The Effect of Origami-based Intervention Therapy on Hallucination Control Among patients with Schizophrenia
Keywords:
Origami-based intervention , Hallucinations, Hallucination control, Schizophrenia , Psychiatric nursingAbstract
Hallucinations are among the most distressing symptoms in schizophrenia, affecting 60–80% of patients and often persisting despite pharmacotherapy. Origami play therapy, a structured fine-motor activity, may improve hallucination control through attention diversion and sensory grounding. This study aimed to determine the effect of origami play therapy on hallucination control ability in patients with schizophrenia. A quasi-experimental one-group pre-post test design was used. The study was conducted at Madani General Hospital, Central Sulawesi, from August to September 2025. Twenty-five inpatients with active hallucinations were selected using purposive sampling. Participants received six 30-minute origami therapy sessions over 14 days. Hallucination control was measured using the Hallucination Control Scale (HCS) before and after the intervention. Data were analyzed using the Wilcoxon signed-rank test. The mean hallucination control score increased significantly from 12.4 (SD = 0.71) pre-intervention to 19.2 (SD = 1.38) post-intervention. The median score improved from 12 to 20. The Wilcoxon test revealed a significant improvement (Z = -2.10, p = 0.036). Origami play therapy was associated with significant improvement in hallucination control. However, due to the one-group design without a control group, causality cannot be established. Randomized controlled trials are needed to confirm efficacy before clinical implementation.
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Agustina, C. F., Esty, F., & Ati, A. (2025). Community Health Empowerment For Early-Detecting And Reintegrating Of Schizophrenia In Indonesia. IJNPPY, 28(Supplement 2). https://academic.oup.com/ijnp/article/28/Supplement_2/ii177/8236753
Alfianti, A. L., & Pratiwi, A. (2025). Dampak terapi handicraft ‘meronce’ terhadap penurunan frekuensi halusinasi pendengaran. Holistik Jurnal Kesehatan, 19(1), 8–14. https://doi.org/10.33024/hjk.v19i1.771
Antriska, Breitborde V. M. (2024). Application of General Nursing Intervention Drawing Activities Towards Schizophrenia Patient with Hallucination. JOURNAL EDUCATIONAL OF NURSING(JEN), 7(1), 40–44. https://doi.org/10.37430/jen.v7i1.185
Aulia, N., Raharjo, B. B., & Widowati, E. (2025). Evaluation of Mental Health Services: Family Experiences, Stigmatization, Health Cadres Schizophrenia in Semarang City. Public Health Perspectives Journal, 9(2). http://journal.unnes.ac.id/sju/index.php/phpj
Breitborde, N. (2026). The Global Burden of Schizophrenia: Findings from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study. Schizophrenia Bulletin Open, 7(1). https://doi.org/10.1093/schizbullopen/sgag012
Charlson, F. J., Ferrari, A. J., Santomauro, D. F., Diminic, S., Stockings, E., Scott, J. G., McGrath, J. J., & Whiteford, H. A. (2018). Global epidemiology and burden of schizophrenia: Findings from the global burden of disease study 2016. Schizophrenia Bulletin, 44(6), 1195–1203. https://doi.org/10.1093/schbul/sby058
Ciufalo, J., Zaccone, S., Fatiga, G., & Caputo, G. B. (2024). Creative puppet therapy reduces hallucinations in patients diagnosed with schizophrenia: Preliminary findings. Psychiatry Research, 342. https://doi.org/10.1016/j.psychres.2024.116211
Diatmika, I. D. P. O., Yusran, S., & Sudayasa, I. P. (2025). Analysis of factors influencing the incidence of schizophrenia in the inpatient room of mental Hospitals in Southeast Sulawesi Province in 2025. World Journal of Advanced Research and Reviews, 28(3), 326–338. https://doi.org/10.30574/wjarr.2025.28.3.4018
Firdaus, R., Hernawaty, T., Suryani, S., & Banda, K. J. (2023). Implementation of hallucination strategies - A case study on adolescent with hearing hallucinations. The Journal of Palembang Nursing Studies, 2(3), 186–195. https://doi.org/10.55048/jpns89
He, H., Liu, Q., Li, N., Guo, L., Gao, F., Bai, L., Gao, F., & Lyu, J. (2020). Trends in the incidence and DALYs of schizophrenia at the global, regional and national levels: results from the Global Burden of Disease Study 2017. Epidemiology and Psychiatric Sciences, 29. https://doi.org/10.1017/S2045796019000891
