INTRODUCTION
The
Corona Virus Disease (COVID 19) outbreak has threatened the world with
increasing deaths. This virus was identified at the end of December 2019 with
the discovery of many victims in the Wuhan area and quickly spread to all
corners of the world (Tiwari, Abakah, Karikari, & Gil-Alana, 2022). In recent months,
Corona Virus Disease 2019 or COVID-19, has been in the spotlight because of its
rapid and widespread spread in a relatively short time, so people worldwide are
becoming more aware of the transmission of this virus.
The
World Health Organization declared a public health outbreak (International
Emergency) on January 30, 2020, and declared a pandemic country on March 11,
2020. Prevalence of COVID-19 cases on May 17, 2020, reached > 4, 71 million
cases in more than 188 countries and territories, resulting in >315,000
deaths and >1.73 million people have recovered (Santoso, 2021).
In
Indonesia, the number of Corona cases as of May 4, 2020, was 11,587 people, 864
died, and 1,954 cases recovered throughout Indonesia (Damarjati, 2020). Based on reports
from the Task Force for handling COVID-19, data on the update of Corona cases
that occurred in the country on May 25, 2021, the number of confirmed cases was
1,786,187 cases that underwent treatment, as many as 94,486 people, 1,642,074
people recovered, and 1,642,074 people died. 49,627 souls. From the comparison
of these data, it can be concluded that the number of Covid-19 cases continues
to increase rapidly.
The
increase in high morbidity and mortality rates throughout the world, especially
in Indonesia since the outbreak in December 2019, can increase the risk of
exposure to Covid-19 so that the current pandemic can impact everyone's mental
and psychosocial health conditions.
The
increasing number of deaths and difficulties caused by COVID-19 also resulted
in the number of people experiencing fear and anxiety increasing and lasting
for a long time (Sari, Nirmalasari, & Hidayati, 2021).
Respondents
experienced increased fear (79%), anxiety (83%) and depression (38%) during the
COVID-19 pandemic (Croll et al., 2020). The prevalence of
stress was 29.6% (total sample of 9,074 from 5 studies), and anxiety in 17
studies with a sample size of 63,439 was 31.9 %. The prevalence of depression
in 14 studies with a sample size of 44,531 people was 33.7% during the COVID-19
pandemic (Salari et al., 2020).
Anxiety
is a concern due to a perceived threat to health. Health concerns and anxiety
associated with an epidemic or pandemic can have a significant psychological
impact (e.g., stress, intrusive negative thoughts, avoidance). They may be
associated with ineffective or unfavourable preventive behaviour (Jungmann & Witthöft, 2020).
Anxiety
in a pandemic situation can arise in various forms, including fear of death.
This happens because of the number of deaths due to the corona outbreak, which
is increasing daily. Fear of being infected with the coronavirus or infecting
other people. Fear of lack of availability of medicine due to Until now, no
vaccine or antiviral for covid.19 has been found. Worried about losing
work/income; due to restrictions on going out of the house, Large-Scale Social
Restrictions have caused businesses to be empty of buyers, or workplaces are
closed, fear of lack of essential food items due to panic throughout the
community buy groceries until they are scarce market (Jarnawi, 2020).
A
person's anxiety response to a pandemic can vary from person to person. In some
people, the anxiety response can involve temporary physiological reactions such
as a faster heart rate, sweating, abdominal pain, headache, itching and other
symptoms. People can use self-defence (defence mechanism) by increasing
cognitive or motor activity (Vibriyanti, 2020).
After a person begins to feel anxiety, the self-defence system will then
reassess the threat that occurs to him and be accompanied by efforts to
overcome, reduce or eliminate the feeling of being threatened (Vibriyanti, 2020).
Self-defence
mechanisms are unconscious psychological strategies that aim to reduce or
eliminate anxiety arising from conditions/stimuli potentially harmful to life.
Self-defence mechanisms can protect the mind, self or ego from perceived
negative consequences. Self-defence mechanisms can become pathological if used
continuously to lead to maladaptive behaviour that adversely affects a person's
social functioning and physical or mental health (Walker & McCabe, 2021).
