260 JNK JURNAL NERS DAN KEBIDANAN (JOURNAL OF NERS AND MIDWIFERY) http://jnk.phb.ac.id/index.php/jnk Spiritual Emotional Freedom Technique (SEFT) as an Effort to Improve Mood Swing Premenstruation Syndrome Indah Lestari Faculty of Nursing, University of Bina Sehat PPNI Mojokerto, Indonesia Article Information Abstract Towards or during the menstrual cycle there are changes in the balance of various hormones such as endorphins, serotonin, and other hormones that determine mood. Mood swings, commonly known as premenstrual syndrome, fluctuate involving alternating feelings of happiness, sadness, anger, and depression, which are often known as Mood Swings. This condition can be minimized with non-pharmacological therapy, one of which is SEFT (Spiritual Emotional Freedom Technique). The purpose of this study was to prove the effect of SEFT (Spiritual Emotional Freedom Technique) therapy in improving the mood of Premenstrual Swing Syndrome at Darussalam Islamic Boarding School. The design of the study was a pre-experimental one-group pretest-posttest approach. The population was all female students who experienced premenstrual syndrome Mood Swings at Darussalam Islamic Boarding School with a total of 232 respondents. A sample of 186 respondents, was selected by random sampling technique. The instruments in the study were standard SEFT therapy procedures and the FDMS (Four Dimension Mood Scale). History Article: Received, 22/05/2023 Accepted, 17/07/2023 Published, 30/08/2023 Keywords: mood swings, syndrom pre-mesntruasi, seft © 2023 Journal of Ners and Midwifery Correspondence Address: University of Bina Sehat PPNI Mojokerto – East Java, Indonesia P-ISSN : 2355-052X Email : ns.indah@yahoo.com E-ISSN : 2548-3811 DOI: This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/) http://jnk.phb.ac.id/index.php/jnk mailto:ns.indah@yahoo.com Lestari, Spiritual Emotional Freedom Technique (SEFT) as an Effort to Improve Mood … 261 INTRODUCTION Premenstrual syndrome is a collection of unpleasant symptoms, both physical and psychological, experienced by women before their menstrual period. One of the symptoms that appear is mood disorders, which can be in the form of feelings of depression, irritability, emotional lability, crying quickly, anxiety, confusion, wanting to be alone, decreased concentration, insomnia, increased desire to rest, and changes in sexual desire. This condition is known as mood swings. Prevalence of Premenstrual syndrome in Indonesia, obtained as many as 40% of Indonesia is found to be 40% of women, and as many as 2-10% experience severe symptoms. The results of Fidora & Yuliani's research (2020) experienced moderate premenstrual syndrome (94.3%), and (3.7%) experienced severe premenstrual syndrome (Ifazatul Nurlatifah, 2016). Pradana (2018) in Tumapel village of 62 young women who experienced mild premenstrual syndrome 4.8%, moderate 61.3%, and severe 33.9%. The results of interviews with 6 students at Islamic boarding schools complain that they often feel irritable, depressed, anxious, and depressed, headaches, tight breasts, and back pain. The hormone Estrogen is associated with mood swings. Changes in estrogen levels before menstruation will affect the work of serotonin, which is a chemical compound in the brain that is responsible for regulating moods and emotions. Mood changes can hinder daily activities, and interfere with learning concentration, and the social environment. Women who are experiencing menstruation are often less able to regulate their emotions. Spiritual Emotional Freedom Technique (SEFT) is a complementary therapy in the Mind- Body Therapy category, providing interventions with various techniques to facilitate thinking capacities that affect physical, psychological, and bodily functions (Puspita et al., 2018a). Using the index finger and middle finger tap lightly on some of the body's meridian points. In addition, by involving God in the process of psychological energy. The benefits of Spiritual Emotional Freedom Technique therapy can overcome various problems of emotional disturbances such as phobias, trauma, depression, anxiety, stress, difficulty sleeping, irritability, and nervousness. With the Spiritual Emotional Freedom Technique (SEFT), emotional and physical problems experienced by a person will be easily overcome. This is because the Spiritual Emotional Freedom Technique (SEFT) places more emphasis on elements of spirituality (prayer) and the body's energy system using the tapping method. at certain points on the body. In addition to the body's energy system, there are also relaxation methods involving the patient's belief factor which is believed to reduce the complaints that are felt (Puspita et al., 2018b). Based on the above studies, researchers are interested in proving the effectiveness of SEFT in improving mood swings premenstrual syndrome resulted in a p-value = 0.001, which means that SEFT therapy is proven to improve mood swings syndrome. Giving SEFT therapy can have a relaxing effect thereby reducing mood swings during pre-menstruation METHODS This study used pre-experimental design research, one group pretest-posttest approach. In this study, the population was all female students who experienced premenstrual mood swings at Darussalam Islamic Boarding School, a total of 232 students, with a sample of 186 people, taken by simple random sampling. The independent variable was the spiritual emotional freedom technique (SEFT), and the dependent variable was premenstrual mood swings syndrome. SEFT used a standard procedure by applying 3 techniques, namely The Set-Up, The tune-In, and Tapping, while mood swings used the FDMS (Four Dimension Mood Scale) questionnaire sheet which consists of 4 dimensions: Positive energy, tiredness, negative activation, and relaxation. Analysis using the Wilcoxon sign rank test. RESULTS The results showed that the characteristics of the respondents were mostly 13-15 years old, junior high and normal menstrual cycles, as shown in table 1 below. 