Effectiveness of creative Javanese Wayang Media in enhancing spirituality among HIV/AIDS patients in Surakarta

Abstract

Introduction: People living with HIV/AIDS (PLWHA) frequently experience spiritual distress, including guilt, loss of meaning, and diminished hope, which can undermine holistic well-being. Culturally grounded media such as Javanese wayang (shadow puppetry) may facilitate meaning-making and connectedness, thereby supporting spiritual well-being.Objectives: This study evaluated the effectiveness of a creative Javanese wayang intervention in enhancing spiritual well-being among PLWHA in Surakarta.Methods: A pre-experimental one-group pretest–posttest design was employed with 44 purposively sampled participants. Spiritual well-being was measured using the Spiritual Well-Being Scale (SWBS). The Shapiro–Wilk test was used to assess normality. Based on distributional results, either paired t-tests or Wilcoxon signed-rank tests were conducted to compare pre- and post-intervention scores (two-tailed, α = .05).Results: Mean scores on the Spiritual Well-Being Scale (SWBS) increased from 73.32 before the intervention to 76.36 after the intervention, representing a change (Δ) of 3.04 points. This difference was statistically significant (p = .001). The specific statistical test used and effect size measures, including Cohen’s d and a 95% confidence interval, are provided in the full text.Conclusions: A brief, culturally sensitive Javanese wayang intervention was associated with improved spiritual well-being among PLWHA in this pre–post study. Wayang-based storytelling may serve as a feasible adjunct to spiritual care in nursing practice. However, due to the absence of a control group and the use of purposive sampling, controlled or randomized studies with extended follow-up and detailed fidelity assessments are necessary to confirm effectiveness and generalizability.