Concept analysis of emotion control among schizophrenia

Emotional control in schizophrenia patients is closely related to the patient's ability to control his negative emotions. Negative emotions in question are feelings of anger, fear and sadness. In the United States about 1.5 million crime cases occur each year. These events are mostly carried out by schizophrenic patients due to their inability to contr emotions. The purpose of this article is to describe the methodological analysis used to clarify the concept of emotional control in schizophrenia patients. The concept analysis procedure from Walker and Avant is used in this paper. Literature review is carried out using online databases such as Google Scholar, Science Direct, and EBSCHO with keywords of concept analysis, emotional control, and schizophrenia. Antecedents of the concept of emotional control in schizophrenia: self control, mental self determination. Concept attributes: situation selection, situation modification, attentional deployment, cognitive change, and response modulation. The consequences of the concept: success in controlling emotions, happiness, positive results, and leadership effectiveness. This open access article is under the CC–BY-SA license.


Concept analysis of emotion control among schizophrenia , Ashri Maulida
Emotional control in schizophrenia patients is closely related to the his negative emotions. Negative emotions in question are feelings of anger, fear and sadness. In the United States about 1.5 million crime cases occur each year. These events are mostly carried out by schizophrenic patients due to their inability to control negative emotions. The purpose of this article is to describe the methodological analysis used to clarify the concept of emotional control in schizophrenia patients. The concept analysis procedure from Walker and Avant is used in review is carried out using online databases such as Google Scholar, Science Direct, and EBSCHO with keywords of concept analysis, emotional control, and schizophrenia. Antecedents of the concept of emotional control in schizophrenia: self control, mental boundaries, and self determination. Concept attributes: situation selection, situation modification, attentional deployment, cognitive change, and response modulation. The consequences of the concept: success in controlling sults, and leadership effectiveness. license.

Introduction
Negative symptoms in schizophrenia patients are a health problem of concern because the impact is not only felt by sufferers and their families but also on society. Some things that are negative symptoms in schizophrenia patients are tantrums, threats, and swearing using harsh words. These negative symptoms arise due to the patient's inability to control emotions (Wright et al., 2009).
The impact that will arise if a schizophrenic patient is unable to control his/ her emotional feelings is that the patient will be seen as a dangerous individual and can put the patient at risk of committing suicide, major depression, and decreased interaction/communication with the community and family. In addition to being self-defeating, the inability to control emotional feelings in schizophrenia patients can also have an impact on other people, such as going berserk and breaking things.
Based on data from the Federal Bureau of Investigation (FBI) in the United States, about 1.5 million crimes occur each year (murder, robbery, and assault). This incident is mostly carried out by schizophrenic patients due to the inability to control their negative emotions (Corrigan & Bink, 2015).
Emotional control in schizophrenic patients is closely related to the patient's ability to deal with negative emotions. The negative emotions referred to are feelings of anger, fear, and sadness (Wongtongkam et al., 2015., Muarif, A., & Adiyanti, M. 2020).
The concept of emotional control is closely related to emotional regulation. A person who has emotional regulation can maintain or increase emotions that are felt both positive and negative (Gross, 2014).
Currently, the discussion of emotional control can be used as an important consideration for evaluating the final outcome of effectiveness in providing health services to determine the benefits of medical actions that will be given to patients (Aisyiyah, 2017).
For example, the concept of emotional control is used to evaluate the ability to control emotions and assess the ability to cope with excessive emotions in pulmonary TB patients (Sadipun et al., 2018).
Based on the explanation above, the purpose of this paper is to describe the conceptual analysis used to clarify the concept of emotional control in schizophrenic patients.

Method
The use of Walker and Avant's concept analysis method aims to broaden understanding and clarify the concept of emotional control. The concept analysis steps are as follows: 1) Choosing a concept to be analyzed; 2) Explain the purpose of the analysis; 3) Identifying all uses of the concept; 4) Determine the attribute explanation based on literature review; 5) Identification of a case model; 6) Identification of cons, boundary lines, the relationship of discovery, legitimate cases; 7) Identification of antecedents (events that cause previous events) and consequences associated with the concept; 8) Determine empirical references; 9) Making a final definition of the concept (Green, 2002).
The literature sources used in the preparation of this literature review use journal articles from 2003-2019. The process of searching for articles through Google Scholar, Science Direct, and EBSCO. The search keywords were concept analysis, emotional control, schizophrenia.

Meaning of the emotional control concept
Emotional control is the ability to hide and suppress emotions rather than express emotions. Emotional control and emotional regulation are closely related. Groos states that emotional regulation is a conscious or unconscious strategy to maintain, strengthen, and reduce one or more aspects of emotional responses (Gross, 2014).
Emotional regulation is the ability possessed by individuals to assess, manage, and release appropriate emotions in order to achieve emotional balance. The ability to control emotions will make individuals ready to face tensions in their life (Gross & John, 2003). Emotion regulation can also be defined as the way individuals influence the emotions they have when they feel them and how they experience or express these emotions (Roberton et al., 2012).
Emotional regulation has specific goals depending on the circumstances experienced by a person. Emotion regulation is concerned with reducing and increasing negative and positive emotions. These positive and negative emotions arise when individuals have goals in interacting with their environment and others (Yusainy et al., 2019).