To
help people adapt to the anxiety and stress they face during the COVID-19
pandemic, education about various ways to reduce anxiety and stress needs to be
done. Increased knowledge impacts community behaviour in reducing anxiety and
stress during the COVID-19 pandemic (Sari et al., 2021).
Based
on the description of the data above, it is necessary to do community service
by providing "public education about managing anxiety in dealing with the
Covid-19 pandemic in Alue Awe Village, Muara Dua District, Lhokseumawe City in 2021".
METHOD
Community service is conducted
through face-to-face methods/health education, leaflets, and demonstrations.
The initial survey was conducted by distributing questionnaires about the
impact of Covid-19 to measure the level of public knowledge.
A. Data Collection and Analysis
Based on the results of the initial survey in Alue
Awe Village, Muara Dua
District, Lhokseumawe City, the following data were
obtained:
1) Many people do not apply health protocols correctly during
activities outside the home.
2) No health team provides direct education to the public.
3) There have been 9 community members who have been confirmed
positive for COVID-19.
4) Some people say they are afraid of Covid-19.
5) People who are not healthy are afraid to seek treatment at the Cut
Meutia Hospital, a COVID-19 referral hospital in
North Aceh district and Lhokseumawe City.
B. Stages of implementation
This community service method is in
collaboration with village midwives and health cadres. The implementation of
activities is conducted utilising counselling and demonstrations/exercises to
manage anxiety in families and communities in Alue
Awe Village, Muara Dua
District, Lhokseumawe City. The implementation method
is carried out in several stages, namely:
1) Identification stage
At this stage we use the door-to-door, which is to go directly
to several residents' homes to ask and submit questionnaires about their
understanding of the Covid-19 pandemic and managing anxiety in the face of the
COVID-19 pandemic.
2) Implementation
At this stage, we conduct health
education/education about covid-19 and training on managing public anxiety in
the face of the covid-19 pandemic.
3) Evaluation stage
At this stage, we evaluate the counselling and
training that have been carried out:
a) For changes in knowledge, we did it by giving questionnaires about
understanding the Covid-19 pandemic to people who had received training.
b) To evaluate changes in attitudes and behaviour, we carried out a
checklist on changes in people's behaviour in managing anxiety about the
COVID-19 pandemic.
C.
Initial survey results
The results of the initial survey before
educating the public are as follows:
Table 1. Pre Test Results
|
No
|
Description
|
Total
|
Percentage
|
|
A
|
Gender
|
|
|
|
1
|
Male
|
13
|
43,3%
|
|
2
|
Female
|
17
|
56,7%
|
|
B
|
Covid-19 Awareness
|
|
|
|
1
|
Good
|
18
|
60%
|
|
2
|
Moderate
|
8
|
27%
|
|
3
|
Poor
|
4
|
13%
|
|
C
|
Anxiety Level
|
|
|
|
1
|
High
|
7
|
23%
|
|
2
|
Medium
|
14
|
47%
|
|
3
|
Low
|
9
|
30%
|
|
D
|
Ability to
manage anxiety
|
|
|
|
1
|
Good
|
1
|
3%
|
|
2
|
Moderate
|
6
|
20%
|
|
3
|
Poor
|
23
|
77%
|
Based on the table above, we can describe that
community service activities carried out in Alue Awe
Village with an initial survey carried out on Monday and Tuesday, 20-21
September 2021, obtained:
1. There were 30 participants, with details of which male sex was 13
people or 43.3%, and 17 people were female or 56.7%
2. The level of knowledge about Covid-19 in the excellent category is
18 people or 60%, and the level of knowledge in the medium category is 8 people
or 27%. The level of knowledge in the moderate category is 4 people or 13%.
3. The level of anxiety is as follows: 7 people or 23% feel high
anxiety, 14 people or 47% feel moderate anxiety, and 9 people or 30%
4. The level of knowledge about managing anxiety is as follows: those
who claim to be able to manage anxiety with a suitable category of 1 person or
3%, with a moderate category of 6 people or 20% and with a low category are 23
people or 76%.
