Syntax Literate: Jurnal Ilmiah Indonesia p�ISSN: 2541-0849 e-ISSN: 2548-1398

Vol. 7, No. 10, October 2022

THE EFFECT OF DHIKIR THERAPY TO REDUCE ANXIETY IN PREGNANT WOMEN IN FATIYA CLINIC, SLEMAN REGENCY

Reza Mina Pahlewi

State Islamic University Sunan Kalijaga, Indonesia

Abstract

Physical and psychological changes in pregnant women cause anxiety that can affect fetal development. Dhikr therapy is an effort to reduce the anxiety of pregnant women by remembering the existence of Allah in the form of pronunciation with the tongue or heart. Therefore, the purpose of this study was to examine the effect of dhikr therapy in reducing anxiety in pregnant women. The participants consisted of 14 pregnant women with gestational ages between 4 to 34 weeks, ages between 20 to 40 years, and were classified into two groups, namely the experimental group and the control group, where the experimental group received dhikr therapy while the control group did not receive therapy (waiting list). The design of this study used a quasi-experimental design with pretest-posttest and follow-up. anxiety scale for pregnant women Anxiety Scale for Pregnancy (API)Data from both groups were analyzed by independent sample t-test, then the value of t = -4.708 and p = 0.001 (p < 0.01) is known. This shows that there is a difference in the level of anxiety of pregnant women between the experimental group and the control group, where the experimental group experienced a significant decrease in the anxiety of pregnant women compared to the control group. Based on the results of this study, it was concluded that dhikr therapy had an effect on reducing the anxiety level of pregnant women.

Keywords: Pregnant Women, Pregnancy Anxiety, Dhikr Therapy.

Introduction

Pregnancy is a natural and happy thing that happens to married couples. However, sometimes it is not easy to go through a pregnancy that occurs until the delivery process. During pregnancy, mothers experience physical and psychological changes that occur due to hormonal changes. These changes will make it easier for the fetus to grow and develop until the time it is born. The process of adjusting to new conditions experienced by pregnant women can then cause anxiety (Andriyani et al., 2017).

Pregnancy for some women is a period of crisis in their life. This new experience gave her mixed feelings, between happiness and hope with worry about what would happen during pregnancy (Subandi, 2009).

This anxiety can arise because the long period of waiting for the birth is full of uncertainty, in addition to the image of scary things during the birth process even though what he imagined may not necessarily happen. This situation causes drastic changes, not only physically but also psychologically (Kartono, 1992). The anxiety faced by pregnant women varies during pregnancy.

(Rasmaningrum's, 2003) research on anxiety in pregnant women also found that the anxiety was divided into problems with the baby's condition, appearance problems, problems with the birth process and economic problems. Pregnant women who experience anxiety, the possibility of the baby being born can be premature, underweight, or swollen due to excess sodium (pre-eclampsia). Mothers who are anxious during pregnancy can increase the hormone adrenaline. According to research conducted by Lee from Hong Kong University, about 57% of pregnant women experience anxiety (Nurtantri, 2008).

Anxiety disorders experienced by the mother will become an emergency for both the mother and the fetus during the delivery process, which can cause the release of stress hormones, including Adreno Cortico Tropin Hormone (ACTH), cortisol, catecholamines, -Endorphins, Growth Hormone (GH), prolactin. and Lutenizing Hormone (LH) / Follicle Stimulating Hormone (FSH). The release of these stress hormones results in systemic vasoconstriction, including contraction of the uterine vasa utero which causes disruption of blood flow in the uterus, so that oxygen delivery to the myometrium is disrupted and results in weak uterine muscle contractions (Suliswati, 2005). This incident causes the length of the labor process (long parturition) so that the fetus can experience an emergency (fetal distress). In addition, with the increase in plasma cortisol, resulting in a decrease in the immune response of the mother and fetus. This condition can lead to the death of the mother and fetus. If this condition is left unchecked, the mortality and morbidity rates in pregnant women will increase.

Spiritual factors become interesting to study because these factors are important factors that also affect the healing process and psychological intervention. WHO (World Health Organization) in 1984 (Hawari, 2005) stated that complete human health is indicated by 4 things, namely physically healthy (biological), mentally healthy (psychologically), socially healthy and spiritually healthy (spiritual). Therefore, the handling of human health, including the health of pregnant women, must meet these 4 dimensions.

One intervention that has been shown to be effective for reducing anxiety and has been frequently used is Dhikr. Dhikr is remembering the favors of God. Furthermore, dhikr includes the notion of mentioning dhikr pronunciations and remembering Allah at all times, fearing and hoping only for Him, feeling confident that humans are always under the will of Allah in all matters and their affairs (Ash-Shiddieqy, 2001).

