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Schizophrenia is a mental disorder characterized by deviation in attitudes, thoughts and behaviors, and can cause positive and negative symptoms. One of the most frequently occurring negative symptoms is social withdrawal, which leads to the problem of Social Isolation: Withdrawal. Social isolation is a condition that causes individuals to experience a decline or even inability to interact with others and their environment. The purpose of this case study was to apply nursing care to patients with social isolation: withdrawal due to undifferentiated schizophrenia in Gatotkaca Ward of RSJD dr. Amino Gondohutomo, Central Java Province. This scientific paper was written using a descriptive method in the form of a case study through the nursing process approach. Data collection methods used were interview, observation, documentation study, and literature study. Nursing diagnoses that emerged in the patient with Social Isolation: Withdrawal were Social Isolation as the Core Problem, Low Self-Esteem as the Cause, Risk of Hallucination as the Effect, and Self-Care Deficit as a concurrent problem. Interventions were only carried out on Social Isolation and Self-Care Deficit problems, consisting of SP 1 through SP 3 for Social Isolation and SP 2 for Self-Care Deficit: Grooming. After nursing implementation for 4 days, of the 4 nursing diagnoses that emerged, only 2 nursing diagnoses were intervened, namely Social Isolation and Self-Care Deficit. SP 1 through SP 3 for Social Isolation and SP2 for Self-Care Deficit: Grooming were competently achieved. This indicates that the goals of the Implementation Strategy provided were achieved cognitively, affectively, and psychomotorically.

Background: Schizophrenia is a serious chronic mental disorder that can affect thinking, perception, feelings, and behavior. Patients with undifferentiated schizophrenia are at risk of experiencing the nursing problem of risk of violent behavior (RPK) due to their inability to control emotions and anger. Based on data from the medical records of RSJD dr. Amino Gondohutomo, Central Java Province, from August to October 2025, the risk of violent behavior was the highest nursing diagnosis in the Gatotkaca Ward, reaching 56.5%–77% of all inpatients. Objective: To perform nursing care on Tn. K with the main problem of risk of violent behavior due to undifferentiated schizophrenia at RSJD dr. Amino Gondohutomo, Central Java Province. Methods: This study used a descriptive method with a nursing process approach. Data collection was carried out through interviews, observation, documentation studies, and literature review. Nursing care was provided from November 18 to 22, 2025. Results: Assessment findings on Tn. K (19 years old) with undifferentiated schizophrenia and a history of physical abuse, parental rejection, and family violence revealed four nursing problems: risk of violent behavior (core problem), sensory perceptual disorder: auditory and visual hallucinations, self-concept disorder: low self-esteem, and self-care deficit. Implementation was carried out through nursing strategies (SP) 1 to 4 for risk of violent behavior (physical, medication, verbal, and spiritual control), SP 1 and SP 3 for self-care deficit, and SP 1 to SP 2 for sensory perceptual disorder: hallucinations. All implementation stages were optimally achieved. Conclusion: Nursing evaluation showed that the client was able to achieve cognitive, affective, and psychomotor goals in all implemented SPs. Collaboration with ward nurses was carried out to continue SP 3 and SP 4 for hallucinations and the entire low self-esteem intervention due to time constraints.

Background: Schizophrenia is a psychiatric disorder characterized by positive psychotic symptoms (such as hallucinations) and negative symptoms accompanied by cognitive decline. Auditory hallucinations represent the most common positive symptom, occurring in more than 75% of patients with schizophrenia. Objective: This study aimed to describe the comprehensive nursing care for Mr. F with a primary problem of perceptual sensory disorder: auditory hallucinations due to undifferentiated schizophrenia at Gatot Kaca Ward, RSJD dr. Amino Gondohutomo, Central Java Province. Method: This study used a descriptive method with a nursing process approach, including assessment, nursing diagnosis, intervention planning, implementation, and evaluation. Data collection was carried out through interview, observation, and literature study. Results: Nursing problems identified were: perceptual sensory disorder (auditory hallucinations) as the core problem, social isolation (withdrawal) as the causa, risk of violent behavior as the effect, and self-care deficit as an accompanying problem. Nursing interventions were conducted using the implementation strategy (SP) 1, 2, and 3 for hallucinations and SP 1 for self-care deficit. Conclusion: After 4 days of nursing implementation, 2 out of 4 nursing diagnoses were resolved: perceptual sensory disorder (auditory hallucinations) and self-care deficit, while social isolation (withdrawal) and risk of violent behavior remained unresolved. Patients with hallucinations are expected to be able to control hallucinations using the methods that have been taught.