262 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 260-264 Table 1: Frequency Distribution of Respondent characteristics based on Age, Education and menstrual cycles on female students at Darussalam Islamic Boarding School No Characteristics Responden Frequency Percentage 1 Age 13-15 years 123 66.1 16-19 years 63 33.9 Total 186 100% 2 Education Levels Junior High School 128 66.9 Senior High School 58 33.1 Total 186 100% 3 Menstrual cycle 28 days 95 51 <28 days 86 46.2 >28 days 5 3.8 Total 186 100% Source: Primary Data Table 2 below shows a significant difference in premenstrual syndrome mood swings after being given SEFT therapy. Based on the analysis results, with p-value = 0.001, it can be concluded that SEFT can improve premenstrual syndrome mood swings. Table 2: Differences in mood swings of respondents before and after being given SEFT No Mood Swings Level Pre test Post Test f % F % 1 Very good 0 0 81 43.5 2 Good 0 0 96 51.6 3 Fairly good 26 13.9 5 2.7 4 Less good 145 77.9 3 1.6 5 Not good/bad 15 8.2 1 0.6 Total 186 100% 186 100% p-value = 0,001 DISCUSSION Mood swings often appear before menstruation. This is natural, but it can also interfere with social aspects. Adolescence also contributes, hence the need for diversion and control in a positive way. SEFT (Spiritual Emotional Freedom Technique) is a technique that uses psychology and spiritual knowledge with prayer in overcoming one's negative emotions. This therapy deals directly with the disruption of the energy system in eliminating negative emotions by re-integrating energy into one's body (Ainsworth et al., 2022). SEFT is a mixing technique of body energy and spiritual healing using tapping on energy points in the body. This therapy can work like an acupuncture technique that seeks to stimulate energy points in the body's energy pathways. The difference with acupuncture is that it uses spiritual therapy which is very safe, easy, fast, and simple because it only uses tapping (Khalidatul Khair Anwar et al., n.d., 2019). Zuyina (2019), SEFT therapy can generate vital hippocampal (memory center) impulses to coordinate all things absorbed by the senses) to produce Gaba (gama amino batyric acid) which controls emotional response and inhibits acetylcholine, serotonin and neurotransmitters that produce cortisol secretion, resulting in homeostasis (balance) and repair the disrupted neurotransmitter system, and bring up optimism and positive thoughts. The mechanism of the Spiritual Emotional Freedom Technique (SEFT) in influencing psychological responses by stimulating the body's meridian points. The Spiritual Emotional Freedom Technique (SEFT) uses the fingertips to do light tapping (tapping) on the body's meridian Lestari, Spiritual Emotional Freedom Technique (SEFT) as an Effort to Improve Mood … 263 points. Tapping (tapping) on the meridian points will send kinetic energy to the energy system and release obstacles that block the flow of energy. So that it brings relaxation and pain will decrease, later the mood will improve. The tapping points in SEFT therapy are points that represent organs in the body, so that when tapping there will be an increase in the process of traveling neurotransmitter signals which downregulates the Hypothalamic-Pitutiary- Adrenal Axis (HPA axis) thereby reducing the production of stress hormones. namely cortisol (Alawy et al., 2022). Rodrigues (2012) explained that pressure on the body's meridian points will stimulate the body to release endorphins and monoamines, two compounds that function to control feelings. pain and induce relaxation. Emphasis on the body's meridian points aims to stimulate the body's organs that are sick or experiencing disorders. In the hands, some nerves become points of relaxation. The relaxed point on the hand will transmit a kind of shock wave heading to the current brain. These waves will be received by the brain and forwarded to the affected organ. When the meridian points are pressed, the waves that propagate will destroy the blockage so that the blood flow returns smoothly. If the energy in the meridians runs smoothly, it means that the body is in a comfortable condition (Zakiyyah, n.d.). In addition, SEFT therapy involves God in this psychological energy process, making SEFT experience an amplifying effect so that the spectrum of problems that can be overcome is much wider, including physical, psychological, emotional, self-success, heart happiness and pave the way to personal greatness. This is because SEFT places more emphasis on the elements of spirituality (prayer) and the body's energy system by using the tapping method at certain points on the body. In addition to the body's energy system, there are also relaxation methods involving the patient's belief factors that can reduce pain and improve mood (sastra, 2016). SEFT can perceive the source of the client's stress and respond with coping stress. When a positive stress response can be managed properly, the body's response to stress will be more positive (Zaka & Mahmood, n.d.). From the results of the study, researchers can say that the SEFT therapy can be used as a sustainable alternative. besides being cheap, it has no impact, because it is more inclined to the spiritual aspect, it is also safe to apply to anyone. when our thoughts are positive, good energy will flow, which will improve mood. CONCLUSION Mood swings are a normal condition for women before menstruation, but they can also be very annoying. It takes effort to be able to improve one's mood. The results showed that SEFT therapy can improve mood swings premenstrual syndrome. Looking at the p-value results, in general SEFT therapy can be applied to women with mood swings. The results will be better if we can be more focused and full of confidence. SUGGESTION SEFT can be used as a complementary therapy in treating mood swings that often occur in pre- menstrual syndrome. ACKNOWLEDGEMENT The researchers would like to thank Darussalam Islamic Boarding School for the support to this study. Thanks to the research respondents, for their positive contributions. To the chairman of LPPM for supporting researchers. FUNDING This research was carried out thanks to the role of LPPM in supporting lecturers' research performance. CONFLICTS OF INTEREST The author declares that there are no conflicts of interest with the topic or any associated objects upon the publication of this study. 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