Iwan Purnawan(1*), Arif Imam Hidayat(2), Sidik Awaludin(3), Galih Noor Alivian(4), Eman Sutrisna(5), Ikit Netra Wirakhmi(6)
(1) Jurusan Keperawatan, Fakultas Ilmu-ilmu Kesehatan, Universitas Jenderal Soedirman
(2) Universitas Jenderal Soedirman
(3) Universitas Jenderal Soedirman
(4) Nursing Departmen Orcid ID : https://orcid.org/0000-0001-5285-9325 Google Scholar URL: https://scholar.google.co.id/citations?user=OzLz1d0AAAAJ&hl=id
(5) Universitas Jenderal Soedirman
(6) Universitas Harapan Bangsa Purwokerto
(*) Corresponding Author
DOI : 10.30604/jika.v8i3.2243


Elevated stress biomarkers, such as cortisol, in response to stress conditions, can impede the healing process, prolong hospitalization, and escalate healthcare costs. This research examines the influence of religious therapy on cortisol levels in Intensive Care Unit (ICU) patients. Employing a true experimental design, 40 ICU patients were randomly assigned to the intervention or control group, comprising 20 participants each. Salivary cortisol samples were collected before and after the intervention and analyzed using the ASSAY method.
The intervention group received religious therapy consisting of 15-minute sessions of listening to Quranic recitations, while the control group received no treatment. Statistical analysis involved an independent t-test to assess mean differences in cortisol level reduction between the two groups. Homogeneity testing confirmed that both groups had similar demographic characteristics regarding gender and age (p > 0.05).
The results showed a significant difference in mean cortisol level reduction between the intervention group (16.3 + 25.3 ng/ml) and the control group (-0.4 + 18.2 ng/ml) (p = 0.021). Additionally, Cohen's d-test indicated a substantial effect size of 0.71, highlighting the notable impact of religious therapy on cortisol level reduction. In conclusion, religious therapy effectively reduced cortisol levels among critically ill patients in the ICU.



Intensive Care Unit; cortisol; critically ill patients; stress; religious therapy


Adisty, N. I., Hutomo, M., & Indramaya, D. M. (2015). Salivary Cortisol Levels Representing Serum Cortisol Levels in Atopic Dermatitis Patients. BIKKK - Berkala Ilmu Kesehatan Kulit Dan Kelamin - Periodical of Dermatology and Venereology, 27(3), 170–175.

Al-Kaheel, A. (2011). Al Qur’an the healing book. Tarbawi Press.

Alivian, G. N., Purnawan, I., & Setiyono, D. (2019). The Effectiveness Of Listening To Murottal And Prayer To Reduce Anxiety In Hemodialysis Patients. Jurnal Keperawatan Sriwijaya, 6(2), 13–17.

Che Wan Mohd Rozali, W. N. A., Ishak, I., Mat Ludin, A. F., Ibrahim, F. W., Abd Warif, N. M., & Che Roos, N. A. (2022). The Impact of Listening to, Reciting, or Memorizing the Quran on Physical and Mental Health of Muslims: Evidence From Systematic Review. International Journal of Public Health, 67(August), 1–10. https://doi.org/10.3389/ijph.2022.1604998

Choi, J. C., & Lee, Y. . (2012). Modulation of pain sensation by stress-related testosterone and cortisol. In Anaesthesia (Vol. 67, Issue 10, pp. 1146–1151). https://doi.org/10.1111/j.1365-2044.2012.07267.x

El Tumi, H., Johnson, M. I., Dantas, P. B. F., Maynard, M. J., & Tashani, O. A. (2017). Age-related changes in pain sensitivity in healthy humans: A systematic review with meta-analysis. European Journal of Pain (United Kingdom), 21(6), 955–964. https://doi.org/10.1002/ejp.1011

Fajar. (2016). Apa itu Mujawwad & Murottal? http://www.ustadzkris.com/index.php/2016/03/23/apa-itu-mujawwad-murottal/

Faradina, A. (2017). Pengaruh Terapi Relaksasi Audio: Murottal Al Quran Terhadap Perubahan Tingkat Stres Pada Pasien di Ruang ICU RS PKU Muhammadiyah Gombong. Stikes Muhammadiyah Gombong.

