The effect of cognitive behavioral therapy in managing blood-injury-injection phobia (BIIP) in a biomedical laboratory setting

Putri Djamilah Wahidah; Tika Dwi Tama; Dea Aflah Samah; Dewa Bagus Prasetayo; Nailyaa Faza Hendrawan

doi:10.14421/edulab.2025.102.02

Authors

Putri Djamilah Wahidah Universitas Negeri Malang, Indonesia https://orcid.org/0000-0003-3210-0092 (unauthenticated)
Tika Dwi Tama Universitas Negeri Malang, Indonesia https://orcid.org/0000-0003-4963-8243 (unauthenticated)
Dea Aflah Samah Universitas Negeri Malang, Indonesia https://orcid.org/0000-0002-4024-7310 (unauthenticated)
Dewa Bagus Prasetayo Universitas Negeri Malang, Indonesia
Nailyaa Faza Hendrawan Universitas Negeri Malang, Indonesia

DOI:

https://doi.org/10.14421/edulab.2025.102.02

Keywords:

Biomedical laboratory, Blood-Injury- Injection Phobia, Cognitive Behavioral Therapy, Fear

Abstract

Purpose – This study aimed to examine the effect of Cognitive Behavioral Therapy (CBT) in reducing vasovagal responses among individuals with BIIP, as measured by indicators of fear severity, perception, heart rate, and oxygen saturation.

Design/methods/approach – This study employed a pre-experimental design using a one-group pretest–posttest approach with purposive sampling. The sample consisted of 24 undergraduate students enrolled in a public health program. Four variables were examined: fear severity, perception, heart rate, and oxygen saturation. Data were analyzed using univariate analysis through frequency distribution and tabulation. Bivariate analysis was conducted using the Wilcoxon Signed Rank Test to determine the significance of therapeutic outcomes by comparing pretest and posttest results. The Kruskal–Wallis test with post hoc analysis was also applied to identify which CBT sessions were most effective in reducing BIIP-related anxiety symptoms.

Findings – Of the four variables examined, fear severity and perception showed p-values greater than 0.05, indicating non-significant changes following the intervention, although percentage improvements were observed. Heart rate demonstrated a statistically significant effect, with a p-value of 0.028 (< 0.05), indicating a significant improvement, particularly during sessions four and five. In contrast, oxygen saturation yielded a p-value of 0.485, suggesting no statistically significant improvement across sessions one through five.

Research implications/limitations – These findings suggest that CBT may be particularly effective in modulating physiological responses associated with BIIP in educational laboratory settings. However, the absence of a control group, the relatively small sample size, and variability in session attendance limit the generalizability of the results. Future studies employing controlled experimental designs and larger samples are recommended to strengthen causal inferences.

Originality/value – This study contributes original empirical evidence by integrating psychological and physiological indicators to evaluate the effectiveness of CBT for BIIP within a biomedical laboratory context. The findings offer practical insights for implementing CBT-based interventions to enhance student safety and preparedness during laboratory-based blood-related procedures.

References

Adinata, F., Wahidin, M., Nitami, M., Situngkir, D., Putri, E. C., & Utami, D. (2025). Studi deskriptif depresi, kecemasan, dan stres pada pekerja bagian finishing PT X tahun 2025. Jurnal Penelitian Nusantara, 1(9), 104–112. https://doi.org/10.59435/menulis.v1i9.646

Adriani, N. (2016). Analisis manajemen laboratorium kimia SMA negeri di Kota Tanjungpinang guna meningkatkan kompetensi guru dan peserta didik. Jurnal Zarah, 4(1), 1–8. https://doi.org/10.31629/zarah.v4i1.135

Agustini. (2019). Penerapan cognitive behavior therapy untuk mengurangi fobia darah pada usia dewasa awal. Biopsikososial, 89–105.

Apriyanti, A., Dekawaty, A., & Yelisni, I. (2023). Pengaruh cognitive behavior therapy (CBT) terhadap depresi postpartum: Literature review. JIKA: Jurnal Inspirasi Kesehatan, 1(2), 181–194. https://doi.org/10.52523/jika.v1i2.71

Arda, K. N., Akay, S., & Yetkin, S. (2020). Oxygen saturation and MRI-induced anxiety? A prospective study. Clinical Imaging, 60(2), 147–152. https://doi.org/10.1016/j.clinimag.2019.12.005

Gunawan, D. A. P., Natalya, L., & Sutanto, N. (2025). Terapi fobia spesifik sesi tunggal dengan the heart technique. Jurnal Penelitian dan Pengukuran Psikologi, 14(1), 54–67. https://doi.org/10.21009/JPPP.141.06

Health and Safety Executive. (2025). Work-related stress, depression or anxiety statistics in Great Britain, 2025 (March).

Izzah, A., Rusmiyati, & Yuliana, A. T. (2025). Cognitive behavioural therapy in educational settings: Empowering students to overcome concentration challenges through individual counseling. EDUCATIONE: Journal of Education Research and Review, 3(2), 295–304. https://doi.org/10.59397/edu.v3i2.102

Jarvis, C. (2016). Jarvis’s physical examination & health assessment (2nd ed.). Elsevier.

Laboratorium IKM UM. (2024). Survei service excellent Laboratorium IKM UM 2024.