Use of the emotion control concept
The use of the concept of emotional control has been widely discussed in various studies that specifically study the use of the concept of emotional control in various disciplines. For example, the use of the concept of emotional control is to determine the relationship between sibling rivalry and emotional regulation in late childhood. This study was conducted to determine the extent to which emotional control abilities can affect sibling rivalry in late childhood (Saputri, I. K. E., Sugiariyanti, 2016).
The use of the concept of emotional control is also used in research on the relationship between emotion regulation and assertiveness in adolescents. The purpose of this study was to determine the relationship between emotional regulation and assertiveness in adolescents (Silaen & Dewi, 2015).
On the other hand, the concept of emotional control can also collaborate with mindfulness therapy. Research that has been done is mindfulness as an emotional regulation strategy. The purpose of this study was to determine the effectiveness of mindfulness as a strategy for emotional regulation (Yusainy et al., 2019)

Emotion control concept attribute
The process of emotional control occurs twice, namely at the beginning of the action and regulation that occurs at the end of the action which includes five components of the process, namely: strategies to approach and avoid people or situations that have an impact on the emotions that will arise (situation selection), actions to modify the situation so that the emotional effects distracted (situation modification), is a way for individuals to divert their attention in an Jurnal Aisyah: Jurnal Ilmu Kesehatan, 5(2), December 2020, -131 Rahman; Dwidiyanti; Wijayanti; Rahmawati Concept analysis of emotion control among schizophrenia unpleasant situation to avoid excessive emotions (attentional deployment), is a person's way of re-evaluating a situation by changing the way of thinking to be more positive so that it can reduce the strong influence of emotions (cognitive change), and individual efforts to regulate and display emotional responses that are not excessive (response modulation) (Gross, 2014). Initial regulation consists of changing thinking about the situation to reduce emotional impact, whereas late regulation inhibits the release of emotional cues. Emotion regulation emphasizes how and why emotion itself is able to regulate and facilitate psychological processes, such as focusing, problem-solving, and social support (Sadipun et al., 2018).
There are three aspects of emotional regulation, including the following: 1) Able to properly regulate positive and negative emotions, 2) Able to be aware of emotions, control emotions consciously and automatically, 3) Able to master the pressure resulting from the problems at hand (Roberton et al. , 2012).

Model Case
A nurse who works in the ward at the Mental Hospital who deals with a male patient who gets angry and breaks things. When the nurse examines the patient, the nurse conducts an assessment to find out why the patient often throws tantrums and breaks things by using the stages of the emotional regulation process.

Healing process
In the first stage; The nurse approaches the patient and tries to calm him down with deep breathing techniques and teaches the patient to avoid situations or people that make their emotions arise.
In the second stage; The patient is asked to do activities that aim to modify the situation so that his emotions are distracted, for example, when the patient's emotions arise, the patient is advised to hit the pillow.
In the third phase; When the patient experiences excessive emotions, the nurse must be able to accompany the patient by asking him to talk to change unpleasant situations in order to avoid excessive emotions.
Fourth stage; The nurse must be able to change the patient's mindset to be more positive so that it can reduce the strong influence of emotions, for example, when the patient is emotional, the nurse teaches the patient to get closer to God and tries to accept the problems that trigger emotions in the patient.
In the fifth stage; when the patient is resentful, the nurse teaches the patient to vent their emotions by telling others so that their emotions can be slightly reduced.

Identification of the consequences
After carrying out these five stages, it is hoped that the patient will be able to control his emotions and look happier and be able to realize mistakes that trigger the release of excessive emotions.

Boundary Line
The boundary line, in this case, is that the patient is willing to try to control his emotions by getting closer to God. Then the visible behavior change is that the patient is able to realize mistakes and is willing to carry out activities that aim to divert his emotions.

Empirical references
Empirical references are a way of measuring a concept. Empirical references to emotional control include selfconfidence, emotional self-control, empathy, and leadership. Emotional control ability cannot be assessed objectively (Abuatiq, 2015). Emotional control cannot be considered as a static state (fixed) and each individual may have different levels of ability to control emotions (Foley & Davis, 2017). This is in line with Groos's explanation, which in theory states that the concept of emotional control is related to emotion regulation. Each individual has different emotional regulation abilities depending on individual coping (Gross, 2014).

Conclusions and Recommendations
The basic analysis of the concept of emotional control begins with the clarification of the various definitions of the concept of emotional control. In general, emotional control is the ability of an individual to control or divert negative emotions with positive activities and the individual in living his life in conditions that are comfortable, away from threats, and can adequately meet their basic needs. Individuals who can control their emotions can certainly socialize with society without worrying about the negative stigma from society and the environment. The way to control emotions in schizophrenia patients and pulmonary tuberculosis patients in the Donatus Korbianus study has similarities, namely: can use the emotional control component in the theory of emotional regulation. For future research, I hope other researchers can compare ways of controlling emotions with different health problems and symptoms.