Forouhari, S., Honarvaran, R., Maasoumi, R., Robati, M., Hash-, I., & Setayesh, Y. (2011). Evaluation of the Auditory Effects of the Sound of Qur’anul Karim on Labor Pain. 1(2), 14–18. https://doi.org/10.5812/quranmed.4978

Ghiasi, A., & Keramat, A. (2018). The Effect of Listening to Holy Quran Recitation on Anxiety : A Systematic Review. Iranian Journal of Nursing and Midwifery Research, 23(6), 411–420. https://doi.org/10.4103/ijnmr.IJNMR

Handayani, R., Fajarsari, D., Asih, D. R. T., & Rohmah, D. N. (2014). Pengaruh Terapi Murottal Al-Quran Untuk Penurunan Nyeri Persalinan dan Kecemasan pada Ibu Bersalin Kala I Fase Aktif. Jurnal Ilmiah Kebidanan, 5(2), 1–15.

Hudiyawati, D., Aji, P. T., Syafriati, A., & Jumaiyah, W. (2022). Pengaruh Murotal Al-Qur ’ an Terhadap Kecemasan Pada Pasien Pre- Percutaneous Coronary Intervention. Jurnal Berita Keperawatan, 15(1), 8–14.

John, Verma, S., & Khanna, S. K. (2010). The Effect of Music Therapy on Salivary Cortisol as a Reliable Marker of Pre-Competition Stress in Shooting Performance. Journal of Exercise Science and Physiotherapy, 6(2), 70–77.

Koenig, H., Koenig, H. G., King, D., & Carson, V. B. (2012). Handbook of religion and health. Oup Usa.

Kyavar, M., Karkhaneh, S., Rohanifar, R., Azarfarin, R., Sadeghpour, A., & Ghadrdoost, B. (2016). Effect of Preferred Music Listening on Pain Reduction in Mechanically Ventilated Patients After Coronary Artery Bypass Graft Surgery. Research in Cardiovascular Medicine, 5(4). https://doi.org/10.5812/cardiovascmed.33769.Research

Maendra, I. K., Munayang, H., Dundu, A. E., & Ekawardani, N. (2014). Prevalensi Tingkat Kecemasan Pada Pasien Infark Miokard Lama di Poliklinik Jantung RSUP Prof. Dr. R.D. Kandou. E-CliniC, 2(3). https://doi.org/10.35790/ecl.2.3.2014.6342

Marofi, M., Abedini, F., Shirazi, M., Badiei, Z., Baghersad, Z., & Nikobakht, F. (2018). Effect of the sound of the holy Quran on the physiological responses and pain caused by blood sampling from the heels of hospitalized neonates at the neonatal intensive care unit. Iranian Journal of Neonatology, 9(3), 57?63. https://doi.org/10.22038/ijn.2018.28102.1376

Mogil, J. S. (2012). Sex differences in pain and pain inhibition: Multiple explanations of a controversial phenomenon. Nature Reviews Neuroscience, 13(12), 859–866. https://doi.org/10.1038/nrn3360

Mulyani, N. S., Purnawan, I., & Upoyo, A. S. (2019). Differences in Effects of Murottal Therapy for 15 Minutes and 25 Minutes on Reduction of Pain Scale in Post-Surgery Cancer Patients. Journal of Bionursing, 1(1), 1–13. https://doi.org/10.1017/CBO9781107415324.004

Nilsson, U. (2014). Caring Music ; music intervention for improved Health Department of Anaesthesia and Intensive Care and Centre for Health Care Sciences.

Oktora, S. P. D., Purnawan, I., & Achiriyati, D. (2016). The Effect Of Murottal Al Qur’an Therapy On Sleep Quality In The Social Rehabilitation Unit Of The Dewanata Cilacap. Jurnal Keperawatan Soedirman, 11(3), 168–173. http://jks.fikes.unsoed.ac.id/index.php/jks/article/view/710/397

Puntillo, Miaskowski, & Summer. (2003). Pain. In: Pathophysiological Phenomena in Nursing: Human Responses to Illness. (Carrieri-Kohlman, Lindsey, & W. CM (eds.); Third Edit). Saunders.

