Mental health is a condition of prosperity when someone is able to realize the potential that is owned, productive and able to contribute to society.¹ Soul problems are one of the four major health problems in developed and modern countries. The four main health problems are degenerative diseases, cancer, mental disorders and accidents. Mental illness does not cause death directly, but the disorder is invalidated both individually andgroups are unproductive and efficient and thus hinder development.

People with mental health problems in the world are 450 million people, currently around 10% of adults experience mental health problems and an estimated 25% of the population will experience mental disorders at a certain age during their lifetime, according to the World Health Organization (WHO). The age of young adults between 18 and 21 years is a very wide age. According to the National Institute of Mental Health mental health disorders will reach 13% of the overall disease and are expected to develop to 25% in 2030 [2, 3].

Indonesia 90% of schizophrenic patient groups occupy all mental hospitals [3]. In Indonesia the prevalence of severe mental disorders is schizophrenia 1.7 per 1000 residents or around 400.000 people [4].

Central Java Province the number of cases of mental disorders each year increased, in 2013 there were 121.962 people, in 2014 it increased to 260.247 people and in 2015, it increased to 317.504 people [5].

Medical record data of the Regional Mental Hospital Dr. Amino Gondohutomo, Central Java Province, from January to December 2017, residual type schizophrenia was 7.081 patients with details of 4.126 patients, 2.950 female patients, 1 female patient and 4 sufferers. Factors affecting the amount of outpatient care are more than hospitalizations, first the patient's rudeness and family support about the importance of regular and second-line therapy Dr. RSJD Amino Gondohutomo is a "Central Mental Hospital" in Central Java Province.

A maladaptive response characterized by a psychotic reaction that affects the thoughts, feelings, perceptions, behaviors and social relationships of individuals is a symptom of schizophrenia. This maladaptive response is easily recognized by the symptoms shown by respondents with schizophrenia [3]. Skyszophrenia is a mental disorder that must be handled appropriately and correctly. Lack of family knowledge about schizophrenia, can cause the wrong understanding on the part of the family and the surrounding environment, causing healing of family members suffering from schizophrenia last longer. This problem can cause confusion for families looking for appropriate health services for the treatment of schizophrenia [2].

Relationship to low self-esteem with schizophrenia. Schizophrenia is a disease that affects the brain as a form of functional psychosis, with symptoms of the disorder; thoughts, perceptions, emotions, movements, strange behavior and disharmony or personal rifts. Symptoms of low self-esteem; prolonged feelings of worthlessness, insignificance, and inferiority, withdrawing from the social environment and these symptoms are common in residual type schizophrenia. Patients who experience low self-esteem are the effects of suffering schizophrenia. In the nursing process nurses need to apply nursing care to patients. In Indonesia, mental nursing therapy is used more using the psychotherapy approach, but over the times and the increasing number of people needing health services, a therapeutic technique is developed known as complementary therapy. Complementary therapies provide healing techniques that are relatively fast, easy and not at high risk.

Gary Craig in the mid-1990s developed Emotional Freedom Technique (EFT), namelya form of complementary therapy which is one variant of the new branch of psychology called Energy Psychology, in which the technique combines psychotherapy and acupuncture techniques with methods tapping on several parts of the body to improve the body's energy system which affects the state of mind, emotions and behavior.⁶ Complementary alternative therapies themselves are a group of various systems of medicine and health care, practices and products that are generally not part of conventional medicine [7].

Nursing interventions use Emotional Freedom Technique (EFT) has been done by several researchers to overcome psychological problems and physical problems. Examples of therapy for psychological problems; therapy EFT increases the self-esteem of female prisoners with the results of the value (p = 0.000) and Effect Size = 0.3.⁶ therapy EFT decreases the anxiety of students facing national final exams and the results show p= 0.000 and Effect Size = 0.4 [8].

