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Abstract
ABSTRAK: Tuberkulosis paru merupakan penyakit menular yang memerlukan pengobatan jangka panjang dengan tingkat kepatuhan yang tinggi. Penelitian ini menguji efektivitas Acceptance and Commitment Group Therapy (ACT-G) dalam meningkatkan kepatuhan minum obat pada pasien TB paru. Desain penelitian quasi-experiment dengan pendekatan randomized pretest-posttest control group melibatkan 10 pasien TB yang dibagi dalam kelompok eksperimen dan kontrol. Kepatuhan diukur menggunakan Morisky Medication Adherence Scale (MMAS-8). Analisis data menggunakan uji Wilcoxon dan Mann-Whitney menunjukkan peningkatan signifikan pada kelompok eksperimen setelah intervensi (p = 0,038) dan perbedaan signifikan antara kedua kelompok (p = 0,006). Hasil ini mendukung bahwa ACT-G efektif dalam meningkatkan kepatuhan minum obat pasien TB paru, dengan implikasi pada keberhasilan terapi TB jangka panjang.
Kata kunci: Acceptance and Commitment Group Therapy, kepatuhan minum obat, MMAS-8, tuberkulosis paru.
ABSTRACT: Pulmonary tuberculosis (TB) is a contagious disease requiring long-term treatment and high medication adherence. This study examined the effectiveness of Acceptance and Commitment Group Therapy (ACT-G) in improving medication adherence among pulmonary TB patients. Using a quasi-experimental randomized pretest-posttest control group design, 10 patients were assigned to either an experimental or control group. Adherence was measured using the Morisky Medication Adherence Scale (MMAS-8). Data analyzed with Wilcoxon and Mann–Whitney tests showed a significant increase in adherence in the experimental group after intervention (p = .038) and a significant difference between groups (p = .006). These findings suggest that ACT-G effectively enhances medication adherence among TB patients, with implications for improving long-term TB treatment outcomes.
Key words: Acceptance and Commitment Group Therapy, medication adherence, MMAS-8, pulmonary tuberculosis.
Keywords
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Copyright (c) 2025 Sandy Aditya Pradana, Cahyaning Suryaningrum, Ni’matuzahroh

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References
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- Eilenberg, T., Fink, P., Jensen, J. S., Rief, W., & Frostholm, L. (2016). Acceptance and commitment group therapy (ACT-G) for health anxiety: A randomized controlled trial. Psychological Medicine, 46(1), 103–115. https://doi.org/10.1017/S0033291715001579
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- Harris, R. (2021). Trauma-focused ACT: A practitioner’s guide to working with mind, body, and emotion using acceptance and commitment therapy (1st ed.). Context Press.
- Hayes, S. C., Strosahl, K. D., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
- Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). The Guilford Press.
- Kalodner, C. R., & Hanus, A. E. (2011). Groups across settings. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195394450.013.0022
- Kemenkes RI. (2022). Dashboard TB: Situasi TB di Indonesia. Kemenkes RI. https://tbindonesia.or.id/pustaka-tbc/dashboard-tb/
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- Sukatemin. (2022). Faktor yang berkorelasi dengan kejadian drop out pada pengobatan tuberculosis paru. Indonesian Health Issue, 1(2), 224–246.
- Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33(8), 965–978. https://doi.org/10.1016/j.cpr.2013.07.002
- Vernon, A., Fielding, K., Savic, R., Dodd, L., & Nahid, P. (2019). The importance of adherence in tuberculosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLOS Medicine, 16(12), e1002884. https://doi.org/10.1371/journal.pmed.1002884
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- Zargar, F., Monzavi, P., Tarrahi, M. J., & Salehi, S. A. (2023). Medication beliefs, cognitive defusion, and valued living in hypertensive patients with varying medication adherence. ARYA Atherosclerosis, 19(1), 17–24. https://doi.org/10.48305/arya.2022.11811.2471
References
As’hab, P. P., Keliat, B. A., & Wardani, I. Y. (2022). The effects of acceptance and commitment therapy on psychosocial impact and adherence of multidrug-resistant tuberculosis patients. Journal of Public Health Research, 11(2), 66–71. https://doi.org/10.4081/jphr.2021.2737
Atefi, G. L., de Vugt, M. E., van Knippenberg, R. J. M., Levin, M. E., Verhey, F. R. J., & Bartels, S. L. (2023). The use of Acceptance and Commitment Therapy (ACT) in informal caregivers of people with dementia and other long-term or chronic conditions: A systematic review and conceptual integration. Clinical Psychology Review, 105, 102341. https://doi.org/10.1016/j.cpr.2023.102341
Dewi, A. R., Hamid, A. Y. S., & Susanti, H. (2023). Impact of Acceptance and Commitment Therapy (ACT) on medication adherence of people with schizophrenia. Nursing and Health Sciences Journal (NHSJ), 3(3), 313–319. https://doi.org/10.53713/nhsj.v3i3.267
Eilenberg, T., Fink, P., Jensen, J. S., Rief, W., & Frostholm, L. (2016). Acceptance and commitment group therapy (ACT-G) for health anxiety: A randomized controlled trial. Psychological Medicine, 46(1), 103–115. https://doi.org/10.1017/S0033291715001579
El-Ashry, A. M., & Nashwan, A. J. (2024). Value component of acceptance and commitment therapy (ACT) among patients with schizophrenia. Academia Mental Health and Well-Being, 1(1), 1–5. https://doi.org/10.20935/MHealthWellB6197
Harris, R. (2021). Trauma-focused ACT: A practitioner’s guide to working with mind, body, and emotion using acceptance and commitment therapy (1st ed.). Context Press.