RESULTS
AND DISCUSSION
A. Results
The results of the evaluation of the implementation of education
to the public regarding the management of public anxiety during the COVID-19
pandemic are as follows:
Table 2.
Post Test Results
|
No
|
Description
|
Total
|
Percentage
|
|
A
|
Gender
|
|
|
|
1
|
Male
|
5
|
25%
|
|
2
|
Female
|
15
|
75%
|
|
B
|
Covid-19 Awareness
|
|
|
|
1
|
Good
|
12
|
60%
|
|
2
|
Moderate
|
8
|
40%
|
|
3
|
Poor
|
0
|
0%
|
|
C
|
Tingkat kecemasan
|
|
|
|
1
|
Tinggi
|
0
|
0%
|
|
2
|
Sedang
|
5
|
25%
|
|
3
|
Rendah
|
15
|
75%
|
|
D
|
Ability to manage
anxiety
|
|
|
|
1
|
Good
|
14
|
23%
|
|
2
|
Moderate
|
6
|
47%
|
|
3
|
Poor
|
0
|
0%
|
Based on
the table above, we can describe that community service activities by providing
education to the community, which were carried out in Menasah
Alue Awe Village on Wednesday, September 22 2021,
obtained: results.
1. The participants who attended were 20 people, with details of 5
men or 25%, and 15 women or 75%.
2. The level of knowledge about Covid-19 in the excellent category is
12 people or 60%, and the level of knowledge in the medium category is 8 people
or 40%.
3. The anxiety levels are as follows: 5 people or 25% still
experience moderate anxiety, and 15 people or 75% experience low-level anxiety.
4.
The knowledge about managing
anxiety is as follows: those who state that they can manage anxiety in a
suitable category are 14 people or 70%, and those who can manage anxiety in a
moderate category are 6 people or 30%.
B. Constraints
Obstacles
encountered during the process of implementing community service in Alue Awe Village include:
1. Availability of time for the team in carrying out the initial
screening to select residents who are willing to participate because the
community service team must find time outside official hours.
2. Availability of time for residents to accompany the team in
filling out questionnaires because most residents are busy with their
activities such as working outside the home for civil servants.
3. It is finding the right time to be able to visit so as not to be
disturbed by residents' work and rest time.
C. Discussion
Against
the disease. Community service activities began by giving a letter of
application for permission to the Alue Awe Village
Head. Then the initial survey was carried out on Monday and Tuesday, September
20-21, 2021, at 16.30 WIB by distributing initial questionnaires to measure
community knowledge about Covid-19 disease and how to manage anxiety.
Furthermore, health education/counselling activities will be conducted on
Wednesday, September 22, 2021, starting at 09.00 WIB. The level of
understanding/knowledge and anxiety management techniques will be evaluated on
the same day at Meunasah Alue
Awe Village.
The
results of the initial activity of 30 people surveyed with male characteristics
13 people and 17 women about the level of knowledge and level of anxiety showed
data on the category of good knowledge level about Covid-19 disease amounted to
18 people (60%), the category of moderate level of knowledge was as many as 18
people. 8 people (27%), and the knowledge category still lacks as many as 4
people (13%).
Meanwhile,
the data on the level of knowledge for managing anxiety are as follows: those
who state that they can manage anxiety in a suitable category of 1 person or
3%, with a moderate category of 6 people or 20% and with a low category of 23
people or 76%.
Anxiety is
an unpleasant emotional response to various kinds of stressors, both explicit
and unidentified, characterised by fear, worry, and feeling of being threatened
(Patimah, Suryani, & Nuraeni, 2015). Among the causes of public anxiety, among others,
is the high infection rate. Some residents have been infected even though they
have not travelled far from the city (Patimah, Suryani, &
Nuraeni, 2015). Health problems
are a big problem for people affected by disasters, significantly increasing
mental health problems. Each type of disaster has its characteristics and is
closely related to the problems it can cause (Keliat, 2018). By knowing the
characteristics of each disaster, we can discover the behaviour that appears
and develop preventive measures and mitigation, including preparing operational
plans when a disaster occurs.
