Providing tokens as incentives promotes positive behaviors related to oral hygiene and self-care in individuals with mental illness
DOI: https://doi.org/10.56922/mhc.v4i4.1827
Oral Hygiene Schizophrenia Self-Care Deficit
Abstract
Background: Mental disorders, particularly schizophrenia, cause a decline in mental function, impacting individuals' inability to perform self-care activities independently, including dental and oral hygiene. This self-care deficit is caused by cognitive impairment, lack of motivation, and the inability to organize and carry out daily activities. Appropriate interventions are essential to support the restoration of independence and improve patients' quality of life.
Purpose: To determine the effectiveness of implementing the token economy method in improving oral hygiene in patients with self-care deficits due to mental disorders.
Method: An in-depth case study was conducted on one patient diagnosed with self-care deficit using the token economy method as an intervention. Data were collected through observations, a token economy checklist, and self-care (oral hygiene) activity observation sheets for two weeks, from October 20 to November 1, 2025. Analysis focused on improving the patient's oral hygiene score.
Results: After two weeks of the token economy intervention, there was a significant improvement in patients' toothbrushing activity, as measured by token scores. Oral hygiene scores improved from poor (10) to fair (30), with patients showing consistent progress in performing self-care independently.
Conclusion: This intervention successfully motivated patients to maintain regular and independent oral hygiene.
Keywords: Oral Hygiene; Schizophrenia; Self-Care Deficit.
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References
Baskara, D. A., Darsana, I. W., & Indrayani, N. M. A. W. (2019). Gambaran Kemandirian Melakukan Perawatan Diri Pada Pasien Skizofrenia. Journal Center of Research Publication in Midwifery and Nursing, 3(2), 6-15.
Boersma, G. J., van Enthoven, M., Smid, Y., Nordkamp, R., Huisman, W., & Lancel, M. (2025). Evaluation of a token economy program to improve daily functioning of forensic psychiatric inpatients: a quasi-experimental mixed-methods pilot study. The Journal of Forensic Practice.
Brooks, H., Irmansyah, I., Susanti, H., Utomo, B., Prawira, B., Iskandar, L., & Lovell, K. (2019). Evaluating the acceptability of a co-produced and co-delivered mental health public engagement festival: Mental Health Matters, Jakarta, Indonesia. Research involvement and engagement, 5(1), 25.
Eni, R. (2023). Edukasi Pada Keluarga Dalam Peningkatan Pengetahuan Merawat Anggota Keluarga Dengan Gangguan Jiwa: Halusinasi. Initium Community Journal, 3(1), 1-6.
Hendriyani, M. E., Rafenia, V., Maharani, S., & Al-Azis, H. (2023). The Implementation of the Independent Curriculum through Independent Project on Sustainable Lifestyle Theme for Grade 10 Students. Jurnal Pendidikan Indonesia Gemilang, 3(2), 242-253.
Hickey, V. (2018). Using a Novel Digital Token Economy Intervention to Improve Adherence to Self-care Behaviors in Hospitalized Pediatric Patients (Doctoral dissertation, Xavier University).
Kuo, M. W., Yeh, S. H., Chang, H. M., & Teng, P. R. (2020). Effectiveness of oral health promotion program for persons with severe mental illness: a cluster randomized controlled study. BMC Oral Health, 20(1), 290.
Lasanudin, H. V., Ilham, R., & Sabali, R. (2023). Penerapan Terapi Aktivitas Kelompok Sosialisasi Pada Lansia Dengan Harga Diri Rendah di Panti Griya Lansia Jannati. Jurnal Ventilator, 1(2), 83-88.
Mawarpury, M., Maulana, H., Khairani, M., & Fourianalistyawati, E. (2022). Buku Seri Kesehatan Mental Indonesia: Kesehatan Mental di Indonesia Saat Pandemi. Syiah Kuala University Press.
Mintarsih, R. A. (2021). Pengaruh token ekonomi untuk meningkatkan kemampuan rawat diri pada individu dengan gangguan skizoafektif. Procedia: Studi Kasus Dan Intervensi Psikologi, 9(4), 145-151.
Mohamed Zaki, S., Rabea Mohamed, S., & Nagy Kotb, F. (2024). Effect of Emotion Regulation Program on Negative Symptoms among Patients with Schizophrenia. Egyptian Journal of Health Care, 15(4), 1865-1880.
Nasution, M. L., Daulay, W., & Wahyuni, S. E. (2021). Implementation of behavioral therapy (economic token) on the ability of people with mental disorders in fulfilling self-cleaning (personal hygiene) in medan sunggal subdistrict. Open Access Macedonian Journal of Medical Sciences, 9(T3), 84-86.
Pertiwi, L. A., Setiaji, B., Rahayu, D., Adyas, A., Noviansyah, N., & Pratiwi, D. U. (2024). Pengaruh Media Promosi Kesehatan Booklet Terhadap Peningkatan Pengetahuan Pendamping Penderita Skizofrenia. Jurnal Ilmiah Kesehatan Media Husada, 13(1), 21-33.
Sainyakit, E., Agustina, M., & Safitri, A. (2024). Pengaruh Strategi Pelaksanaan terhadap Kemampuan Self Care pada Pasien Defisit Perawatan Diri di Ruang Kenanga Rumah Sakit Jiwa Dr Soeharto Heerdjan Tahun 2023. Journal of Management Nursing, 3(4), 406-415.
Salsabila, I., & Harjana, R. (2024). The Impact of the Token Economy Technique on the Self-Development Abilities Related to Dental Hygiene of Students with Physical Disabilities at SLB Langensari. Special and Inclusive Education Journal (SPECIAL), 5(2), 146-153.
Suri, N., & Rony, F. Q. (2025). Assessing the Impact of Adherence on the Cost of Illness among Schizophrenia Outpatients. Indonesian Journal of Clinical Pharmacy Volume, 14(1).
Syafiin, A. (2023). Token Ekonomi: Metode untuk meningkatkan kepatuhan minum obat pada skizofrenia. Procedia: Studi Kasus dan Intervensi Psikologi, 11(4), 116-120.
Syukur, S. B., Sudirman, A. N. A., & Harun, S. R. (2023). Peran Advokasi Perawat di Ruang Rawat Inap RSUD Dr. Hasri Ainun Habibie. Journal of Educational Innovation and Public Health, 1(2), 154-164.
Vitha, V. V. (2024). Penerapan Metode Token Ekonomi Terhadap Aktifitas Perawatan Diri Pada Pasien Defisit Perawatan Diri Di Ruang Abimanyu Rsjd Dr. Arif Zainudin Provinsi Jawa Tengah (Doctoral dissertation, Universitas Kusuma Husada Surakarta).
Wardini, H., Saswati, N., & Harkomah, I. (2024). Efektivitas Token Economy Terhadap Perawatan Diri Pada Klien Skizofrenia. Lontara Journal of Health Science and Technology, 5(1), 13-20.
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