Efforts have been made to address the problem of schizophrenic patients; Group Attention Therapy (TAK), Cognitive Therapy, Cognitive Behavior Therapy (CBT), other generalist therapies,have not been able to overcome the problem of low self-esteem, caused by many factors; individuals, families, the environment and many others. Skiszofrenia does not cause death directly, but individuals who experience it cannot contribute to their families, communities, nations and countries because they are not productive and efficient.

Music therapy is part of complementary therapy. Therapy Music is the skill of using music or musical elements by a therapist to improve, maintain and restore mental, physical, emotional and spiritual health. The type of music used in music therapy can be adapted to the wishes, such as classical music, mentality, slow music, and orchestras. Soft and regular music therapy such as intrumental and classical music is often used music [9].

Music and self-esteem are very closely related, according to a number of music studies can help individuals to be confident because music increases individual autonomy. The choice of instruments and musical genres indicates that individuals are confident and able to interact with others who can increase their confidence [10]. Until now there has been no research on merging therapyMusicandEFT Therapyto improve the self-esteem of residual schizophrenia patients with low self-esteem nursing problems in mental hospitals.

Based on the description above, the importance of making a new innovation about EFT TherapyPlus Musicto improve the self-esteem of schizophrenic patients with nursing problems of low self-esteem in the RSJD Dr. Amino Gondohutomo, Central Java Province.

The type of this study used research Quasy-Experimental with the design of the Pretest-Posttest Control Group Design. The researchers compiled two groups, namely the intervention group and the control group. Observing the behavior of patients using MRPKD was done twice namely before the treatment (pretest) and after treatment (posttest).

The population in this study were all residual type schizophrenia respondents with an indication of low self-esteem in the Dr.Amino Gondohutomo RSJD treatment room in Central Java Province. Determination of the minimum number of samples using techniques non sampling probability with purposive sampling method and based on inclusion and exclusion criteria were 32 respondents divided into 2 groups with each of 16 female patients in the control group and 16 male patients in the intervention group. In this study researchers conducted data collection by observing, identifying, interviewing and filling out the questionnaire. The collected data was analyzed through the IBM SPSS program version 21.0, and continued with a different test, namely the non-parametric (test Wilcoxon and TestWithney Mann Test). The processed data is used as the basis for discussing problem statements, which are then presented in table form so conclusions can be drawn.

Table 1 Frequency distribution of the intervention group and control group based on demographic characteristics (n = 50)

Based on table 1 above, the description of the characteristics of respondents is as follows: Age group, Education, employment and marital status are equal, if the carried out the levene test is value (p value > 0.05) on each respondent's characteristics is done.

Table 2 Overview esteem respondents schizophrenia before and after treatment

Table 2 above shows a picture of the value of self-esteem measured using a questionnaire Modified Self-Confidence Assessment Rubric (MRPKD) During the 7 days of treatment both in the control group and the treatment group experienced an increase in scores, respondents felt less confident to be respondents in confidence. In the treatment group, the score increased more than the control group.

The results of the table analysis above the effectiveness of EFT Plus Music increase the self-esteem of schizophrenic respondents based on data analysis and interpretation: Significant EFT Plus Music and TAK. Treatment group results of the pre test shows mean = 17.31, SD = 1.014, in the control group the mean = 16.62, SD = 1.258. The results of the pres test showed that both groups had scores of lack of confidence. After post test in the treatment group the results showed mean = 28.62, SD = 1.025, in the control group the results showed mean = 24.38, SD = 4.015. This means that there is a difference between the treatment groups who received EFT Plus Music therapy and the control group that received TAK. It can be concluded that the treatment group that received Emotional Freedom Technique (EFT) plus music therapy with self-confidence increased more than the control group that received TAK. The results of the analysis and interpretation of data on the different test pairs using the Man Whitney test obtained p = 0.001 with Effect Size = 1.1 (very strong category), significant Emotional Freedom Technique (EFT) therapy Music Plus increased the self-esteem of schizophrenic respondents. Thus the hypothesis (Ho) is accepted.