Dhikr was chosen because of the repeated recitation of words that are believed to have more effect on the body than meaningless words (Davis, et al., 1995). Dhikr helps individuals to form perceptions other than fear, namely the belief that any stressor will be dealt with well with Allah's help. Muslims believe that the repeated mention of Allah (dhikr) can heal the soul and cure various diseases (Subandi, 2009). When a Muslim gets used to dhikr, he will feel himself close to Allah, in His care and protection, which will then generate confidence, strength, feelings of security, peace, and happiness (Najati, 2005). Dhikr will make a person feel calm so that it then suppresses the work of the sympathetic nervous system and activates the work of the parasympathetic nervous system (Saleh, 2010).

According to (Maimunah, 2009) Anxiety in pregnant women is the anxiety felt by pregnant women related to themselves and the baby in their womb which is influenced by experiences in previous pregnancies, child status related to decision making, family ability and readiness, mother's health, mother's image. on miscarriages, deformed babies, twins, premature births as well as mothers' views on matters surrounding childbirth.

(Nevid et al, 2005) revealed that someone who experiences anxiety will experience the following symptoms: a) Physical symptoms: chest pain, shortness of breath, sweating, muscle spasms, dizziness, headaches and indigestion, restlessness, nervousness, fainting , feeling weak or numb, stiff throat, chills, frequent urination and diarrhea; b) Thoughts: considers himself unable to cope with threats, thinks nothing can help him, will think something bad will happen, worry about something, fear of being unable to face problems; c) Feelings: nervous, irritable, restless and panicked; d) Behavior: avoiding something that will cause anxiety, leaving situations that will cause anxiety and dealing with situations that will cause anxiety.

Anxiety and worry in pregnant women if not handled seriously will have an impact and influence on the physical and psychological, both for the mother and the fetus. Mothers who experience anxiety or stress will affect the hypothalamus to stimulate the endocrine glands that regulate the pituitary gland (Suliswati, 2005). This reaction causes an increase in hormone production that affects most of the body's organs, such as a pounding heart, rapid pulse and breathing, excessive sweating, and others (Hawari, 2006). In addition, it will also cause vasoconstriction which causes disruption of blood flow into the uterus, so that the oxygen received by the fetus will be minimal or disrupted (Suliswati, 2005). One of the interventions used to reduce anxiety is religious coping, for example: prayer, fasting, dhikr and so on.

In this study, researchers used dhikr to reduce anxiety. Dhikr was chosen because of repeated recitation of words that are believed to have more effect on the body than meaningless words (Maimunah, 2009). Dhikr helps individuals to form perceptions other than fear, namely the belief that any stressor will be dealt with well with Allah's help. Muslims believe that the repeated mention of Allah (dhikr) can heal the soul and cure various diseases (Subandi, 2009). When a Muslim gets used to dhikr, he will feel himself close to Allah, in His care and protection, which will then generate confidence, strength, feelings of security, peace, and happiness (Najati, 2005). Dhikr will make a person feel calm so that it then suppresses the sympathetic nervous system and activates the parasympathetic nervous system (Saleh, 2010).

Dhikr therapy seeks to bring memories to Allah SWT in daily activities both by mentioning certain pronunciations that are in accordance with the Qur'an and Sunnah, as well as by contemplating the creation of His creatures. When the dhikr activity can be applied in daily life, the positive impact as described above will appear on a person.

Dhikr, it contains many psychological essences, namely: a) Dhikr as a medium of relaxation. The focus of this relaxation is not on muscle relaxation but on certain phrases that are repeated with a regular rhythm accompanied by an attitude of submission to the object of transcendence, namely God. The phrases used can be the names of gods or words that have a calming meaning. Pronunciation of lafadz dhikr accompanied by confidence in His love, protection and other good qualities will create a sense of calm and security (Purwanto, 2006). b) Dhikr as a cathartic medium. Dhikr will always be related to prayer and has a strong bond, especially in relation to being a healer of the heart, so dhikr is more important to be delivered in sincere prayer (Haq, 2011). c) Dhikr as a medium of hope for God (expectation). Dhikr will create a feeling of optimism in Allah SWT that Allah will always help him in dealing with all the calamities that befall him. d) Dhikr as a medium to surrender to Allah SWT. Dhikr makes one constantly remember the Creator. They will always be happy and content with what Allah has given them (Haq, 2011).

From the description above, it can be seen how dhikr therapy can have a positive influence in the form of feelings of optimism, spaciousness, more self-control, and feelings of calm and relaxation. Therefore, dhikr can help with anxiety. In this study, dhikr is used to help pregnant women who experience anxiety.