Background: Schizophrenia is a serious mental disorder characterized by disturbances in thought processes, emotions, and behavior. One of the positive symptoms that can occur in schizophrenic clients is the risk of violent behavior. Risk of violent behavior is one of the nursing diagnoses frequently found in the Citroanggodo Ward of RSJD dr. Amino Gondohutomo, Central Java Province. Therefore, the author conducted psychiatric nursing care for Mrs. N with the main problem of risk of violent behavior due to undifferentiated schizophrenia. Methods: The writing method used is descriptive with a case study approach. Data collection was carried out through interviews, observation, documentation studies, and literature studies. The general objective of this Scientific Paper is to provide nursing care to patients with Risk of Violent Behavior due to Undifferentiated Schizophrenia. Results: The nursing diagnoses that emerged in the patient with Risk of Violent Behavior due to Undifferentiated Schizophrenia were: Risk of Violent Behavior, Self-Concept Disorder: Low Self-Esteem, and Self-Care Deficit. Nursing interventions carried out included SP 1 through SP 4 for Risk of Violent Behavior and SP 2 for Self-Care Deficit. Conclusion: After 8 days of nursing implementation, of the 3 diagnoses raised, 1 diagnosis was partially resolved (risk of violent behavior), 1 diagnosis was resolved (self-care deficit), and 1 diagnosis was not implemented (self-concept disorder: low self-esteem).

Background: Schizophrenia is a type of mental disorder that affects how sufferers behave, think, and feel. This condition can trigger nursing problems such as low self-esteem (harga diri rendah). In 2023, approximately 970 million people worldwide experience mental disorders, with schizophrenia prevalence in Indonesia reaching 3 per 1,000 households and in Central Java approximately 5.1% of households. Methods: This study used a descriptive approach in the form of a case study through the nursing process, including observation, interview, documentation study, and literature review. The general objective of this writing was to implement psychiatric nursing care for Ny. W with the main problem of Self-Concept Disorder: Low Self-Esteem Due to Undifferentiated Schizophrenia. Results: Nursing diagnoses that emerged were low self-esteem, social isolation, and self-care deficit. Interventions carried out included SP 1 and SP 2 for low self-esteem (HDR) and SP 2 for self-care deficit (DPD). Conclusion: After 4 days of nursing care on Ny. W according to the nursing action plan, the patient was able to establish a trusting relationship, identify positive abilities she possessed, perform chosen activities, and interact with her environment.

Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations and has a significant impact on patients’ psychosocial functioning. This condition can reduce medication adherence, thereby increasing the risk of relapse. In this context, the role of caregivers is crucial in supporting treatment success. This study aims to describe psychiatric nursing care for patients with auditory hallucinations in improving medication adherence through caregiver involvement. The method used is a case study with a nursing process approach, including assessment, nursing diagnosis, planning, implementation, and evaluation. Interventions focus on hallucination management, psychoeducation, and caregiver involvement in care. The results show an increase in patients’ and families’ knowledge regarding the illness and its treatment, improved medication adherence, and enhanced patient ability to control responses to auditory hallucinations. Caregiver involvement has been shown to assist in supervision and providing support to patients. Therefore, comprehensive psychiatric nursing care through hallucination management, psychoeducation, and caregiver involvement is effective in improving medication adherence and controlling symptoms in patients with auditory hallucinations.