Purnawan, I., Hidayat, A. I., Sutrisna, E., Alivian, G. N., & Wirakhmi, I. N. (2021). Efficacy of Listening to Murattal in Reducing the Pain Experienced by ICU Patients. Jurnal Keperawatan Soedirman, 16(3), 97–100. https://doi.org/10.20884/1.jks.2021.16.3.1567

Purnawan, I., Setiyarini, S., Probosuseno, P., & Widyastuti, Y. (2021). The Effect of the Dreamer Spiritual Therapies on Saliva Cortisol Hormone and Pain Score Patients in the Intensive Care Unit : A True-experimental Study. Macedonian Journal of Medical Sciences, 9, 281–287.

Rianti, D. (2017). Hubungan Antara Kecemasan dan Kadar Kortisol Pada Kejadian Premenstrual Syndrom. Universitas Hasanuddin Makasar.

Ristianingsih, D., Septiwi, C., & Yuniar, I. (2014). An Overview of Nursing Motivation and Actions in Fulfilling Patient Spiritual Needs in the ICU PKU Muhammadiyah. Kesehatan, 10(2), 100–107.

Roelfsema, F., Roelfsema, F., Heemst, D. Van, Iranmanesh, A., & Takahashi, P. (2017). Impact of age, sex and body mass index on cortisol secretion in 143 healthy adults. Endocrine Connection. https://doi.org/10.1530/EC-17-0160

Saniyah, K., & Ekawati, H. (2014). Perbedaan Nyeri Persalinan Pada Kala I Fase Akif Sebelum dan Sesudah Mendengarkan Ayat Suci Al Quran. 03(xix).

Shafiei, Salari, & Sharifi. (2011). Comparison of listening to the Quran Arabic recitation and Arabic recitation along with Persian translation on decreasing patients ’ anxiety and vital signs stability before anaesthesia induction. Quarterly of Quran & Medicine, 1(1).

Shekah, M. S., Hassan, A. O., & Othman, S. A. (2013). Effects of Quran Listening and Music on Electroencephalogram Brain Waves. J. Exp. Biol, 9(1), 1–7. http://www.egyseb.org

Sussex, R. (2015). How different cultures experience and talk about pain. The Conversation. https://theconversation.com/how-different-cultures-experience-and-talk-about-pain-49046

Urden, L. D., Stacy, K. M., & Lough, M. E. (2014). Critical Care Nursing : Diagnosis and Management (7th ed.). Mosby.

Wahida, S., Nooryanto, M., & Andarini, S. (2015). Al Qur’an Surah Arrahman Recital Therapy Increases ?-Endorphin Levels and Reduces Childbirth Pain. Jurnal Kedokteran Brawijaya, 28(3), 213–216.

Wirakhmi, I. N., Novitasari, D., Purnawan, I., & Kunci, K. (2018). Pengaruh Stimulasi Titik Akupresur Liv 3 ( Taichong ) Terhadap Nyeri Pada Pasien Hipertensi The Influence of Stimulation Point Acupressure Liv 3 ( Taichong ) on Pain in Hypertension Patients. 16(1).

Wirakhmi, I. N., Purnawan, I., & Utami, T. (2021). Hipertensi Effect of Therapy Classic Music Mozart and Murotal Ar Rahman on Decreasing Systolic Blood Pressure in Women Hypertension. Jurnal Kebidanan Dan Keperawatan Aisyiyah, 16(2), 274–282. https://doi.org/10.31101/jkk.1626

Wirakhmi, I. N., Utami, T., & Purnawan, I. (2018). Comparison of Listening to Mozart Music With Murotal Al Quran On The Pain Of Hypertension Patients. Jurnal Keperawatan Soedirman, 13(3), 100–106. https://doi.org/10.20884/1.jks.2018.13.3.813

Yadak, M., Ansari, K. A., Qutub, H., Al-Otaibi, H., Al-Omar, O., Al-Onizi, N., & Farooqi, F. A. (2017). The Effect of Listening to Holy Quran Recitation on Weaning Patients Receiving Mechanical Ventilation in the Intensive Care Unit: A Pilot Study. Journal of Religion and Health, 1–10. https://doi.org/10.1007/s10943-017-0500-3

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