Mason, E. C., Gaston, J. E., Pestell, C. F., & Page, A. C. (2022). A comprehensive group-based cognitive behavioural treatment for blood-injection-injury phobia. British Journal of Clinical Psychology, 61(2), 494–509. https://doi.org/10.1111/bjc.12345

Miloyan, B., & Eaton, W. W. (2016). Blood-injection-injury phobia in older adults. International Psychogeriatrics, 28(6), 897–902. https://doi.org/10.1017/S1041610215002331

Muslim, A., & Arofiati, F. (2019). Efektivitas kombinasi latihan pernapasan dalam dan terapi spiritual terhadap perubahan parameter kardiovaskuler pada pasien hipertensi di Desa Darungan Kabupaten Kediri. Jurnal Keperawatan, 17(1), 30–39. https://doi.org/10.35874/jkp.v17i1.468

Nurhayati, N., Nuliana, L., Subu, L., & Andriyani. (2022). Analisis indeks kepuasan mahasiswa (IKM) praktikan terhadap kualitas penyelenggaraan praktikum di Laboratorium Terpadu Unit Kimia UHO semester genap tahun 2021/2022. SAINS: Jurnal Ilmu Kimia dan Pendidikan Kimia, 11(2), 148–152.

Raharja, E. (2025). Nyeri dalam perspektif keperawatan: Teori, praktik, dan inovasi. PT Adab Indonesia.

Ruiz-García, A., Valero-Aguayo, L., & Hurtado-Melero, F. (2019). Creating a computerized instrument for the assessment of blood-injury-injection phobia. Spanish Journal of Psychology, 22, e44. https://doi.org/10.1017/sjp.2019.38

Sari, D. P., Hariani, Y., & Muhammad, N. (2024). Dampak pengetahuan, sikap, dan masa kerja dengan kejadian kecelakaan kerja di PT X Palembang tahun 2024. Jurnal Kesehatan Terapan, 11(2), 148–155. https://doi.org/10.54816/jk.v11i2.798

Siev, J., Sinex, R. H., Sorid, S. D., & Behar, E. (2024). Anxiety sensitivity and disgust sensitivity predict blood-injection-injury fears in individuals with dental anxiety. Behavioural and Cognitive Psychotherapy, 52(1), 100–104. https://doi.org/10.1017/S1352465823000310

Siregar, E. Y., & Siregar, R. H. (2013). Penerapan cognitive behavior therapy (CBT) terhadap pengurangan durasi bermain games pada individu yang mengalami game addiction. Jurnal Psikologi, 9(1), 17. http://dx.doi.org/10.24014/jp.v9i1.136

Swarjana, I. K. (2022). Konsep pengetahuan, sikap, perilaku, persepsi, stres, kecemasan, nyeri, dukungan sosial, kepatuhan, motivasi, kepuasan, pandemi COVID-19, dan akses layanan kesehatan (R. Indra, Ed.). CV Andi Offset.

Thng, C. E. W., Lim-Ashworth, N. S. J., Poh, B. Z. Q., & Lim, C. G. (2020). Recent developments in the intervention of specific phobia among adults: A rapid review. F1000Research, 9, 20082. https://doi.org/10.12688/f1000research.20082.1

Triviño-Martínez, Á., Carreño-Cutillas, C., Azorín-Maciá, I., Sola-Verdú, J. C., Mira, A., & Soler-Climent, E. (2025). Virtual reality in the management of hematophobia in hospital settings: Impact on anxiety reduction. Virtual Reality, 29(97), 96–97. https://doi.org/10.1007/s10055-025-01178-1

Vergeer-Hagoort, F., Kraiss, J. T., Drossaert, C. H. C., & Bohlmeijer, E. T. (2024). Exploring the benefits and acceptance of blended positive psychotherapy as an adjunctive treatment for clients with residual depressive symptoms: A mixed-method study. Journal of Contemporary Psychotherapy, 54(4), 315–325. https://doi.org/10.1007/s10879-024-09623-z

Wani, A. L., Bhat, S. A., & Ara, A. (2016). Persistence and inheritance of blood injury and injection phobia. Gulhane Medical Journal, 58(1), 67–73. https://doi.org/10.5455/gulhane.172838

Wardani, L. M. I. (Ed.). (2020). Aplikasi psikologi positif: Pendidikan, industri, dan sosial. PT Nasya Expanding Management.

Wilson, A. C., & Gullon-Scott, F. (2024). ‘It’s not always textbook social anxiety’: A survey-based study investigating the nature of social anxiety and experiences of therapy in autistic people. Autism, 28(11), 2923–2936. https://doi.org/10.1177/13623613241251513

Wilson, G. A., Krause, K. L., & Antony, M. M. (2016). Anxiety, panic, and phobias. In Encyclopedia of mental health (2nd ed., Vol. 1, pp. 74–80). Elsevier. https://doi.org/10.1016/B978-0-12-397045-9.00001-X

World Health Organization. (2025). Anxiety disorders. https://www.who.int/news-room/fact-sheets/detail/anxiety-disorders

Wulandari, T., & Wigunantiningsih, A. (2022). Pengaruh aktivitas fisik terhadap saturasi oksigen pada relawan SAR Karanganyar. Jurnal LINK, 18(2), 113–118. https://doi.org/10.31983/link.v18i2.8935