The Application Of Hallucination Management Using The Shutting-Out Technique For The Control Of Auditory Hallucinations In Schizophrenia Patients In The Angruk Ward Of Prof. Dr. Margono Soekarjo General Hospital, Purwokerto. Schizophrenia is a severe mental disorder often accompanied by auditory hallucinations. Auditory hallucinations may cause patients to talk to themselves, appear restless, and experience difficulty in controlling responses to internal stimuli. One non-pharmacological nursing intervention that can be applied is the rebuking technique, a strategy used to firmly reject or dismiss hallucinatory voices. This study aimed to examine the application of the rebuking technique in controlling auditory hallucinations in patients with schizophrenia. This research employed a descriptive case study design using a nursing process approach and was conducted from February 17 to 19, 2026, on a patient diagnosed with schizophrenia experiencing auditory hallucinations. The intervention was implemented over three days, with one session per day lasting approximately 15–20 minutes. The results showed an improvement in the patient’s ability to recognize and control hallucinations, as indicated by a reduction in self-talking behavior, increased awareness of hallucination onset, and the ability to independently apply the rebuking technique. In conclusion, the rebuking technique is an effective nursing intervention to assist patients with schizophrenia in controlling auditory hallucinations.

Schizophrenia is a chronic mental disorder that requires long-term medication adherence to prevent relapse and improve patients’ quality of life. Caregivers play a crucial role in encouraging medication adherence through emotional, informational, instrumental, and supervisory support. This descriptive quantitative study with a cross-sectional design aimed to describe caregiver support and medication adherence among schizophrenia patients at the South Denpasar Public Health Center. A total of 100 respondents, who were family members or caregivers of schizophrenia patients, were selected using a consecutive sampling technique. Data were collected through structured interviews using questionnaires and analyzed descriptively. The results showed that most caregivers provided good support (63%), particularly in accompanying patients during medication intake, actively interacting with them, and following health workers’ recommendations. Furthermore, patients’ medication adherence was mostly in the moderate (45%) and good (35%) categories. These findings indicate that caregiver support plays a significant role in improving medication adherence among schizophrenia patients. Strengthening caregiver knowledge and optimizing health education by healthcare workers are essential to further enhance adherence.

Long-term treatment adherence is critical for schizophrenia patients, yet non-adherence remains a significant global challenge, contributing to relapse, re-hospitalization, and increased healthcare costs. Understanding the underlying multidimensional factors is crucial for developing effective interventions. This systematic literature review aims to identify and categorize the dominant factors contributing to medication non-adherence among schizophrenia patients, based on current quantitative evidence (2019-2024). A systematic search of Google Scholar and PubMed targeted quantitative cross-sectional studies using the PICOST framework. Article selection followed PRISMA guidelines, and quality was assessed using the JBI Critical Appraisal Checklist. Seven articles were included in the final narrative synthesis. The synthesis confirms that non-adherence is multifactorial. Identified factors were categorized into three groups: (1) Patient-related factors (e.g., poor illness insight, feeling cured, treatment fatigue); (2) Treatment-related factors (e.g., medication side effects, therapy duration); and (3) System and social factors (e.g., low family support, stigma, poor therapeutic alliance). Non-adherence is a complex issue arising from the interplay of patient, treatment, and social factors. Low family support and poor patient knowledge consistently emerge as key determinants. Interventions require a holistic approach extending beyond pharmacotherapy, focusing on comprehensive psychosocial education for patients and families, active side-effect management, and strengthening the family's role in care.

Schizophrenia is a complex psychiatric disorder that disrupts cognition, emotion, perception, and behavior, significantly affecting daily functioning and social interaction. Paranoid schizophrenia, a well-recognized subtype, is characterized by persistent paranoid delusions, frequently accompanied by hallucinations—most commonly auditory—and other perceptual disturbances, often leading to unpredictable or aggressive behaviors. A 34-year-old male patient, Mr. A, was brought to Cut Meutia General Hospital on February 9, 2024, by his father and the village chief due to episodes of aggression. The patient reported that his behavior occurred because a creature was controlling his body and disturbing him. His family indicated that he had experienced similar episodes in the past and had previously been hospitalized for the same condition. Based on established clinical guidelines, he was diagnosed with paranoid schizophrenia. Pharmacological management was initiated, including risperidone, clozapine, lodemer injection, diazepam injection, divalproex, and trihexyphenidyl, targeting psychotic symptoms, agitation, and behavioral disturbances, with the aim of stabilizing his mental state, preventing further aggressive episodes, and supporting overall functional recovery.

