Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 The Effect Of Positive Affirmation Therapy And Ablution Therapy Before Bed On The Level Of Insomnia In The Elderly At PSTW Budi Luhur Febri Tri Andini.
Kintan Resqitha Ekaputri.
Rina Oktaria.
Riska Amalya Nasution.
Putri Irwanti Sari Nursing Study Program .
Faculty of Medicine and Helath Sciences.
Universitas jambi.
Jambi.
Indonesia Correspondence : febritrian058@gmail.
Received : 9 November 2025.
Revised : 15 December 2025.
Accepted : 16 December 2025
ABSTRACT
Insomnia is an inability to sleep complaints simultaneously increasing due to increasing The purpose of this research is to know the influence of positive affirmation and ablution therapy before going to bed in elderly at PSTW Budi Luhur.
Research design used in the study is pre experiment with the approach of one group pretest posttest.
Sampling techniques with non-probability sampling methods with purposive sampling retrieved 15 samples of respondents.
Method of data collection using the questionnaire KSPBJ Insomnia Rating Scale as for the analysis of data using t tests.
Based on statistical t test obtained p value = 0.
005 less than = 0.
05 ( p value= 0.
005 < = 0.
It indicates Ho is rejected and H1 accepted, it means that there was influence of positive affirmation and ablution therapy before going to bed in the level of insomnia in elderly of PSTW Warga Tama.
Inderalaya.
The results of this research suggest that the elderly can overcome insomnia by applying positive affirmations and ablution therapy before going to bed as a reference in the elderly health improvement efforts especially the elderly who experience insomnia.
Keywords : Positive affirmation, ablution therapy, insomnia, elderly INTRODUCTION Every human being will experience the aging process which is part of the growth and development process.
The aging process begins from infancy, childhood, adulthood, and finally old age .
The increasing number of elderly people causes the need for more attention to the elderly.
The elderly are more susceptible to various diseases because as they age, the function of the body's organs will experience a decline.
This decline in physical condition will also affect the mental condition of the elderly.
Mental problems in the elderly are usually caused by factors such as loneliness, dependency, and lack of self-confidence, which can cause the elderly to become depressed, anxious, and stressed.
This can trigger elderly people to experience sleep disorders .
Insomnia in the elderly, if not treated immediately, can have serious consequences, such as difficulty concentrating, daytime fatigue, poor interpersonal relationships, an increased risk of death, an increased risk of accidents due to excessive fatigue which can trigger various physical illnesses .
This sleep disorder (Insomni.
is also experienced by the elderly at the Budi Luhur Social Welfare Home.
Based on data collection conducted by researchers on December 20, 2023 at the Budi Luhur Social Welfare Home, data was obtained that there were 61 elderly residents and the majority were Muslim.
Based on the results of interviews with the researcher's home Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 staff, direct interviews with the elderly, and filling out the KSPBJ - IRS (Jakarta Biological Psychiatry Study Group - Insomnia Rating Scal.
questionnaire, the researchers found that out of 61 people, 30 elderly people experienced insomnia with various complaints such as frequently waking up at night, difficulty starting to sleep again and complaining of often waking up too early.
Furthermore, based on interviews with PSTW Budi Luhur officers, insomnia is managed solely through pharmacological approaches, such as medication.
This pharmacological approach is still considered ineffective, as some elderly individuals experiencing insomnia still complain of difficulty falling asleep and frequently waking up early.
In addition to being considered ineffective, pharmacological management must consider the effectiveness and side effects of medications, such as cognitive decline and falls due to impaired motor coordination, as well as excessive daytime sedation .
While taking sleeping pills is normal and acceptable, consuming them too frequently and excessively can have adverse health The risk of death from excessive use of sleeping pills has been reported to be as high as 30 percent .
Despite the potentially dangerous long-term effects of medication, nonpharmacological approaches can be very helpful without the side effects of medication and are equally or more effective, including positive affirmations and ablution therapy.
Affirmation techniques are part of cognitive behavioral therapy (Cognitive Behavioral Therap.
