452 | pISSN: 1858-3598  eISSN: 2502-5791 Jurnal Ners Vol. 15, No. 2, Special Issue 2020 http://dx.doi.org/10.20473/jn.v15i2.20354 This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License Original Research The Effect of Paradoxical Intension Session 1 Logotheraphy on Prisoners Anxiety in LAPAS Kediri Lingga Kusuma Wardani, Byba Melda, Dhita Kurnia, and Nurul Azizah Institut Ilmu Kesehatan STRADA Indonesia, Kediri, Indonesia ABSTRACT Introduction: Living in the prison can causing anxiety to the prisoner. The major factor of anxiety is feeling worry their society won’t accept them again a lot of people stay away from ex-prisoner. logotherapy paradoxical intention session 1 can effect anxiety prisoner in LAPAS Kediri. The purpose of this study is to determine the effect of paradoxical intention session 1 on the anxiety in LAPAS Kediri. Methods: The design of this study was pre-experimental with a one-group pretest posttest design approach. The population studied were detainees who were in LAPAS Kediri, totalling 109 people, with a random sampling technique obtained by a sample of 78 people. The independent variable paradoxical intention logotherapy session 1 with dependent variable anxiety. Collected data using questionnaire. Data analysis using the Wilcoxon test at α = 0.05. Results: The results of the study before logotherapy showed that the majority of respondents in a panic situation were 33 respondents (42.3%) and after logotherapy showed that the fraction in severe anxiety were 18 respondents (23.1%). The results of the analysis, p-value (0.000) < (0.05), it means there is an effect of paradoxical intention session 1 on the anxiety of prisoner in LAPAS Kediri. Conclusion: Anxiety was not significant caused of age, education, length of detention, and logotherapi given as session 1, lenght of administration, and provider of logotherapy. ARTICLE HISTORY Received: Feb 27, 2020 Accepted: April 1, 2020 KEYWORDS anxiety; logotherapy paradoxical intention session 1 CONTACT Lingga Kusuma Wardani  linggakusumawardani@gmail.com  Institut Ilmu Kesehatan STRADA Indonesia, Kediri, Indonesia Cite this as: Wardani, L, K., Melda, B., Dhita, K., & Azizah, N. (2020). The Effect of Paradoxical Intension Session 1 Logotheraphy on Prisoners Anxiety in LAPAS Kediri. Jurnal Ners, Special Issues, 452-456. doi: http://dx.doi.org/10.20473/jn.v15i2.20354 INTRODUCTION Penitentiary (LAPAS) is a technical implementing unit under the Directorate General of Corrections of the Ministry of Law and Human Rights (formerly the Department of Justice). The purpose of LAPAS is to care for and foster the occupants who are in it. LAPAS residents can be inmates (prisoners) or Penitentiary Prisoners (WBP) even prisoners whose status is still in the judicial process and have not been found guilty or not by the judge (Katona Cornelius &Coper Claudia, 2008). According to Hadjam (2014), the problem experienced by many prisoners who are in prison is anxiety. Data from the International Center for Prison Studies (2015) shows that the total population of prisoners in the world is around 9 million. Indonesia is ranked 9th for the country with the most prisoners in the world. The Directorate General of Corrections of the Ministry of Law & Human Rights (2015) reported that on 22 February 2015 there were 137,495 prisoners and prisoners spread across 33 regions of Indonesia (Asmadi, 2010) This number consists of 45,138 adult prisoners, 666 child prisoners, 89,659 adult prisoners, and 2,032 child prisoners. The incidence of mental emotional disorders based on the results of Riskesdas 2013 shows the prevalence of mental emotional disorders in the population aged ≥ 15 years is 6.0% with a prevalence in East Java of 6.5%. According to Riskesdas mental emotional disorder is a condition that indicates an individual experiences an emotional change that can develop into a pathological state if it continues (Widianti et al., 2011). The prevalence of prisoners' psychosocial problems, namely anxiety, is https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/ mailto:linggakusumawardani@gmail.com http://dx.doi.org/10.20473/jn.v15i2.20354 JURNAL NERS http://e-journal.unair.ac.id/JNERS | 453 the finding of Trencin (WHO, 2008) in the International Journal of Nursing Studies (2010) which states that one in nine perpetrators suffers from severe mental health problems, some suffer from mild mental health problems such as mild anxiety and depression (Asmadi, 2010) Widianti (2011) mentioned that out of 33 prisoners, 16 of them experienced anxiety problems, 80% of which were severe anxiety, 15% were moderate anxiety and the rest were mild anxiety.