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Life sciences · Journal article
Malahayati Nursing Journal · September 28, 2026
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ABSTRACT Breast cancer is a malignant disease that not only affects physical health but also has significant psychological impacts, especially in the form of situational low self-esteem due to changes in body image and the effects of prolonged treatment. This case study aims to describe the application of psychiatric nursing care through affirmation therapy using guided imagery and stress management techniques to reduce situational low self-esteem in breast cancer patients. The study subject, a 27-year-old married woman diagnosed with stage IIIA breast cancer, underwent chemotherapy, radiotherapy, and a mastectomy, which caused emotional distress and decreased self-esteem. Data were collected through interviews, observations, and nursing documentation, then analyzed using a nursing process approach, including assessment, diagnosis, intervention, implementation, and evaluation. After 3 sessions of affirmation therapy, guided imagery, and stress management, the patient showed improvements in self-acceptance, self-confidence, emotional stability, and motivation to continue treatment. Conclusion: HER2-positive breast cancer is aggressive and often diagnosed late. Holistic management that includes medical and psychosocial aspects is needed to improve the patient's quality of life. Keywords: Guided Imagery, Situational Low Self-Esteem, Breast Cancer, Stress Management, Affirmation Therapy. ABSTRAK Kanker payudara merupakan penyakit ganas yang tidak hanya memengaruhi kesehatan fisik tetapi juga memiliki dampak psikologis yang signifikan, terutama berupa harga diri rendah situasional akibat perubahan citra tubuh dan efek pengobatan yang berkepanjangan. Studi kasus ini bertujuan untuk mendeskripsikan penerapan asuhan keperawatan jiwa melalui terapi afirmasi menggunakan teknik guided imagery dan manajemen stres untuk menurunkan harga diri rendah situasional pada pasien kanker payudara. Subjek penelitian, seorang perempuan yang sudah menikah dan berusia 27 tahun yang didiagnosis kanker payudara stadium IIIA, menjalani kemoterapi, radioterapi, dan mastektomi, yang menyebabkan distres emosional dan penurunan harga diri. Data dikumpulkan melalui wawancara, observasi, dan dokumentasi keperawatan, kemudian dianalisis menggunakan pendekatan proses keperawatan, meliputi pengkajian, diagnosis, intervensi, implementasi, dan evaluasi. Setelah 3 kali sesi terapi afirmasi, guided imagery, dan manajemen stres, pasien menunjukkan peningkatan dalam penerimaan diri, kepercayaan diri, stabilitas emosional, dan motivasi untuk melanjutkan pengobatan. Kesimpulan, Kanker payudara HER2 positif bersifat agresif dan sering terdiagnosis lanjut. Penatalaksanaan holistik yang mencakup aspek medis dan psikososial diperlukan untuk meningkatkan kualitas hidup pasien. Kata Kunci: Guided Imagery, Harga Diri Rendah Situasional, Kanker Payudara, Manajemen Stres, Terapi Afirmasi.