According to data from the World Health Organization (WHO), approximately 24 million people worldwide, or about one in every 300 individuals, live with schizophrenia. Individuals with schizophrenia commonly experience reduced independence in performing daily functions and social roles, including self-care, employment, and social interaction. This decline in independence is closely related to disturbances in thought processes, which subsequently affect their ability to carry out activities of daily living (ADL). This study aimed to examine the relationship between family support and the level of ADL independence among patients with schizophrenia at Embung Fatimah Hospital, Batam City, in 2024. The research employed an analytical correlation approach with a cross-sectional design and involved 60 families who lived in the same household as schizophrenia patients. Data collection was conducted from October 1 to October 9, 2024, using a purposive sampling technique and structured questionnaires. The findings revealed that the majority of respondents perceived family support as adequate, accounting for 38 respondents (63.3%), while 29 patients (48.3%) demonstrated a sufficient level of ADL independence. Bivariate analysis using the Spearman rank correlation test showed a correlation coefficient of r = 0.605 with a p-value of 0.000 (< 0.05), indicating a statistically significant relationship between family support and ADL independence. These results confirm that stronger family support is associated with higher levels of independence in daily activities among schizophrenia patients. Therefore, families are encouraged to consistently provide emotional, instrumental, and motivational support to help patients maintain and improve their daily functioning.

Schizophrenia is a serious mental illness that requires long-term treatment and carries a high risk of recurrence. The recovery process for patients relies not only on medical intervention, but also requires optimal involvement and support from their families. The presence of a supportive family is believed to strengthen patient motivation and contribute positively to their psychological well-being. This study aims to identify the relationship between family support and relapse rates in schizophrenia patients undergoing treatment at the Aceh Mental Hospital Polyclinic. This study uses a correlational design with a Cross-Sectional method. Through Accidental Sampling, 114 samples were selected from a population of 3,233 individuals. Data collection took place between April 14 and 28, 2025, using a questionnaire focused on family support and relapse rates. To analyze the relationship between the two variables, a Chi-Square statistical test was applied. The main findings of the study show that aspects of family support in general (p=0.000), informational support (p=0.000), appreciative support (p=0.000), instrumental support (p=0.001), and emotional support (p=0.002) are correlated with the recurrence rate of patients. Based on the analysis of the results, it can be concluded that there is a correlation between family support and the recurrence of schizophrenia patients at the Aceh Mental Hospital Polyclinic. The practical implications of this research are expected to serve as a reference for the families of schizophrenia patients to increase their understanding and activity in providing support, including consulting with mental health professionals as an effort to prevent possible recurrence.

Schizophrenia is a severe mental disorder often accompanied by various psychopathological manifestations, one of which is auditory hallucinations that limit social functioning and reduce the quality of life of affected individuals. Dhikr therapy, as a psychoreligious approach, is believed to provide inner peace and reduce the intensity of hallucinatory symptoms. This study aims to evaluate the effectiveness of dhikr therapy among schizophrenia patients with auditory hallucinations who were treated at Aceh Mental Hospital. The research employed a quasi-experimental design with a pretest–posttest model and purposive sampling technique, involving 15 patients experiencing auditory hallucinations. The intervention was conducted for three consecutive days, with each session lasting 10–20 minutes and consisting of a sequence of dhikr recitations including istighfar, tasbih, tahmid, and takbir. The severity of hallucinations was measured using the Auditory Hallucination Rating Scale (AHRS). Data analysis was performed using the Wilcoxon test. The results showed a significant decrease in auditory hallucination scores with a p-value of 0.001. These findings indicate that dhikr therapy is effective in helping patients manage hallucinatory symptoms and may serve as a non-pharmacological therapeutic alternative in psychiatric nursing care for schizophrenia patients