(Widianti et al., 2011) Preliminarystudy conducted on 18 September 2018 at the Penitentiary Class II A of the City of Kediri based on interviews conducted with 20 detainees found that anxiety that occurred in detainees ie 1 person experienced mild anxiety with the client's symptoms having a bad feeling about his future, 10 people experienced moderate anxiety with rapid and hardened pulse symptoms, difficulty sleeping for several days, and thought of family health at home, and 9 people experienced severe anxiety with fast and hardened pulse symptoms, did not ask for activities carried out at the prison, wanted to get out immediately, and the client looked nervous and confused. To deal with the anxiety of detainees, there are currently no supporting facilities to deal with it, so that most detainees make diversions by praying, reciting, or going around the prison to feel tired. LAPAS Kediri is a State Institution that has the authority and obligation to be responsible in handling the life of prisoners to be able to foster, care for and humanize prisoners (Widhiarso & Hadjam, 2014). Prison is occupied by several people who commit acts of guilty against the law, one of them a prisoner . Detainee is a person who is in detention, a prisoner who is still in the process of investigation,prosecution and examination in a state court, a high court and a supreme court placed in a detention center (Agoes, 2008) . Life in prison has a different dynamic from the life of the community in general. Limiting activities and communication with others are some things that must be experienced by inmates while in prison. Not infrequently life in prison raises psychological effects in prisoners one of them anxiety (Widhiarso & Hadjam, 2014). Anxiety is an unpleasant emotional state, involving subjective fear, body discomfort, and physical symptoms (Katona Cornelius &Coper Claudia, 2008) Some of the problems that often become conflicts that cause anxiety to prisoners are fear of not being accepted by the environment, shame to get back into the community, self-esteem and community attitudes that tend to stay away from them, but also because of the atmosphere of detainees such as their relationship with prisoners others, and with officers (Effendi dkk, 2009).anxiety can provide anxious response, easily surprised, confused, guilty, and ashamed. (Gail W. Stuart, 2013) Towsend (2009) states that the use of anti-anxiety drugs continuously can cause physical and psychological dependence so it is not recommended for long-term use. In addition to the psychopharmaceutical approach, anxiety management can be done with a psychotherapy approach. One of the psychotherapies that can be applied as anxiety solutions is logotherapy paradoxical intention. Paradoxical Intention for short-distance treatment of phobia patients (irrational fear) and obsessive compulsive behavior, anxiety and social difficulties (Suhita et al., 2020). The implementation of logotherapy on the client can be carried out in the form of group therapy, with group therapy providing an opportunity for participants to solve their problems in the presence of others, observing how other people react. In the Logotherapy Group Therapy session Paradoxical Intention, each member directly searches for and reveals the meaning of life related to the experience they experience. It aims to find the meaning or wisdom of a life event even though it is considered very heavy or sad. From the background description above, the researcher is interested in conducting a study entitled "The Effect of Logotherapy Paradoxical Intention Session 1” on Prisoner Anxiety in Class II A Penitentiary in Kediri City." MATERIALS AND METHODS Design pre-experimentalone group pretest posttest design. The study population was all prisoners who were in Class II A in Kediri City. The sampling method used was random sampling and 78 samples were obtained. Data collection was carried out using a questionnaire to obtain data on anxiety experienced by prisoners by giving a questionnaire pre tes then prisoners were treated in the form of logotherapy paradoxical intention session . I then given a questionnaire posttest anxiety, logotheraphy session 1 give twice treatment in one weeks. Data processing using editing is the process of re- examining the data records obtained for the next process.Coding is changing data in a more concise form by using codes. Analysis of the data used is the Statistical Program for Social Science (SPSS) software with the "" statistical Wilcoxon Test . The degree of significance is determined α = 0.005 meaning that if the statistical test results show a p value ≤ 0.005 then there is a significant influence between the variables independent with the variable dependent. RESULTS The results of this study were elaborated on the characteristics of the respondents, cross tabulation anxiety before and after the first “logotherapy session of paradoxical intention.” Based on table 1 it is known that of the 78 respondents mostly aged 21-30 years as many as 49 respondents (62.8%). Based on table 2, it is known that from 78 respondents most of them had elementary school education of 30 respondents (38.5%). Based on table 3 it is known that of the 78 respondents mostly detained for 1-2 months, 34 respondents (43.6%). Based on Table 4, cross- tabulation of prisoners' anxiety before and after L. K. WARDANI ET AL. 454 | pISSN: 1858-3598  eISSN: 2502-5791 paradoxical intention session logotherapy, after logotherapy, it was found that a small proportion experienced severe anxiety as many as 18 respondents (23.1%). Based on Table 5, the results of outputrank the influence of logotherapy paradoxical intention session 1 on prisoners anxiety in class II A penitentiary in Kediri, obtained results, from a total of 78 data, there are 30 data with negative rank, nodata positive rank, and there are pairs of data with the same value. 