Benson Therapy in Gastritis Patients to Reduce Pain

ABSTRACT


INTRODUCTION
Gastritis is an inflammation of the gastric mucosa that is acute and chronic. Gastritis has signs such as feeling bloated, frequent burping, nausea and vomiting, anorexia, and heartburn (Rosiani et al., 2020) Gastritis is also a disease that we often encounter in society. However, people often underestimate gastritis, even though if the inflammation gets bigger and worse, the mucosal layer will appear puffy, red and bleed easily (Suprapto, 2020).
Based on a review conducted by the World Health Organization (WHO) 2011 gastritis cases reached 1.8-2.1 million based on the total population each year. In some countries that use percentages, namely, the UK 22%, China 31%, Japan 14.5%, Canada 35%, and France 29.5%. The occurrence of gastritis in Southeast Asia is approximately 583,635 based on the total population each year (Baiturrahim et al., 2016). Meanwhile, according to the Ministry of Health (2015) gastritis in Indonesia, to be precise the West Java region, reached 31.2% (Barkah et al., 2021). According to Zhaoshen L (2010) in Indonesia gastritis has a relatively high prevalence, namely with a total of 274,396 cases out of 238,452,952 population (Baiturrahim et al., 2016). Irregular diet can cause gastritis. An irregular diet causes the stomach to be sensitive when stomach acid increases. Excessive HCL production can cause friction on the walls of the stomach and small intestine, resulting in pain called gastric ulcers (Schwartz, 1997). Gastritis is also usually characterized by damage to the stomach and 12-finger intestine due to the use of non-steroidal anti-inflammatory drugs that cause disturbances in the physicochemical defense of the gastric mucosa (Furst & Munster, 2002). These drugs can impair prostaglandin synthesis as an intermediary in inflammation and lead to reduced inflammatory indication. The inhibition of prostaglandin synthesis will reduce mucosal resistance with effects in the form of minor or severe injuries that can cause pain (Amrulloh & Utami, 2016).
Based on the results of the assessment, it was found that the client felt pain in the left abdomen and radiated to the back on a scale of 5 (0-10). Pain is felt during activity and pain decreases during rest. Pain is felt in the solar plexus or epigastrium (Utami & Kartika, 2018). Pain is an unpleasant feeling and is only felt by oneself and cannot be felt by others (Astutiningrum, 2019). Pain is a sensory and emotional experience in the form of abnormal sensations than usual due to damage to a tissue. Pain measurement according to NRS (Numeric Rating Scala) can be distinguished by no pain (0), mild pain using a scale (1-3), moderate pain using a scale (4-6) & severe pain using a scale (7-10) (Benson, 2021).
Benson relaxation is a religious therapy that involves religious beliefs. patients to further increase their spirituality and get closer to God as a result, a good relaxation technique is done in dealing with the problem of discomfort, namely using the Benson Relaxation Technique (Novitasari   , 2014). This technique can also provide relaxation so that clients feel relaxed and their pain is reduced. The way that is done is by uniting relaxation with the religion that is adhered to, where this technique focuses on certain sentences that are said a certain number of times in a regular manner accompanied by a feeling of surrender to what happens to God Almighty while doing a deep breath (Green & Setyowati, 2005).

METHOD
This research is a descriptive case study design with a nursing care approach where this research is carried out by collecting data starting from assessment, formulating diagnoses, planning, implementing actions and evaluating with the focus of Benson Relaxation interventions with acute pain problems.
In this case study the population taken is one subject. The selection of participants in this case study was the client Mrs. S, 68 years old, female, complaining of pain. The location and time of the research was conducted in the Dahlia Room BLUD RSU Kota Banjar which was held for 4 days, on May 27-30, 2022. For data collection, researchers used direct interview techniques, observation, physical examination and documentation.

RESULTS AND DISCUSSION
Data collection was carried out on May 27, 2022 at 09.00 WIB in the Dahlia Room BLUD RSU Kota Banjar, the patient was Mrs.S aged 68 years old address Sumanding Wetan Village, Mekarsari, Banjar City with complaints of pain, the patient said she had a history of Hypertension, Diabetus Melitus with the person in charge Mrs.A..
The results of the physical examination, namely vital signs, there is a breathing frequency of 18x / min, blood pressure 150/70 mmHg, temperature 36.4 oC, pulse frequency 85x / min. The therapy given is that the patient is attached to a lactated Ringer infusion.
From the results of the assessment, the nursing problem that arises is acute pain associated with irritation of the gastric mucosa (PPNI, 2017).
After finding nursing problems that arise researchers apply nursing interventions that can be done in acute pain. Providing nursing care to Mrs.S with gastritis at Banjar City Hospital was carried out from 27th to 30th May 2022. In theory nursing care in Mrs.S is carried out by direct assessment, setting diagnoses, planning action, implementation, and evaluating (Sari, 2014).
The results of the assessment carried out on Mrs. S the author did not experience obstacles where the client, the family could cooperate well. Although the client is in pain but the client can be cooperative in the implementation of the nursing process. From the results of the assessment on Mrs.S with gastritis disorders the author found subjective and objective data.
Based on the results of the assessment. The client said that when the gastritis recurred, the client complained of pain in the left abdomen and radiated to the back of the pain like twisting with a scale of 5 (0-10) according to the Numeric rating scale accompanied by nausea. Pain is felt during activity and pain decreases when resting, besides that the client says nausea is felt when eating late.
After conducting an assessment to Mrs.S based on the results of data analysis, not all nursing diagnoses appear based on theory.
The gap in nursing diagnoses can be seen through the comparison between diagnoses that appear based on the theory and diagnoses that appear based on nursing care.
Diagnoses that may appear based on the theory: a) Acute pain associated with biological injury agents characterized by irritation of the gastric mucosa.
To overcome these problems, researchers plan appropriate actions on the problems found, namely: Benson relaxation technique to reduce pain.
Evaluation results are the final stage of the nursing process. In the case of Mrs.S with gastritis, one problematic diagnosis was obtained, namely: acute pain associated with biological injury agents characterized by irritation of the gastric mucosa. Basically, this care has been resolved after providing intervention. The client said he always did Benson relaxation to reduce pain.
Benson's relaxation technique has proven effective in reducing pain. Evidenced in Mrs. S who routinely does Benson Relaxation after 3 days of reduced pain. Benson relaxation is a relaxation that reduces pain by diverting attention so that the pain decreases, the relaxation used is to unite relaxation and beliefs that are adhered to by the client (Astutiningrum & Fitriyah, 2019).

CONCLUSIONS AND RECOMMENDATIONS
The results of the research that has been done can be concluded that the benson relaxation technique on acute pain is felt to decrease every day with a difference of 1 point with this stating that the technique is very effective to be given. Benson relaxation therapy intervention