Hendrawati, H., Amira, I., & Rosidin, U. (2025). Efektifitas Art Therapy Untuk Mengurangi Halusinasi Pada Pasien Skizoprenia. Malahayati Nursing Journal, 7(8), 3540–3556. https://doi.org/10.33024/mnj.v7i8.20580
Hikmat, R., Suryani, S., Yosep, I., Jeharsae, R., Widianti, E., Hidayati, N. O., Sutini, T., Hernawaty, T., Sriati, A., & Rafiyah, I. (2025). Community-based recovery interventions for improving mental health in schizophrenia patients: a scoping review in Southeast Asia. BMC Psychiatry, 25(1). https://doi.org/10.1186/s12888-025-06962-6
Ibrahim, M., & Samiaji, . (2021). The Effectiveness of Drawing Occupation Therapy on the Ability to Control Hallucinations in Schizophrenia: Literature Review. KnE Life Sciences, 635–641. https://doi.org/10.18502/kls.v6i1.8737
Lestari, R. (2017). Effect Of Socio-Art Working Group Therapy In Reducing The Symptoms Of Hallucinations In Community Health Center. Public Health of Indonesia Lestari R and Ahsan. Public Health of Indonesia, 3(3), 124–130. http://stikbar.org/ycabpublisher/index.php/PHI/index
Litasari, M., & Fitria, Y. (2023). Pemberian Terapi Okupasi : Menggambar untuk Mengontrol Halusinasi Pendengaran Pada Pasien Skizofrenia. Madago Nursing Journal, 4(2), 117–123. https://doi.org/10.33860/mnj.v4i2.2886
Luo, W., Gao, J., Guo, Z., Han, X., Song, J., Su, X., Da, X., & Liu, X. (2025). Trends and cross-country inequalities in schizophrenia from 1990 to 2021, with prediction to 2035: a systematic analysis of the global burden of disease study 2021. BMC Psychiatry, 25(1). https://doi.org/10.1186/s12888-025-07273-6
Erlando, R. P. A., Wuryaningsih, E. W., Kusumaningsih, A., & Hikmah, F. (2025). The effectiveness of drawing occupation therapy on auditory hallucinations among patients with schizophrenia. JOURNAL OF Mental Health Concerns, 4(4), 217–224. https://doi.org/10.56922/mhc.v4i4.1590
Saha, S., Chant, D., Welham, J., & McGrath, J. (2005). A systematic review of the prevalence of schizophrenia. In PLoS Medicine (Vol. 2, Number 5, pp. 0413–0433). https://doi.org/10.1371/journal.pmed.0020141
Saputra, F. (2016). Abandoned: Can It Be A New Diagnosis In Psychiatric Nursing In Indonesia? Belitung Nursing Journal, 2(3), 40–43. http://belitungraya.org/BRP/index.php/bnj/
Sayied, N., & Ahmed, Z. (2017). Efficacy of teaching self-management strategies on auditory hallucinations among schizophrenic patients. Egyptian Nursing Journal, 14(2), 168. https://doi.org/10.4103/enj.enj_25_17
Subagyo, R., Prasetya, E. C., Hamida, A., Rafida, M., Ramzi, M., Nugraha, M. T., Haniifah, U., & Anas, M. (2022). Paranoid Schizophrenia: Case Report. Journal of Islamic Medicine, 6(2), 113–118. https://doi.org/10.18860/jim.v6i2.17456
Sujiah, S., Warni, H., & Fikrinas, A. (2023). The effectiveness of application of drawing activity occupational therapy against auditory hallucination symptoms. Media Keperawatan Indonesia, 6(2), 83. https://doi.org/10.26714/mki.6.2.2023.83-91
Susanti, H., Brooks, H., Keliat, B. anna, Bradshaw, T., Wulandari, D., Fadilah, R., Diorarta, R., Suherman, Bee, P., Lovell, K., & Renwick, L. (2024). Stakeholder perspectives of family interventions for schizophrenia in Indonesia: a qualitative study. BMC Psychiatry, 24(1). https://doi.org/10.1186/s12888-024-05504-w
Wahyudi, D., Cahyati, P., Somantri, I., Riyana, A., & Keperawatan Poltekkes Tasikmalaya, J. (2023). Penerapan Terapi Zikir Untuk Mengurangi Frekuensi Halusinasi Pendengaran Pada Pasien Dengan Skizofrenia Di Wilayah Puskesmas Sindangkasih Kabupaten Ciamis. Jurnal Keperawatan Galuh, 5(2). https://jurnal.unigal.ac.id/index.php/JKG/37
Wardani, S., & Afrizal. (2021). Risk Factors Of Skizofrenia In The Puskesmas Selat Panjang, Meranti Islands District. Bina Generasi ; Jurnal Kesehatan, 13(1). https://ejurnal.biges.ac.id/index.php/kesehatan/
Yang, C. Y., Lee, T. H., Lo, S. C., & Beckstead, J. W. (2015). The effects of auditory hallucination symptom management programme for people with schizophrenia: A quasi-experimental design. Journal of Advanced Nursing, 71(12), 2886–2897. https://doi.org/10.1111/jan.12754
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