Comparison of Emotional Freedom Technique (EFT) plus Music and TAK therapy. The results of the analysis and interpretation of the data showed EFT Plus Music and TAK therapy increased the self-esteem of residual schizophrenia patients but EFT Plus Music therapy significantly increased the self-esteem of residual schizophrenia compared to TAK. This is evidenced by EFT Plus Music therapy, p = 0.001 and Effect Size = 1.1 (very strong), NO p = 0.001 and Effect Size = 0.2 (very weak), meaning EFT Plus Music therapy is more effective at increasing self-esteem schizophrenic respondents compared to TAK.

Comparison of Research Results with Previous Research. AfterTherapy Emotional Freedom Technique (EFT) Plus music for 7 days in 16 patients obtained mean pre test = 17.31, SD = 1.014, mean post test = 28.62, SD = 1.025 indicating thattherapy EFT Music Plus increases the self-esteem of schizophrenic patients treated at the Irawan Room and the Gatot Koco Room at the Regional Mental Hospital Dr. Amino Gondohutomo, Central Java Province. The results of the analysis, interpretation of the data, different pairs of tests using the Man Whitney Test obtained p = 0.001 with Effect Size = 1.1 (very strong category), significant EFT Plus Music Therapy increased self-esteem.

Based on the comparison of the results of current research and previous research. Research now, the results of analysis and interpretation of data on different test pairs using man whitney test obtained p = 0.001 with Effect Size = 1.1 (very strong category), significant EFT Plus Music Therapy increased self-esteem of schizophrenic respondents in RSJD Dr. Amino Gondohutomo, Central Java Province. These results are in accordance with Mubin's study (2009), from the analysis and interpretation of the data, the mean pre test = 3.043, SD = 0.4259, mean post test = 7.871, SD = 0.3231 with p = 0.001, and Effect Size = 1,2 (very strong category), meaning significant cognitive therapy increases the self-esteem of 11 patients in RW 09, 11 and 13 in Bubulak Bogor. Current research with research conducted by Widowati, (2010), namely TAK, there are differences. The present research is Effect Size = 1.1 (very strong category), while TAK is Effect Size = 0.4 (weak / medium category).

Relationship to schizophrenia with low self-esteem and EFT Plus Music therapy. Schizophrenia is a disease that affects the brain as a form of functional psychosis, with symptoms of the disorder; thoughts, perceptions, emotions, movements, strange behavior and disharmony or personal rifts.

Low self-esteem. Symptoms of low self-esteem; prolonged feelings of worthlessness, insignificance, and inferiority, withdrawing from the social environment and these symptoms are common in residual type schizophrenia. Patients who experience low self-esteem are the effects of suffering schizophrenia. The nursing process, nurses apply nursing care to respondents using EFT Plus Music Therapy.

Emotional Freedom Technique (EFT) Plus Music Therapy. EFT therapy uses tapping on certain meridian points in the respondent's body with the aim of balancing the body's energy system, correcting the negative symptoms found in schizophrenia and low self-esteem. Religious instrumental music is given along with EFT Therapy. Music therapy can improve, maintain and restore biological, mental, emotional and spiritual health.

Energy flow that obstructs obstruction at several key points in the human body caused by past trauma, is tapped lightly using two fingertips (index finger and middle finger) in parts certain body. The body meridian points tapping are; point on the surface of the eyebrow, the point above the bone next to the eye, point 2 cm below the eyelid,the point just below the nose, the point between the chin and the bottom of the lip, the point at the end where the breast bone meets, the first rib and the point on the little finger on the outside of the lower part of the nail.After tapping the disruption of energy flow that is clogged at several key points on the body to function again so that the body's energy flows smoothly and the emotional regulating center becomes normal, the patient experiences self-confidence.

Based on objectives, hypotheses, results, and discussion: