between Depressive Symptoms and Quality of Life in Patients Receiving Hemodialysis. Archives of Psychiatric Nursing, 28(2), 114–118

McCullough, M. E., Emmons, R. A., & Tsang, J.A. (2002). The grateful disposition: a conceptual and empirical topography. Journal of Personality And Social Psychology, 82(1), 112–127.

Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. The Lancet. Oncology, 12(2), 160-174. doi:10.1016/S1470-2045(11)70002-X

Noronha, K. J. (2015). Impact of Religion and Spirituality on Older Adulthood. Journal of Religion, Spirituality & Aging, 27(1), 16-33. doi:10.1080/15528030.2014.963907

O’Neill, C., McCaughan, E., Semple, C. J., & Ryan, A. (2018). Fathers’ experiences of living with cancer: a phenomenological study. European Journal of Cancer Care, 27(1), 1

Peeters, F., Berkhof, J., Delespaul, P., Rottenberg, J., & Nicolson, N. A. (2006). Diurnal mood variation in major depressive disorder. Emotion (Washington, D.C.), 6(3), 383–391

Saldaña, J. (2009). The coding manual for qualitative researchers. SAGE Publications Ltd: London.

Schmid-Büchi, S., Halfens, R. G., Dassen, T., & van den Borne, B. (2011). Psychosocial problems and needs of posttreatment patients with breast cancer and their relatives. European Journal of Oncology Nursing: The Official Journal of European Oncology Nursing Society, 15(3), 260-266. doi:10.1016/j.ejon.2009.11.001

Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5-14. doi:10.1037/0003-066X.55.1.5

Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005). Positive psychology progress: empirical validation of interventions. The American Psychologist, 60(5), 410–421.

Snodgrass, J., & Sorajjakool, S. (2011). Spirituality in Older Adulthood: Existential Meaning, Productivity, and Life Events. Pastoral Psychology, 60(1), 85-94

van den Beuken-van Everdingen, M. J., de Rijke, J. M., Kessels, A. G., Schouten, H. C., van Kleef, M., & Patijn, J. (2009). Quality of life and non-pain symptoms in patients with cancer. Journal of Pain And Symptom Management, 38(2), 216-233. doi:10.1016/j.jpainsymman.2008.08.014

Watkins, P. C. (2014). Gratitude and the good life: Toward a psychology of appreciation. New York, NY: Springer Science + Business Media. https://doi.org/10.1007/978-94-007-7253-3

Whitmer, K. M., Pruemer, J. M., Nahleh, Z. A., & Jazieh, A. R. (2006). Symptom Management Needs of Oncology Outpatients. Journal of Palliative Medicine, 9(3), 628-630.

Wink, P., & Dillon, M. (2008). Religiousness, spirituality, and psychosocial functioning in late adulthood: findings from a longitudinal study. Psychology and Aging, 18(4), 916-924.