Progressive Muscle Relaxation, Spiritual Guided Imagery, Music on Coping and Resilience among Cancer Patients who Undergo Chemotherapy


Cancer diagnosis and chemotherapy cause physical, psychological, social, and spiritual problems for sufferers. Cancer patients who experience emotional distress need to be appropriately managed through good coping mechanisms. The purpose of this study was to analyze the effectiveness of progressive muscle relaxation, spiritual guided imagery and music for coping and resilience of cancer patients undergoing chemotherapy. This study was a quasi-experimental design. A total of 62 respondents (intervention and control groups) were determined using a purposive sampling technique. The independent variable was Progressive Muscle Relaxation therapy with Spiritual Guided Imagery and Music. Meanwhile, the dependent variable was coping and resilience. The instrument used The-14 items Resilience Scale and The Cancer Coping Questionnaire. Data were analyzed using the General Linear Model Repeated Measures. The results showed that coping mechanisms improved in the first week, while resilience was only developed in the second week after being given the intervention. The results of statistical tests are less than a p-value <0.05. In general, there were significant differences in the effect of coping scores and resilience between the treatment group and the control group after being given therapy. The combination of Progressive Muscle Relaxation therapy with Spiritual Guided Imagery and Music can improve coping and resilience in cancer patients undergoing chemotherapy. The government and health workers are expected to consider these findings that can be used as interventions to enhance coping and resilience.


Keywords: coping, resilience, cancer, chemotherapy

[1] Airley, R. (2009). National Cancer Institute The NCI Consumers’ Cancer Dictionary for Peer Review. Oxford: John Wiley & Sons Ltd.

[2] Suzana, Y., Fatin, N. and Nina, K. D. R. (2016). Depressive Symptoms among Cancer Patients Undergoing Chemotherapy. Social and Behavioral Sciences, issue 234, pp.185–192.

[3] Kirana, L. (2016). Dukungan Sosial Dan Resiliensi Pada Pasien Kanker Payudara (Studi Kasus Pada Pasien Kanker Payudara Yang Sedang Menjalani Kemoterapi). Psikoborneo, vol. 4, issue 4, pp. 829– 837.

[4] Min, J., et al. (2013). Psychological Resilience Contributes to Low Emotional Distress in Cancer Patients. Support Care Cancer, issue 21, pp. 2469–2476.

[5] Ahadi, H., Delavar, A. and Rostami, A. M. (2014). Comparing Coping Styles in Cancer Patients and Healthy Subjects. Social and Behavioral Sciences, issue 116, pp. 3467–3470.

[6] Yunitasari, E. (2016). The Development of Coping-Roy’s Adaptation Nursing Care Model to Increase the Resiliency of Post Radikal Hysterectomy + BSO Cervical Cancer Patients who Received Chemotherapy. Universitas Airlangga.

[7] Loprinzi, E. C., et al. (2011). Stress Management and Resilience Training (SMART) Program to Decrease Stress and Enhance Resilience Among Breast Cancer Survivors: A Pilot Randomized Clinical Trial. Clinical Breast Cancer, vol. 11, issue 6, pp. 364–368.

[8] Snyder, M. and Lindquist, R. (2006). Complementary / Alternative Therapies in Nursing. (5th ed.). New York: Springer Publishing Company.

[9] Mohamad-rodi, I, et al. (2013). Impact of Applied Progressive Deep Muscle Relaxation Training on the Health Related Quality of Life among Prostate Cancer Patients — A Quasi Experimental Trial. Preventive Medicine, issue 57, pp. 40–43.

[10] Kaina, Z., et al. (2015). A Clinical Randomized Controlled Trial of Music Therapy and Progressive Muscle Relaxation Training in Female Breast Cancer Patients after Radical Mastectomy: Results on Depression, Anxiety and Length of Hospital Stay. European Journal of Oncology Nursing, vol. 19, issue 1, pp. 54–59.

[11] Theologia, T., Andreas, C. and Evridiki, P. R. (2017). Effectiveness of a Relaxation Intervention (Progressive Muscle Relaxation and Guided Imagery Techniques) to Reduce Anxiety and Improve Mood of Parents of Hospitalized Children with Malignancies: A Randomized Controlled Trial in Republic of Cyprus and Greece. European Journal of Oncology Nursing, issue 26, pp. 9–18.

[12] Yulianto, A. (2012). Spiritual Healing. Jakarta: HPA.

[13] Johnston, T. E., Cheryl, P. and Oladele, J. (2015). Spirituality and Spiritual Care of Adolescents and Young Adults with Cancer. Seminars in Oncology Nursing, vol. 31, issue 3, pp. 227–241.

[14] Wagnild, G. (2003). Resilience and Successful Aging Comparison Among Low and High Income Older Adults. Journal of Gerontological Nursing, vol. 29, issue 12, pp. 42–49.

[15] Oliveira, A., et al. (2014). Confirmatory Factor Analysis of the Resilience Scale Short form in a Portuguese Adolescent Sample. Social and Behavioral Sciences., issue 165, pp. 260–6.

[16] Elisavet, N., et al. (2017). The Greek Version of the Resilience Scale (RS-14): Psychometric Properties in three Samples and Associations with Mental Illness, Suicidality, and Quality of Life. Journal of Psychology and Clinical Psychiatry, vol. 7, no. 5.

[17] Moorey, S., Frampton, M. and Greer, S. (2003). The Cancer Coping Questionnaire: A Self-Rating Scale for Measuring the Impact of Adjuvant Psychological Therapy on Coping Behaviour. Psychooncology, vol. 12, issue 4, pp.331–44.

[18] Karagozoglu, S., Tekyasar, F. and Yilmaz, F. (2012). Effects of Music Therapy and Guided Visual Imagery on Chemotherapy-Induced Anxiety and Nausea – Vomiting. Journal of Clinical Nursing, issue 22, pp. 39–50.

[19] Helen, C. (2019). Progressive Muscle Relaxation. Complement Altern Med Cancer. Retrieved November 28, 2019 from http//

[20] Herrman, H., et al. (2011). What Is Resilience? Can The Canadian Journal of Psychiatry, vol. 56, issue 5, pp. 258–265.

[21] Fletcher, D. and Sarkar, M. (2013). Psychological Resilience A Review and Critique of Definitions, Concepts, and Theory. European Psychologist, vol. 18, issue 1, pp. 12– 23.

[22] Setiadi & Irawandi, D. (2017). Pendidikan Agama Islam Untuk Tenaga Kesehatan (Teori dan Aplikasi Praktek Bagi Mahasiswa dan tenaga Kesehatan di Tempat Praktek). Surabaya: Indomedia Pustaka.

[23] Zainuddin, A. (2012). SEFT for Healing, Success, Happiness, and Greatness. Jakarta: Afzan Publishing.