, which consists of a series of words arranged either in thoughts or written down, then said repeatedly .
Meanwhile, to overcome the psychological problem of insomnia, ablution therapy is necessary before bed.
Ablution therapy is one way to treat insomnia with psychological problems.
Ablution therapy is a therapy with a spiritual approach carried out by Muslims.
Based on the description of the problem above, the researcher will conduct a study entitled "The Effect of Positive Affirmations and Ablution Therapy Before Bed on Insomnia Levels in the Elderly at PSTW Budi Luhur JambiAy.
METHOD
This research method uses a quantitative approach, using a pre-experimental design with a one-group pretest-posttest approach.
This design uses one group as the treatment group .
The design format is as follows: Pre-experimental with a One-Group Pretest-Posttest Pre-test The general population in this study was all elderly people living at the Tresna Werda Budi Luhir Social Home in 2023, totaling 61 people.
The target population was 30 elderly people suffering from insomnia at the Tresna Werdha Budi Luhir Social Home in 2023.
The sample size for this study was 15 people, plus a 10% dropout rate, resulting in a total of 17 people.
There were no dropouts, so the sample size remained 15.
Result Age Tabel 1.
Frequency Distribution of Respondents Based on Age of Elderly People with Insomnia at PSTW Budi Luhur Jambi Age Frequency Percentage Total Based on the data in Table 1 above, it shows that in this study the majority of respondents who suffer from insomnia are 60-74 years old with a percentage of 86.
Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 Gender Tabel 2.
Distribution of Respondent Frequency Based on Gender of Insomnia Elderly at PSTW Budi Luhur Jambi Gender Frequency Persentage Male Female Total Based on the data in Table 2 above, it shows that in this study the majority of respondents who suffer from insomnia are male with a percentage of 53.
Analyzes Univariat Table 3.
Distribution of Frequency of Insomnia Levels in the Elderly Before and After Positive Affirmation and Ablution Therapy Before Bed at PSTW Budi Luhur
Jambi
Variable Category Moderate Insomnia
Severe Insomnia
Insomnia
Levels 9 Ae 13
Insomnia
14 Ae 18
>19
Totalot Mild Based on Table 3, the results of the frequency distribution analysis based on the level of insomnia in the elderly before being given positive affirmation and ablution therapy before going to bed at PSTW Tama Indralaya Ogan Ilir residents, it was found that the majority of the elderly had a mild category insomnia rate of 53.
3% while at the time of the posttest the majority of the elderly were in the non-insomnia category of 46.
Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 Analyzes Bivariat Table 4 Differences in Insomnia Levels Before and After Positive Affirmation and Ablution Therapy Before Sleep in the elderly at PSTW Budi Luhur Jambi Insomnia Levels Intervention Mean .
Before intervention 09 .
After intervention 07 .
Selisih .
95% CI
P value 0,005 Based on the data in Table 4, it can be seen that the level of insomnia in the elderly before being given positive affirmation and ablution therapy before bed was on average 14.
09, which is a moderate level, and after being given positive affirmation and ablution therapy before bedtime was at an average of 10.
07, which was the level of mild insomnia.
The results of the paired sample t test differed in the average value of insomnia levels in the elderly at PSTW Budi Luhur pre test and post test after being given positive affirmation and ablution therapy before obtaining a difference value of 93 which had a positive value, and had a p value = 0.
value < , =0.
The results of this analysis showed that there was a significant difference in the level of insomnia between before and after positive affirmation and ablution therapy before The 95% Cl value in this study was 2.
81 Ae 5.
05 which showed that positive affirmation and ablution therapy before bed were 2.
05 times on changes in the level of insomnia in the elderly at PSTW Budi Luhur
DISCUSSION
Insomnia Levels Before Positive Affirmation and Ablution Therapy Before Bed The measurement of insomnia values in this study was carried out 2 times, before and after positive affirmation and ablution therapy before bed in 15 Based on the results of the study before positive affirmation and ablution therapy before bed, 8 respondents with mild insomnia levels were obtained.
The elderly who experience mild insomnia are caused by several factors, one of which is the aging process.
