EFFECT OF MUSIC THERAPY ON PAIN, ANXIETY AND CORTISOL LEVEL IN PRIMIGRAVIDA DURING ACTIVE PHASE BASED ON KOLCABA’S THEORY Yurike Septianingrum* ) , Hermanto Tri Juwono** ) , Mira Triharini *** ) *)FKK Universitas Nahdlatul Ulama Surabaya **) SMF Obsgyn RSUD Dr. Soetomo Surabaya ***) Fakultas Keperawatan Universitas Airlangga Surabaya Email: yurikesepti1209@unusa.ac.id ABSTRACT Background: Labor pain and anxiety are closely interrelated with each other. Pain and anxiety together canincrease level of cortisol, may result in a decrease uterine contractions so that the risk of causing prolonged labor.The purpose of this study were to examine the effect of music therapy in pain, anxiety, and cortisol level in primigravida during active phase of first stage labor.Method: This study was an experimental research approach with pre-test post-test design at Delivery room Puskesmas Jagir Surabaya. Research subjects of this study was recruited using simple random sampling who was included inclusion criterias. Research subjects in this study was of 32 people who were then divided into two groups, 16 mothers into intervention group and 16 mothers into control group. Data were collected by using observation with VAS and VAAPS, also took venous blood sampling for laboratory test of cortisol serum. Data were analyzed by using paired t-test and independent t-test. Result: The results showed that: 1) Score of VAS in intervention group was less than control group (p= 0,000), 2) Score of VAAPS in intervention group was less than control group (p=0,000), 3) There was no significant differences cortisol level between intervention group and control group (p=0,305). Discussion:Music therapy could reduce pain and anxiety, but could not reduce levelof cortisol in primigravida during active phase of first stage labor.Further research, music therapy should be given since the beginning of third trimester so that primigravida more prepared for childbirth. Keywords: labor, pain, anxiety, cortisol, music therapy INTRODUCTION The delivery process often cause discomfort or pain. Labor pain in the first stage or when first-epoch is felt during uterine contractions which cause dilation and thinning of the cervix and uterine ischemia due to contraction of the myometrium (Hughs, 1992 in Bobak, 2005). Primiparous experience pain longer than multiparous mother for the duration of the first stage of a longer primiparas is 13-14 hours, while multiparas about 7 hours (Wiknjosastro, 2006). Labor pain that lasts longer at risk of maternal emotional fatigue that affectsamong others, tension, anxious, and fearful. (Mozurkewich et al, 2000, in Hosseini et al, 2013). Problems with labor pain is still not getting the attention of health workers, especially nurses and midwives. Results of a preliminary study conducted by researchers at the Puskesmas Jagir Surabaya there is no SOP yet to address labor pain, during this midwife only teaches relaxation breath in and was considered still not optimal. Pain management is absolutely necessary in order to make the mother feel comfortable during labor, but in reality there is no labor pain management in Indonesia. Puskesmas as health care center level 1 expected to cope with labor pain that is accompanied by anxiety so that she can live a normal delivery. Several non-pharmacological alternative methods that can be used to reduce labor pain and anxiety are acupuncture, breathing techniques, acupressure, touch, water therapy, massage, and music (Taghinejad et al, 2010). Music therapy offers a method of distraction that is proven to reduce pain and improve the state of deep relaxation that can distract the mother of pain during childbirth (Martini, 2011). Until now, the effect of music therapy on pain, anxiety and cortisol levels in the first stage of labor primigravidas active phase based Kolcaba theory can not be explained. Oktavia study (2013) showed that 90% of maternal experiencing severe labor pain and 10% had labor pain severe or very severe. brought to you by CORE View metadata, citation and similar papers at core.ac.uk provided by Ners Unair Repository