Metode Penelitian

The research subjects used in this study were pregnant women who were patients at the Fatiya Clinic, Sleman Regency. The characteristics of the research subjects used by the researchers to achieve the objectives of this study were: Muslim women, pregnant women aged between 20 years to 40 years, a minimum gestational age of 4 weeks to 34 weeks of gestation and experiencing anxiety during pregnancy as measured by using Anxiety scale for pregnant women. There are three categories of anxiety for pregnant women, namely mild, moderate and severe. Subjects were selected based on the results of the selection as many as 14 people, then divided into 2 groups. Group 1 will be given dhikr therapy, while group 2 as the control group will not be given therapy.

The measuring instrument used in this study is the (ASP) from (Waters, 1994). Aspects of anxiety for pregnant women, namely infants, childbirth, marriage, self-interest and environmental support, which consists of 14 items.

In ASP the minimum possible score is 14 and the maximum is 56. The group mean is 25.13, the standard deviation is 6.20 and the median is 24.50. ASP's internal consistency was measured by Cronbach's alpha. The reliability of the five subscales ranged from 0.11 to 0.72 per item. This shows high reliability. so that researchers only use items that are valid for use in research. The fourteen item scales were then used at the pretest and posttest and follow-up to determine the subject's level of anxiety.

Dhikr therapy is one of the clinical applications of Islamic relaxation to reduce psychological trauma, anxiety, addiction, migraine and overcome phobias and eye fatigue (Mardiyono & Songwathana, 2009). Dhikr in Arabic means remembering, remembering Allah or zikrullah is something that humans need to do for the benefit of humans themselves, namely he is remembered by the creator (Surah Al-Baqarah: 152), getting a peaceful heart (Surah Ar-Ra'ad: 28), gain profit (Surah Al-Jumuah: 10). A number of hadith qudsi view dhikr as a form of gratitude, a form of friendship between creatures and the divine (Gani, 2011). Zikr is a way or medium to mention and remember the name of Allah. Therefore, the form of activity that aims to get closer to Allah is called Dhikr such as fasting and prayer.

Dhikr according to Prof. Dr. Abu Bakar Aceh is a speech made with the tongue or remembering God with the heart, speech, or memory that consecrates God (Adz-dzakiey, 2002). With dhikr, a person remembers the great power of Allah SWT in his life, so that humans leave everything only to Allah SWT. This is in accordance with the writings of Al-Hafidz ibn Al-Qayyim (pious, 2010) that the benefits of dhikr that are felt by humans are that dhikr brings someone to surrender himself to Allah, so that slowly Allah becomes a refuge from all things. Dhikr can make humans more grateful for the gifts and graces of Allah SWT, so that with gratitude humans can feel the happiness of their lives. In addition, (Khaled, 2007) said that the benefit of dhikr is to gain peace and tranquility. In dhikr there is a cure for people who feel restless, experience the pain of life and turn away from doctors.

Research data analysis was carried out quantitatively using SPSS 22. The analytical technique used to test the hypothesis in this study was the independent sample t-test, because to see the difference in the level of anxiety of pregnant women between the experimental group and the control group after being given dhikr therapy.

Results and Discussions

Based on the results difference test between the two groups showed that there was a difference in the mean value between the pretest and posttest in the experimental group and the control group:

Table 1.

Description of Research Data

Classification	of Experimental					Group Control Group
	Min	Max	Average	SD	Min		Max	Average	SD
Pretest	22	36	27.43	4,685	18		31	24, 57	24,14
Posttest	21	31	3,288	31	23		31	28.00	3,109
Follow-up	3,200	24	17 27 21,29	28,29	2,289		Table	2.	Summary

Table 2.

independent sample t-test test for the experimental group and the control group

Calculation	T	P	Conclusion
� Pretest experiment-control��	1.085	0.299	Not significant
� Posttest experimental-control��	-2.225	0.044	Significant
Follow-up Experiment-control	-4.708	0.001	Very significant

In table 2 shows there is a significant difference in the level of anxiety of pregnant women between the experimental group and the control group at the time of posttest, this is indicated by the score t = -2.225 and p = 0.44 (p< 0.05). This shows that there is a difference in the decrease in anxiety levels of pregnant women between the experimental group that was given dhikr therapy and the control group who was not given dhikr therapy. At the time of follow-up also showed that there was a very significant difference in the level of anxiety of pregnant women between the experimental group and the control group. This is indicated by the score t = -4.708 and p = 0.001 (p<0.001).