The aging process is a natural process, characterized by a decrease or change in psychological, physical and social interactions with Megasari said that the influence of the aging process causes various problems on the physical.
In general, if a person has entered old age, his physical condition will decrease.
The elderly will be more susceptible to various diseases because as they get older, they will experience a decrease in organ function.
addition to these impacts, the elderly at PSTW Budi Luhur also experience a lack of confidence, causing the elderly to be easily angry and difficult to control negative Furthermore, the elderly who experienced moderate levels of insomnia were 5 The elderly complain of difficulty when starting to sleep and waking up at This causes the elderly to be unrefreshed and lethargic in carrying out activities in the morning.
Insomnia can affect concentration or memory and can also affect a person's ability to perform daily tasks.
The elderly who experience severe insomnia are 2 people.
The elderly said that it is difficult to get into sleep and it is Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 difficult to maintain sleep conditions .
ften waking up while sleepin.
, often waking up at night and difficult to go back to sleep, even though they can go back to sleep having to wait for a few minutes or hours, wake up too early and the body still feels unrefreshed even though it has slept, so it is sleepy during the day.
This condition is also caused because the elderly have a history of acute and chronic diseases such as hypertension and joint pain.
According to ,insomnia in the elderly can also occur due to medical conditions.
The improvement of certain medical conditions in the elderly can affect sleep quality, which includes acute and chronic diseases.
stated that a person who experiences joint pain and hypertension at night can cause insomnia.
Waking up earlier than usual unexpectedly is the most common symptom of depressive anxiety, and other psychological disorders are often the cause of sleep disorders.
Insomnia Levels After Positive Affirmation and Ablution Therapy Before Bed Based on the results of the study, after positive affirmation and ablution therapy before bed were carried out for 15 respondents, all respondents experienced a decrease in insomnia levels.
Respondents with the non-insomnia category amounted to 7 people, the level of mild insomnia amounted to 6 people, and the level of moderate insomnia amounted to 2 people.
As for the level of severe insomnia, there is none.
This shows the decrease in the level of insomnia in the elderly at PSTW Tama Indralaya Residents after ablution therapy and positive affirmations before bed.
After doing positive affirmations and ablution therapy before going to bed, the elderly said they felt more comfortable and calm so that it was easier to get into a sleep condition.
According to .
on the limbs affected by ablution, there are many acupuncture points that are receptors for stimuli, so that every time we perform ablution, it means that we are stimulating .
the acupuncture points that will have a positive effect on our body.
said that positive affirmations affect the body's energy.
People who think positively are more carefree and excited, this is the result of a positive program in the subconscious mind.
addition, the elderly also said that the anxiety felt was reduced, so that the elderly did not often experience nightmares and woke up at night.
Positive affirmations affect emotions.
If you start the day with positive words, one will be calmer and more One of the procedures for ablution therapy is to wash your hands.
According to .
, the gentle flow of water with cold temperatures provides a fresh and soothing taste.
By performing ablution, in addition to doing physical relaxation we also do spiritual relaxation.
Elderly people who experience insomnia with complications of chronic diseases such as joint pain and hypertension also experience a decrease in insomnia levels after being given positive affirmations and ablution therapy before bed.
A person who affirms continuously has stronger Muscles will become more active and strong when filled with positive words .
In particular, the purpose of affirmation exercises can also be to increase confidence, motivation, self-esteem, control negative feelings such as frustration, anger or impatience.
Regarding using water as ablution therapy, it is useful to form homeostasis which will subsequently produce therapies that have multiple indications, such as to treat migraines, swelling and stiff fingers .
In addition, rubbing the ears as therapy can also reduce emotions.
Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 Differences in Insomnia Levels in the Elderly Before and After Positive Affirmation and Ablution Therapy Before Bed In this study, the level of insomnia in respondents before and after being given positive affirmation and ablution therapy before bed changed.
The level of insomnia during the pretest showed that the respondents who had a level of mild insomnia were 8 people and the posttest was 6 people.
The level of insomnia was moderate at the pretest of 5 people and 2 people of posttest.
