Implementation of Low Intensity Psychological Intervention (Butterfly Hug, Grounding) and Assertiveness Training Using “SIMOJI” Web Based Application on the Reduction of Psychomotor Agitation in Schizophrenia Patients with Risk of Violent Behaviour

Abstract

Introduction: Schizophrenia is a chronic mental illness characterized by disturbances in thinking, perception, emotion, and behavior. Nursing implementation still relies on manual/paper-based methods in the current era of digitalization. Objective: To identify the application of low intensity psychological intervention (butterfly hug, grounding) and assertiveness training using a digital application SIMOJI on the reduction of psychomotor agitation in Schizophrenia patients with risk of violent behavior in the Gatot Kaca ward, Marzoeki Mahdi Hospital.Method: A quasi-experimental study using one group without a control group, involving 31 patients with risk of violent behavior selected according to inclusion criteria, with agitation measured using the OASS (Overt Agitation Severity Scale) instrument. Results: The butterfly hug, grounding, and assertiveness training interventions using a digital application significantly reduced psychomotor agitation in  risk of violent behavior patients (p < .001), with the median score decreasing from 23 (pretest) to 20 (post butterfly hug and grounding) and to 3 (post assertiveness training). Assertiveness training was proven to be more effective than butterfly hug and grounding, and a history of substance abuse was found to be significantly associated with the level of psychomotor agitation in patients (p < .001). Recommendation: Low Intensity Psychological Intervention (Butterfly Hug, Grounding) can be performed by ward nurses, while assertiveness training should be delivered by mental health specialist nurses to reduce psychomotor agitation using the SIMOJI application