48 data. Based on table 6, the results of data output of the influence of logotherapy paradoxical intention session 1 on prisoners anxiety in class II A penitentiary in Kediri based on statistical tests using Wilcoxon obtained p = 0,000, meaning p value 0.003 <0.05 then H0 is rejected and H1 is accepted which means Influence of Logotherapy Paradoxical Intention Session 1 on Prisoners' Anxiety in Class II A Penitentiary in Kediri City. DISCUSSION However, the output rank shows that from a total of 78 data there are 30 data with negative rank, there is no positive rank data, and there are pairs of data that score as much as 48 data. From the output rank results, it can be interpreted as negative rank 30 data which shows that the resistance that has been given treatment is more than the exception of before the treatment was given. Whereas for the value of positive rank with zero point which showed that anxiety was not found after more than logistical therapy before treatment was given. The evidence was found that the pair of data with the same value as much as 48 data that could be interpreted as anxiety after the logotherapy value was the same as anxiety before treatment was given.Anxiety is a person's emotional turmoil related to something outside of himself and the self mechanism used in overcoming problems. Uneasy feelings whose sources are unclear will be able to threaten a person's personality both physically and psychologically (Asmadi, 2010). According to Routledge (2010) states that an individual who loses meaning to events in his life will more easily experience anxiety(Routledge & Juhl, 2014). Likewise, life in the prison which seems to be alienated from life and communication restrictions is one of the things that can make prisoners experience anxiety, other things that can cause anxiety to detainees are unacceptable to the environment, a sense of shame to be detached from the community, disruption of the price of the people who tend to stay away from them, in addition to being caused by non- acceptance of the environment, embarrassment to the detainees of the detention and detention in relation to other detainees (Effendi dkk, 2009). Anxiety experienced by prisoners after logotherapy did not change to the maximum that can be seen from the negative rank values, there are 30 data and 48 ties, this can be caused by several things, namely the results of the study found that age of most prisoners 21-30 years at this age are productive ages to continue their education or higher education, work or get married according to the Ministry of Health Republic of Indonesia (2009) at the end of adolescence is 17-25 years which is a mature personal development and adulthood at the age of 26- 45 years which is a period of responsibility towards others with imprisoned conditions making them forced to not continue these activities. In terms of education, it is found that most of the elementary school education according to Kaplan and Saddock (2010) the ability to think of a person is influenced by the higher level of education, the easier it is to think rationally and capture new information, formal education can be used to develop one's potential and can be used as an indicator of ability solve the problem.(Kaplan H.I, 2010) The length of detention that is almost half detained 1-2 months which can be said of all categories selected by detention researchers detained less than 1 year detention period which can be related to the transition or adaptation that initially was in a free external environment because criminal acts require entry prisons which are certainly all restricted so that individuals or detainees have to adapt to this according to Stuart (2010) individuals who are in a foreign environment are more prone to anxiety than if he was in the environment he used to Table 1. Distribution of Respondents by Age in Class II A in Kediri City Age Frequency Percent Percent Percent 21-30 year 49 62.8 62.8 75.6 31-40 year 13 16.7 16.7 92.3 41-50 year 6 7.7 7.7 100.0 Total 78 100.0 100.0 Table 2. Distribution of respondents by education in Class II A in Kediri City Education Frequency Percent Percent Percent Elementary 30 38.5 38.5 38.5 Junior 23 29.5 29.5 67.9 Senior 22 28.2 28.2 96.2 Bachelor 3 3.8 3.8 100.0 Total 78 100.0 100.0 Table 3. Distribution of Respondents by Length of Detention in Penitentiary Class II A Kediri City Length of Detention Frequency Percent Percent Percent <20 day 11 14.1 14.1 14.1 1-2 month 34 43.6 43.6 57.7 >2-3 month 15 19.2 19.2 76.9 >3 month 18 23.1 23.1 100.0 Total 78 100.0 100.0 JURNAL NERS http://e-journal.unair.ac.id/JNERS | 455 occupy. (Gail W. Stuart & Michele T. Laraia, 2005)Apart from the length of time in detention that in the study found almost half were new prisoners anxiety prisoners can also be caused by factors of the type of crime committed, from observations found that most respondents committed crimes of theft, ill- treatment, violence and even disappearance.