After positive affirmation and ablution therapy before bed, the elderly who did not experience insomnia became 7 people and the elderly who experienced severe insomnia no longer existed.
The results showed that positive affirmation and ablution therapy before bed were one of the effective therapies for reducing insomnia rates in the elderly.
These results are in line with the results of research .
stating that positive affirmation and ablution therapy to reduce psychological stress so that it can affect the quality of sleep of the elderly and have an impact on the level of insomnia in the elderly.
the research conducted by .
, both used a pre-experimental design with a one group pretest posttest approach.
The first step in positive affirmation is to identify the stimulus that causes insomnia in the elderly, then the elderly learn self talk to neutralize negative statements that cause difficulty sleeping and teach selfreinforcing to the elderly after successfully mastering the situation.
In this study, the sentences used in positive affirmations given to the elderly must be in accordance with the cause of the elderly suffering from insomnia.
An example of a positive affirmation given to the elderly with insomnia is accompanied by other diseases such as hypertension and joint pain such as, "I want to do ablution therapy so that my sleep is more comfortable and my joint pain will be reduced so that I wake up healthy and refreshed".
In the elderly with moderate and mild insomnia, examples of affirmations are given such as, "I want to do ablution therapy so that I sleep better so that I wake up in a healthy and fresh condition.
I am a good person and better every day.
I am the happiest person".
Most of the affirmations given to the elderly who experience insomnia contain motivation to change negative thoughts into positive ones so that it is easier for the elderly to get into sleep conditions.
This positivative affirmation and ablution therapy will dominate the subconscious which will affect feelings and moods.
A positive mood can improve the elderly's ability to regulate emotions so that they can be calmer and more comfortable, make them more altruistic and give them better self-esteem.
Older people who successfully adapt to physiological and psychological changes in aging will have an easier time maintaining Rapid Eye Movement (REM) sleep .
This research is in line with the research conducted by .
which stated that there was a decrease in the level of insomnia after being given positive affirmations.
In the research conducted by .
, the affirmations given both contain words to increase motivation in the elderly.
In this study, researchers provided a combination of positive affirmation and ablution before bed.
Affirmation is a way that can be used to change the way a person thinks and feels about his or her state.
Repeated and regular use can result in a person who can reprogram the thought process, attitude and everything that is already in the subconscious mind, replacing the negative with the positive.
One of the benefits of giving positive affirmations is that they affect If you start the day with positive thoughts and words, a person will be calmer and more relaxed .
Ablution, which in Islamic teachings means an obligation that must be done for a Muslim, is a form of hydrotherapy .
ater therap.
that has been tested by modern research for validity.
Ablution has been proven to help take care of the Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 health of the body, and can even cure various diseases .
Simon Baruch .
, an American physician, created a theory of Baruch's law.
This theory explains that water has a calming effect if the temperature of the water used is the same as the temperature of the skin, while if the water temperature is higher or lower than the skin temperature, then the water will provide a stimulating or stimulating effect .
The effect or stimulation given is that a person will experience relaxation and comfort that will create a state of relaxation.
This is because ablution can also relax muscles or nerve veins and also to improve blood flow .
That relaxed state will affect the Alpha wave.
Alpha waves are brain waves .
that occur when a person experiences relaxation.
When the brain is in the vibration of the alpha wave frequency .
, the brain's work is able to cause a person to feel comfortable, calm and happy, so that the eyes begin to close or begin to be sleepy and more easily enter into a state of sleep .
Before being given positive affirmation and ablution therapy before going to bed, the elderly at PSTW Tama Indralaya residents had difficulty sleeping.
Most of the elderly start sleeping at the time after the Isha' prayer for the category of mild and moderate insomnia.
The elderly wake up in the early morning and to start sleeping again can wait a few minutes.
Then it will wake up again at 03.
00 to 04.
After being ablution, which in Islamic teachings means an obligation that must be done for a Muslim, is a form of hydrotherapy .
ater therap.
that has been tested by modern research for validity.
Ablution has been proven to help take care of the health of the body, and can even cure various diseases .