The long-term care required by schizophrenia patients places a heavy burden on caregivers who are responsible for meeting the patients' needs. Performing these caregiving tasks often causes physical and emotional stress on caregivers, especially due to the long-term nature of the care. In situations like this, coping strategies play a crucial role in supporting the well-being of caregivers so that they are able to face the challenges that arise during the process of caring for schizophrenic patients. This study focuses on examining the correlation between coping strategies and the quality of life of caregivers who provide care for schizophrenic patients at the Aceh Mental Hospital Polyclinic. The research design applied was analytical with a cross-sectional approach. A total of 115 caregivers were sampled through accidental sampling from a total population of 4,035 families. Research data were collected using two measuring instruments, namely the Brief COPE questionnaire and The Schizophrenia Caregiver Quality of Life Questionnaire (SCGQoL). The research process took place at the Aceh Mental Hospital Polyclinic from March 6 to 24, 2025. Data analysis used univariate and bivariate methods. Based on the research results, it was found that 108 caregivers (93.9%) were in the low coping strategy category, while 80 caregivers (69.6%) had a moderate quality of life. Statistical testing with Chi-Square produced a p-value of 0.001, which indicates a significant relationship between coping strategies and the quality of life of caregivers. Therefore, it is hoped that health care institutions can improve mental health nursing interventions for patients' families, particularly through educational programs on managing schizophrenia patients at home and assistance in identifying adaptive coping resources for patients' families.

Schizophrenia is a severe mental disorder characterized by disturbances in thought, perception, emotions, and behavior, with auditory hallucinations being the most common symptom. This study aims to describe the nursing care process for patients with paranoid schizophrenia experiencing sensory perception disturbances, specifically auditory hallucinations. The research applied a descriptive case study design conducted in Dewaruci Ward, RSJD dr. Amino Gondohutomo, Central Java Province, from October to December 2024. Data were collected through interviews, direct observation, and medical record review, then analyzed using thematic analysis based on Miles and Huberman’s framework. The findings revealed that the patient was able to gradually reduce the intensity of auditory hallucinations and showed improvement in social interactions after nursing interventions, including identification of hallucinations, distraction techniques, therapeutic communication, and collaboration in pharmacological treatment. Family involvement also played an essential role in supporting the patient’s recovery process. This study implies that comprehensive nursing care based on bio-psycho-socio-spiritual approaches and family participation is effective in managing hallucinations and enhancing patient outcomes.

Schizophrenia is a severe mental disorder characterized by a decline in cognitive abilities and social skills, an inability to care for oneself, and potential brain function impairment. One of the consequences often observed in schizophrenia patients is social isolation, where the individual is unable to interact with others around them. This study aims to assess and provide psychiatric nursing care for Sdr. A, who is experiencing the primary issue of social isolation: withdrawal due to paranoid schizophrenia at the Gatotkaca ward of RSJD dr. Gondohutomo in Central Java Province. Initial assessment of the patient revealed that Sdr. A is experiencing social isolation, particularly withdrawal from their social environment. Four nursing problems were identified, including social isolation: withdrawal, low self-esteem, sensory perception disturbances such as hallucinations, and self-care deficits. A nursing care plan was developed based on the Indonesian Nursing Diagnosis Standard , Indonesian Nursing Service Standard, and Indonesian Nursing Information System , tailored to the patient's condition at the time. The care plan includes interventions to enhance social interaction, improve self-esteem, address sensory perception disturbances, and promote self-care abilities. The nursing implementation was carried out using a holistic approach involving psychosocial support and appropriate medical therapy based on the patient’s needs. It is expected that through this approach, the patient can reduce social isolation symptoms and improve their quality of life. This study emphasizes the important role of psychiatric nursing care in addressing social issues in patients with paranoid schizophrenia and how a structured nursing care plan can support patient recovery.

Mental health is an important aspect that supports quality of life, including a state of well-being related to happiness, satisfaction, achievement, optimism, and dynamic hope according to life situations (Fitri, 2025; Herlina et al., 2024). Schizophrenia is a severe mental disorder characterized by an inability to communicate, impaired perception of reality (illusions and hallucinations), and loss of self-confidence, included in the category of psychosis (Mardiana et al., 2024). The purpose of writing this scientific paper is to find out and implement psychiatric nursing care for Mr. R, with the main problem of sensory perception disorders: auditory hallucinations due to schizophrenia that are not detailed in the Hudowol Room of Dr. Amino Gondohutomo Mental Hospital, Central Java Province. The method used is a descriptive approach with a case study. The case review results showed that the client heard male and female voices saying negative things and often talked to himself. The problem tree identified sensory perception disorders: auditory hallucinations as the core problem, accompanied by self-care deficits, social isolation, and the risk of violent behavior. Interventions are designed based on implementation strategy guidelines for clients and families, implemented, and evaluated as documented evidence