Discussions

Based on the quantitative analysis of the data, it was found that there was a difference in the level of anxiety between the control group and the experimental group after being given assertiveness training. The results of the Independent Sample T-test analysis showed a score of t = 2.715 and p = 0.019 where p <0.05 indicates that there is a significant difference in the level of anxiety of pregnant women in the experimental group and the control group from pretest to follow-up. The experimental group showed a lower level of anxiety for pregnant women compared to the control group.

During pregnancy, mothers experience significant changes in their physiological and psychological functions. The process of adjusting to this new situation then causes anxiety. Bibring (Stotland & Stewart, 2001) states that pregnancy is a period of crisis involving deep psychological factors, which occurs because of very large somatic changes. This is caused by hormonal changes that also cause the mother's emotions to become unstable. In addition to physical factors, psychosocial factors can also increase anxiety in pregnant women (Gross & Helen, 2007). Information about the frightening experience of childbirth also adds to the anxiety of pregnant women (Andriana, 2007).

The results of this study indicate that dhikr therapy is effective for reducing anxiety in pregnant women based on the analysis of the Independent Sample T-test. In both groups, there were significant differences in anxiety scores of pregnant women between the experimental group and the control group which were affected by dhikr therapy

. Based on the analysis of the Independent Sample T-test showed a score of t = 4.537 and p = 0.001 (p <0.01). This shows that there is a very significant difference between the anxiety levels of pregnant women between the experimental group and the control group after being given dhikr therapy and during follow-up.

The results of this study are in line with and support various previous studies. Based (Maimunah, 2011) it was found that relaxation training with dhikr was to overcome the anxiety of the first pregnant woman. The result was that the group of subjects who followed relaxation therapy with dhikr experienced a significant reduction in anxiety at p=0.008 (p<0.01) compared to the control group. This study shows that Relaxation Therapy with Dhikr can be used as a way to reduce maternal pregnancy anxiety. In addition, (Khairiyah (2013) conducted an experimental study on the effect of dhikr therapy on increasing resilience in patients with low back pain. This study shows that dhikr can increase resilience in patients with low back pain.

Based on the results of the interview, it is known that several causes of the emergence of anxiety experienced by the participants are the condition of the baby in the womb, the delivery process, the relationship with the husband, physical conditions that change during pregnancy and support from the closest people and medical officers related to pregnant women.

Through dhikr therapy, it is able to help heal someone or someone else. This is based on the results of research conducted by (Subandi (2009). Dhikr will lead a person to have the inner ability to accept unpleasant situations and continue to rise to reach his future. This is in line with the research above as conveyed by (Hikmatillah (2005) which states that dhikr can lead a person to his Lord, feel in His protection, strengthen hope to reach His forgiveness, evoke feelings of satisfaction and gracefulness and give birth to calm and peace in one's life. his soul.

Anxiety of pregnant women can be reduced with the help of dhikr, because with dhikr can calm the feelings of anxiety that arise. According to one research subject, he said there was a feeling of anxiety when the baby in the womb didn't move, then the subject read dhikr suddenly the baby in the womb moved. Based on the tasks given to the participants in the recitation of dhikr which was spoken a lot by the participants, namely "Astagfirullahaladzim", "Subhanallah" and "Alhamdulillah".

Laillahaillallah

Decrease the level of anxiety of pregnant women.

Anxiety of pregnant women can be reduced with the help of dhikr, because with dhikr can calm feelings of anxiety that arise. Based on the tasks given to the participants of the dhikr lafaz that were spoken a lot by the participants, namely "Astagfirullahaladzim", ""Alhamdulillah"

Laillahaillallah

1.� Subhanallah. andother health services

The benefits in this study can also be input for any health care center that dhikr therapy can handle patients/clients who experience anxiety during the pregnancy process. The psychology poly can also provide this dhikr therapy in the form of groups because with this dhikr therapy it can build good interpersonal relationships.

2.� Research subjects

Pregnant women are expected to be able to apply dhikr therapy at home to reduce anxiety. The things that have been obtained in the therapy process, if they can be applied in daily life, the anxiety experienced will be reduced, so that it can affect the health of the mother and baby.

3.� Researchers in similar fields Future

a.� researchers can also examine the effectiveness of dhikr therapy not only for anxiety in pregnant women, but can also be carried out at other stages of development or with other diseases and disorders that can be related to stress.

b.� Each research subject has their own uniqueness, as well as pregnant women. As a suggestion, because of the tendency of participants in this study to love to tell stories. In addition, this research also shows curiosity about several things, especially health so that they often ask questions. Therefore, therapists or researchers should enrich themselves with knowledge about health

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Reza Mina Pahlewi (2022)

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