Simon Baruch .
, an American physician, created a theory of Baruch's law.
This theory explains that water has a calming effect if the temperature of the water used is the same as the temperature of the skin, while if the water temperature is higher or lower than the skin temperature, then the water will provide a stimulating or stimulating effect .
The effect or stimulation given is that a person will experience relaxation and comfort that will create a state of relaxation.
This is because ablution can also relax muscles or nerve veins and also to improve blood flow .
That relaxed state will affect the Alpha wave.
Alpha waves are brain waves .
that occur when a person experiences relaxation.
When the brain is in the vibration of the alpha wave frequency .
, then the brain's work is able to cause a person to feel comfortable, calm and happy, so that the eyes begin to close or start to be sleepy and more easily enter into a sleeping condition .
Positive affirmation and ablution therapy before bed, the elderly experience changes in sleep time.
From usually waking up in the early morning to waking up at 30 Ae 05.
The elderly get enough nighttime sleep so that the elderly are fresher in the morning.
As for the elderly who experience insomnia with a severe category, before being given therapy, the elderly start their bedtime at 23.
00 and 76 at 00 in the morning.
Then the time to start sleeping again is about 60 minutes and you will wake up again at 04.
00 until morning.
After being given positive affirmation and ablution therapy before going to bed, the elderly experienced a change in sleep patterns, from usually having a nightly sleep time of only about 3 hours to 4-6 hours.
Affirmation is a technique that is able to increase coping responses and change maladaptive behavior.
This is in line with the research of .
who stated that the purpose of this affirmation practice is to fight negative thoughts, help visualize, affirm to oneself and help make positive changes to life.
Specifically to increase motivation, increase confidence, increase self-esteem, control negative feelings such as frustration, anger or impatience, increase productivity.
The splash of ablution water on several limbs brings a sense of peace and tranquility.
So that the Jurnal Ilmu Ilmu Kesehatan.
Vol 11.
No 2 (December 2.
Jurnal Ilmu-ilmu Kesehatan (JIIKES) ------------------------------- Volume 11 Number 2.
December 2025 p-ISSN 2443-3128 e-ISSN 2828-5859 mind will submit with a sense of peace so that it becomes relaxed and can provide peace of mind and comfort before going to bed so that old age will be easy to enter a sleep condition .
From a health perspective, ablution has the meaning of physical and spiritual therapy.
Explained ablution as hydro therapy, namely water This therapy is very good for individuals who have insomnia, stress and easy blood pressure .
Furthermore, ablution as massage therapy, which is therapy with reflexology massages on certain parts of the face, hands and feet.
In overcoming the problem of insomnia, the cognitive aspect is not only that needs to be considered but also the psychological aspect, so the researcher feels the need to combine positive affirmations with ablution therapy to overcome insomnia problems in the elderly, so that therapy will be more effective both in psychological and cognitive terms.
In this study, the researcher did not know which therapy was more dominant in influencing the level of insomnia in the elderly, because measurements were taken after the intervention was carried out for 7 days using the KSBPJ-IRS questionnaire which could only see the level of insomnia without knowing which therapy was more dominant to affect it.
CONCLUSION
The insomnia rate of 15 respondents before positive affirmation and ablution therapy before bed was obtained by the elderly with a mild insomnia rate of 53.
3%, a moderate insomnia rate of 33.
3% and a severe rate of 13.
3% with an average value of 1.
The insomnia rate of 15 respondents after positive affirmation and ablution therapy before bed was carried out was obtained by the elderly with a mild insomnia rate of 40.
0%, a moderate insomnia rate of 46.
7% and no insomnia of 13.
3% with an average value of 0.
The difference in the average value of the level of insomnia in the elderly at PSTW Tama Inderalaya pre test and post test after being given positive affirmation and ablution therapy before obtaining a difference value of 3.
93 which has a positive value, and has a p value = 005 .
value < , =0.
The results of this analysis showed that there was a significant difference in the level of insomnia between before and after positive affirmation and ablution therapy before bed.
REFERENCES