Schizophrenia is a chronic mental disorder characterized by cognitive, emotional, and behavioral disturbances that may lead to aggressive behavior. Violent behavior risk is one of the most common nursing diagnoses in paranoid schizophrenia patients, which can endanger themselves, others, and the environment. This study aimed to describe psychiatric nursing care for a patient with the main problem of violent behavior risk due to paranoid schizophrenia at Arimbi Ward, RSJD dr. Amino Gondohutomo, Central Java Province. A descriptive case study design was applied, involving data collection through interviews, observation, documentation review, and literature study. The nursing process included assessment, nursing diagnosis, planning, implementation, and evaluation. The results showed that the patient exhibited symptoms of verbal aggression, tension, and refusal to take medication. Nursing interventions provided included pharmacological therapy, family psychoeducation, and group activity therapy. After the interventions, the patient showed decreased frequency of anger, improved cooperation with nurses, and willingness to participate in group activities. These findings highlight the importance of comprehensive psychiatric nursing care that integrates medical treatment and psychosocial interventions to reduce violent behavior risk in schizophrenic patients and to promote recovery and reintegration into the community.

Background: Regular physical activity has a significant impact on improving the quality of health in all age groups. One of the main factors causing the increasing prevalence of Non-Communicable Diseases (NCDs) such as diabetes, heart disease, and obesity is lack of physical activity. Data from various studies show that increasing physical activity and fitness levels can reduce the relative risk of death by 20% to 35%. This condition shows that physical activity is not only important for maintaining fitness, but also has a vital role in preventing premature death caused by chronic diseases. Objective: This study aims to systematically examine the benefits of physical activity on health and fitness through a systematic review of 13 relevant scientific articles. Results: The findings show that regular physical activity can improve and maintain muscle and bone health, reduce the risk of chronic diseases such as diabetes, heart disease, and obesity, and reduce symptoms of mental disorders such as depression and schizophrenia. In addition, physical activity also plays a role in improving psychological well-being. Conclusion: Consistent physical activity contributes to the primary and secondary prevention of various chronic diseases, reduces the risk of premature death, maintains a balanced body composition, and supports optimal organ function. This results in a healthier, fitter body, and individuals being more productive in their daily activities.  

Auditory hallucinations are one of the main symptoms experienced by patients with schizophrenia. Non-pharmacological interventions, such as spiritual therapy, serve as important alternatives to support treatment. One increasingly used method is the recitation of Qur’anic verses (murottal therapy), which provides psychological and spiritual calming effects.  To determine the impact of murottal audio therapy of Surah Ar-Rahman on the intensity of auditory hallucinations in patients with schizophrenia at Gramesia Nursing Home, Cirebon.  This scientific paper is presented in the form of a nursing care report focusing on the application of murottal audio therapy using Surah Ar-Rahman as an intervention.  Before the therapy, the patient experienced moderate auditory hallucinations, accompanied by intense emotional reactions and difficulty controlling behavior. After undergoing murottal audio therapy, there was a decrease in hallucination intensity and improvement in the patient’s emotional condition. Murottal audio therapy of Surah Ar-Rahman is effective as a non-pharmacological approach to reduce auditory hallucinations and support psychological recovery in patients with schizophrenia. Following the intervention, patients reported a significant decrease in the intensity of their hallucinations. Emotional reactions were notably less intense, and patients displayed improved emotional regulation and greater behavioral control. The results suggest that murottal audio therapy using Surah Ar-Rahman is an effective non-pharmacological intervention that not only reduces the intensity of auditory hallucinations but also plays a supportive role in the psychological recovery of patients with schizophrenia. The findings emphasize the importance of integrating spiritual therapies into comprehensive treatment plans, as they offer a holistic approach to managing schizophrenia. This intervention can complement traditional pharmacological treatments, providing patients with a sense of spiritual calm and emotional stability, which can enhance their overall mental health and well-being.