(Agoes, 2008) But there are also respondents who, if asked for their mistakes to go to prison, are unwilling to tell stories and change the subject because it is because the respondent is ashamed of his status as a detainee or his level of serious crime is so unwilling to tell researchers (Gail W. Stuart, 2013). The level of crime that is judged or felt to be high which will have an impact on the length of imprisonment can also cause anxiety in prisoners in line with the theory that anxiety in prison can also occur due to several causes, such as personality factors, severity of detention, and the type of crime committed. Prisoners imprisoned for violent crimes have a higher level of anxiety than prisoners incarcerated who commit crimes without violence (Indonesia et al., 2009). Another thing that causes the administration of logotherapy is not maximal is in terms of logotherapy that is given by yourself, paradoxical intention logotherapy actually has 4 sessions namely session 1; identifying client events and problems, session 2; identifying reactions and how to overcome problems, session 3; paradoxical techniques intention, session 4; meaning of life after using the paradoxical intention technique. While the researchers carried out in this case only session 1 and conducted for 2 meetings so that the results obtained are not optimal, namely there is still anxious prisoners' anxiety, the frequency is the same between before and after logotherapy even though there are prisoners who have decreased anxiety after logotherapy.(Indonesia et al., 2009) Another thing that makes this logotherapy less optimal in reducing anxiety prisoners is in terms of therapy, it can be seen that paradoxical intention logotherapy itself is logotherapy in the logotherapy group for specialists which can be interpreted that in the administration of this logotherapy must be those who master or have this ability as well. with the problem of implementation time which is certainly Table 4. Cross tabulation of prisoners' anxiety before and after a paradoxical intention logotherapy session 1 at the Penitentiary Class II A of the City of Kediri Anxiety pre and post logotheraphy intervention Anxiety post logotheraphy intervention Total mild moderate heavy panic Anxiety pre and post logotheraphy moderate Count 6 13 0 0 19 % of Total 7.7% 16.7% .0% .0% 24.4% heavy Count 0 8 18 0 26 % of Total .0% 10.3% 23.1% .0% 33.3% Panic Count 0 0 16 17 33 % of Total .0% .0% 20.5% 21.8% 42.3% Total Count 6 21 34 17 78 % of Total 7.7% 26.9% 43.6% 21.8% 100.0% Table 5. Results of output rank Effect of Logotherapy Paradoxical Intention Session 1 Against Anxiety Prisoners in Class II A Penitentiary in Kediri City Ranks N Mean Rank Sum of Ranks Anxiety pre and post Logotheraphy Negative Ranks 30a 15.50 465.00 Positive Ranks 0b .00 .00 Ties 48c Total 78 Table 6. Results of data output Effects of Paradoxical Intention Session 1 Logotherapy on Prisoners Anxiety in Class II A Penitentiary in Kediri City Test Statisticsb Anxiety pre and post logotheraphy Z -5.477a Asymp. Sig. (2-tailed) .000 a. Based on positive ranks. b. Wilcoxon Signed Ranks Test L. K. WARDANI ET AL. 456 | pISSN: 1858-3598  eISSN: 2502-5791 not enough with 2 meetings only prisoners anxiety can be directly reduced or not even become anxious, so for further researchers are expected to consider the time of research and therapy providers to obtain maximum results (Suhita et al., 2020). CONCLUSION Anxiety before doing logotherapy paradoxical intention session 1 found that most were in a state of panic as many as 33 respondents (42.3%). Anxiety after logotherapy paradoxical intention session 1 found that a small proportion experienced severe anxiety of 18 respondents (23.1%). After the Wilcoxon test was obtained p = 0.000 which means p value 0.003 <0.05, then H0 was rejected and H1 was accepted, which means that the influence before and after logotherapy paradoxical intention intensification session 1 action against anxiety in the institution of social security in class II A Kediri City . In the output rank obtained from a total of 78 data, there are 30 data with negative rank, there is no positive rank data, and there are 48 pairs of data values. For nursing education, it is expected that this research can be used as input or reference about anxiety of prisoners who get logotherapy paradoxical intention .Researcher is expected to be able to consider sessions in the implementation of paradoxical intensity logotherapy, the timing of administration of logotherapy, and the provider of logotherapy in order to obtain the expected results. Expected to increase the role of nurses in providing services to prisoners. Anxiety in inmates can be overcome with paradoxical therapy (Bastaman, 2008; Indonesia et al., 2009), However, this therapy requires special treatment by trained personnel, one of them is a nurse or physicologis. (Hankin, 2009)For the future, prisons can work together gradually and continuously to provide this therapy for prisoners in prison by fulfilling applicable requirements such as prisoners' conditions who can participate in therapy and they will serve as prison services in maintaining mental health for prisoners.(Towsend, 2009). REFERENCES Agoes, D. (2008). Psikologi Perkembangan. PT. ReflikaAditama. Asmadi. (2010). Teknik Prosedural Keperawatan Konsep dan Aplikasi Kebutuhan Dasar Klien. Salemba Medika. Bastaman, H. . (2008). LOGOTERAPI: Psikologi untuk Menemukan Makna Hidup dan Meraih Hidup Bermakna. Rajawali Pers. Effendi dkk. (2009). Keperawatan Kesehatan Komunitas: Teori Dan Praktek Keperawatan. Salemba Medika. Gail W. Stuart. 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