The Effect of Slow Deep Breathing Combined with Classical Music on Anxiety in Elderly Patients with Diabetes Mellitus: A Gerontological Nursing Case Study
DOI:
https://doi.org/10.71341/bmwj.v3i1.54Keywords:
Diabetes mellitus, Anxiety, Slow deep breathing, Classical music, Gerontological nursingAbstract
Background: Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. Global prevalence is rising, with an estimated 589 million cases in 2024 and a projected 853 million by 2050. Beyond physical health, DM often leads to psychological complications. Anxiety is 20% more prevalent in diabetic patients than in the general population, often resulting in poor glycemic control and a cycle of metabolic decline.
Objectives: This study aims to analyze the effectiveness of combining slow deep breathing therapy with classical music as a non-pharmacological nursing intervention to manage anxiety in elderly patients with DM at Puskesmas Tabanan I.
Method: A descriptive case study design was used, following the five-stage nursing process: assessment, diagnosis, planning, implementation, and evaluation. Three patients (aged 65–79 years) with a nursing diagnosis of Anxiety (SDKI D.0080) participated from December 5–7, 2025. The intervention consisted of a 60-minute session held once daily for three days. Anxiety levels were measured using the Indonesian Nursing Outcome Standard (SLKI L.09093).
Results: After three sessions, all patients showed significant reductions in anxiety. Subjective findings included decreased worry and improved relaxation. Objective indicators showed reduced restlessness, less muscle tension, and the normalization of respiratory and heart rates. Additionally, patients reported higher confidence in managing their symptoms.
Conclusion: Combining slow deep breathing with classical music is an effective, safe, and feasible non-pharmacological intervention for reducing anxiety in elderly diabetic patients. This approach is recommended as a complementary therapy in routine gerontological nursing care.
References
Anggraini, Y. (2021). Upaya Penurunan Gula Darah Dengan Menggunakan Slow Deep Breathing Exercise Pada Pasien Diabetes Mellitus Tipe Ii Di Rsu Uki Jakarta Timur. Jurnal Keperawatan Dirgahayu (JKD), 3(1), 10-17.
Dolang, M. W., Sebe, R. S., & Sillehu, S. (2022). Terapi Musik Klasik Menurunkan Kecemasan Ibu Menjelang Persalinan di Wilayah Kerja Puskesmas Galela Kabupaten Halmahera Utara. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 13(1), 162-165.
Atlas, D. (2015). International diabetes federation. IDF Diabetes Atlas, 7th edn. Brussels, Belgium: International Diabetes Federation, 33(2), 3-6.
Khadlonah, U. (2023). Perbedaan slow deep breathing dan terapi dzikir terhadap kecemasan pada usia dewasa penderita diabetes melitus type II di RS Permata Medika Semarang. [Unpublished manuscript].
Manalu, M., Anggeria, E., Ardila Devi, & Hutabarat, R. (2024). The effectiveness of slow deep breathing in DM patients who experience anxiety. Futurity Medicine, 34–44. https://doi.org/10.57125/FEM.2024.09.30.04
Nusantoro, A., & Listyaningsih Kartika. (2019). Pengaruh SDB (slow deep breathing) terhadap tingkat kecemasan dan kadar glukosa darah pada penderita diabetes melitus. [Unpublished manuscript].
Octiara Lestari, R., & Zul, M. (2025). Penerapan teknik slow deep breathing exercise terhadap penurunan tingkat kecemasan pada pasien diabetes mellitus di Ruangan Kenanga RSUD Arifin Achmad Pekanbaru. Medic Nutricia, 18. https://doi.org/10.5455/MNJ.V1I2.644
Yuliana, A. R., Cahyanti, L., Fitriana, V., & Febrimilajianti, A. (2023). Pengaruh Terapi Musik Klasik Dalam Penurunan Tingkat Stres Pada Siswa: Studi Literatur. Jurnal Profesi Keperawatan, 10(2), 180-188.
Riskesdas. (2018). Hasil utama Riskesdas 2018. Jakarta: Kementerian Kesehatan RI.
Sumantrie, P., & Jumianus. (2022). Terapi musik untuk mengatasi stres dalam asuhan keperawatan dengan gangguan endokrin: Diabetes melitus tipe 2 di Rumah Sakit Advent Medan. [Unpublished manuscript].
Sunaringsih, S., & Wardojo, I. (2024). Kenali diabetes mellitus type II. Penerbit Litnus.
Tim Pokja SDKI DPP PPNI. (2017). Standar diagnosis keperawatan Indonesia: Definisi dan indikator diagnostik. Jakarta: Dewan Pengurus PPNI.
Tim Pokja SIKI DPP PPNI. (2018). Standar intervensi keperawatan Indonesia (SIKI). Jakarta: Persatuan Perawat Indonesia.
Tim Pokja SLKI DPP PPNI. (2019). Standar luaran keperawatan Indonesia. Jakarta: Persatuan Perawat Indonesia.
Ummami, E. A., & Nasution, R. A. (2025). Penerapan kombinasi terapi relaksasi autogenik dan terapi musik klasik dalam menurunkan kecemasan. Journal of Vocational Nursing (JuVokes). https://journal.bengkuluinstitute.com/index.php/juvokes
Warsono, W., & Yanto, A. (2020). Effectiveness of slow deep breathing exercise on decreasing stress levels for patients with diabetes mellitus. South East Asia Nursing Research, 2(2), 55. https://doi.org/10.26714/SEANR.2.2.2020.10-14
Yuliputra. (2022). Hubungan kecemasan dengan kadar glukosa pasien diabetes melitus di Poli Rawat Jalan RSI Sultan Agung Semarang. [Unpublished manuscript].
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