Hayes, S. C., Strosahl, K. D., Strosahl, K., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. Guilford Press.
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). The Guilford Press.
Kalodner, C. R., & Hanus, A. E. (2011). Groups across settings. Oxford University Press. https://doi.org/10.1093/oxfordhb/9780195394450.013.0022
Kemenkes RI. (2022). Dashboard TB: Situasi TB di Indonesia. Kemenkes RI. https://tbindonesia.or.id/pustaka-tbc/dashboard-tb/
Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: A practice-friendly review. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3), 258–270. https://doi.org/10.4081/ripppo.2022.643
Morisky, D. E., Ang, A., Krousel‐Wood, M., & Ward, H. J. (2008). Retracted: Predictive validity of a medication adherence measure in an outpatient setting. The Journal of Clinical Hypertension, 10(5), 348–354. https://doi.org/10.1111/j.1751-7176.2008.07572.x
Nabillah, L., Demartoto, A., & Murti, B. (2022). Meta-analysis: The effect of social support on medication treatment adherence in tuberculosis patients. Journal of Health Promotion and Behavior, 7(3), 250–261. https://doi.org/10.26911/thejhpb.2022.07.03.07
Nasab, A. G., Seyrafi, M., Kraskian, A., & Golkar, M. K. (2021). Effectiveness of acceptance and commitment therapy in health anxiety and adherence to treatment in patients undergoing open-heart surgery. Avicenna Journal of Neuro Psycho Physiology, 8(1), 1–6. https://doi.org/10.32592/ajnpp.2021.8.1.100
O’Hare, A. J., & Gemelli, Z. T. (2023). The effects of short interventions of focused-attention vs self-compassion mindfulness meditation on undergraduate students: Evidence from self-report, classroom performance, and ERPs. PloS ONE, 18(1), e0278826. https://doi.org/10.1371/journal.pone.0278826
Rafii, F., Fatemi, N. S., Danielson, E., Johansson, C. M., & Modanloo, M. (2014). Compliance to treatment in patients with chronic illness: A concept exploration. Iranian Journal of Nursing and Midwifery Research, 19(2), 159–167.
Ritzert, T. R., Forsyth, J. P., Berghoff, C. R., Barnes-Holmes, D., & Nicholson, E. (2015). The impact of a cognitive defusion intervention on behavioral and psychological flexibility: An experimental evaluation in a spider fearful non-clinical sample. Journal of Contextual Behavioral Science, 4(2), 112–120. https://doi.org/10.1016/j.jcbs.2015.04.001
Sadeghi, A. H., Ahmadi, S. A., & Ghodrati-Torbati, A. (2024). The effectiveness of acceptance and commitment therapy on clinical symptoms and treatment adherence in dialysis patients. Journal of Education and Health Promotion, 13(1), 1–7. https://doi.org/10.4103/jehp.jehp_1704_22
Sakamoto, R., Ohtake, Y., Kataoka, Y., Matsuda, Y., Hata, T., Otonari, J., Yamane, A., Matsuoka, H., & Yoshiuchi, K. (2022). Efficacy of acceptance and commitment therapy for people with type 2 diabetes: Systematic review and meta‐analysis. Journal of Diabetes Investigation, 13(2), 262–270. https://doi.org/10.1111/jdi.13658
Sukatemin. (2022). Faktor yang berkorelasi dengan kejadian drop out pada pengobatan tuberculosis paru. Indonesian Health Issue, 1(2), 224–246.
Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: A systematic review. Clinical Psychology Review, 33(8), 965–978. https://doi.org/10.1016/j.cpr.2013.07.002
Vernon, A., Fielding, K., Savic, R., Dodd, L., & Nahid, P. (2019). The importance of adherence in tuberculosis treatment clinical trials and its relevance in explanatory and pragmatic trials. PLOS Medicine, 16(12), e1002884. https://doi.org/10.1371/journal.pmed.1002884
Vika, V., Siagian, M., & Wangge, G. (2016). Validity and reliability of Morisky Medication Adherence Scale 8 Bahasa version to measure statin adherence among military pilots. Health Science Journal of Indonesia, 7(2), 129–133. https://doi.org/10.22435/hsji.v7i2.5343.129-133
World Health Organization. (2018). Global tuberculosis report.
Zargar, F., Monzavi, P., Tarrahi, M. J., & Salehi, S. A. (2023). Medication beliefs, cognitive defusion, and valued living in hypertensive patients with varying medication adherence. ARYA Atherosclerosis, 19(1), 17–24. https://doi.org/10.48305/arya.2022.11811.2471