PENERAPAN MODEL SAFEWARDS MELALUI INTERVENSI CALM DOWN METHODS DALAM MENGONTROL TANDA DAN GEJALA PASIEN HALUSINASI PENDENGARAN: STUDI KASUS

Enjelina Kaghiade. R014242152. IMPLEMENTATION OF THE SAFEWARDS MODEL THROUGH CALM DOWN METHODS TO CONTROL SIGNS AND SYMPTOMS OF AUDITORY HALLUCINATIONS: A CASE STUDY, supervised by Hastuti ABSTRACT Background: Auditory hallucinations are among the most common positive symptoms experienced by patients with schizophrenia and are associated with psychological distress, impairment in daily functioning, and an increased risk of conflict in psychiatric care settings. Nurses play a strategic role in managing these symptoms through recovery-oriented, non�pharmacological interventions aimed at creating a therapeutic environment. The Safewards model was developed to reduce conflict and coercive practices in psychiatric wards, with calm down methods as one of its core interventions. However, empirical evidence specifically examining the effectiveness of calm down methods in controlling auditory hallucinations remains limited, particularly in low- and middle-income country contexts. Objective: This study aimed to explore the application of the Safewards model through calm down methods in controlling the signs and symptoms of auditory hallucinations in patients with schizophrenia. Methods: This study employed a descriptive case study design involving a 44-year-old male patient diagnosed with schizophrenia who experienced persistent auditory hallucinations and was admitted to a psychiatric care unit. The nursing intervention began with General Nursing Therapy (GNT) for hallucinations and was followed by the implementation of Safewards-based calm down methods over six days. The severity of hallucinations was evaluated using the Auditory Vocal Hallucination Rating Scale (AVHRS) through pre-test and post-test measurements, supported by clinical observations based on the indicators of the Indonesian Nursing Diagnosis Standards (SDKI). Results: Following the implementation of calm down methods, the patient demonstrated reductions in the frequency and duration of voices, decreased intensity and levels of emotional distress, and improvements in anxiety and interference with daily functioning. AVHRS scores showed a reduction in the severity of auditory hallucinations across nearly all dimensions, accompanied by enhanced self-control and increased patient participation in environmental interactions. Conclusion: The application of the Safewards model through calm down methods contributes positively to controlling the psychological and functional impacts of auditory hallucinations in patients with schizophrenia. This intervention has the potential to serve as a practical and applicable non-pharmacological nursing strategy to support symptom management and foster a safe and therapeutic psychiatric care environment. Further studies with larger sample sizes and more rigorous designs are recommended to strengthen the empirical evidence.