Public anxiety about COVID 19 is
high because people get information from various social media about the high
consequences caused by covid-19, so all people have anxiety about covid-19.
This is to the statement submitted by (Sukadiyanto, 2010)
that stress or anxiety is pressure or feeling that is pressing inside a person
caused by an imbalance between expectations and reality.
Anxiety in a pandemic situation
can arise in various forms, including fear of death. This happens because of
the death rate due to the corona outbreak, which is getting more significant
daily (Jarnawi, 2020). Fear of being
infected with the coronavirus or infecting other people. Fear of the lack of
availability of drugs because until now, a vaccine or antiviral for COVID 19
has not been found. Worried about losing your job/income; Due to restrictions
on going out of the house, Large-Scale Social Restrictions cause businesses to
be empty of buyers, or workplaces that are closed, fear of lack of essential
food items due to the panic of the whole community who buys necessities until
they are scarce in the market. Fear of losing relatives (Jarnawi, 2020).
Next, the data on the level of
anxiety showed that the community showed high anxiety levels among as many as 7
people (23%) and moderate anxiety levels among 14 people (47%). In comparison,
those with low anxiety levels were 9 people (30%). The condition of Covid-19
has been running for almost three years which can cause people to experience
prolonged stress or anxiety; conveyed by (Muslim, 2020)
that stress is an organism's response to adapt to ongoing demands. These
demands can be in the form of things that happen or new things that might
happen but are perceived. Robbins (2001)
also states that stress is a condition that suppresses a person's psychological
state in achieving an opportunity, where to achieve that opportunity, there are
limitations or barriers. Meanwhile, according to Patimah et al. (2015), anxiety is an
unpleasant emotional response to various kinds of stressors, both explicit and
unidentified, characterised by fear, worry, and a feeling of being threatened.
The response to Covid-19 is
ongoing to reduce anxiety levels and understand some of the ways/techniques
that can be done when feeling anxious, especially about Covid-19. The process
is evaluated during public education activities about anxiety management. The
education/ health counselling activity was attended by 20 participants
consisting of 5 men and 15 women. The participants were quite interested in the
material presented and enthusiastic in the question and answer session because
the participants' curiosity level was relatively high. The activity
implementation was also quite conducive because the participants focused and
paid close attention to what was conveyed/explained by the presenters.
The results of the final evaluation after carrying out educational
/ outreach activities with material about covid-19, it was found that there was
an increase in public knowledge with criteria that were well known as many as
12 people (60%), moderate level of knowledge was 8 people (40%), and no one
else did not understand how the management of anxiety against Covid-19.
Suppose the condition of stress or anxiety is not handled
correctly. In that case, there will be a disturbance in one or more body organs
which causes the person concerned to be unable to carry out his job functions
properly (Muslim, 2020). However, suppose
the problem is found a good solution. In that case, the anxiety will be
reduced, and there will be no disturbance. After implementing education to the
community, as the implementation team, we can assess that the implementation
has been successful and that the community feels satisfied with our activities.
After
being evaluated verbally, the people who attended the counselling said they
felt comfortable and no longer felt negative things such as fatigue even though
they were not working (Sukadiyanto, 2010). Appearances that
look like exhausted people indicate fatigue—an indication of stress. Although
not after working hard, stressed individuals look like very, very tired people,
so they are reluctant to do various physical activities.
CONCLUSION
Participants in the
education/health education activity were attended by 20 participants, with the
majority of participants attended by women. At the time of the pre-test or
initial evaluation, it was found that some participants had a moderate level of
anxiety even though their level of knowledge was quite good because some of
them still did not understand how to manage anxiety when they were experiencing
this condition, especially the management of anxiety about Covid-19.
During the educational activity, the participants'
cooperation was excellent and conducive because they paid close attention to
the material explained, and the participants were enthusiastic about asking
questions related to anxiety management techniques. There were a few obstacles
during the activity because some participants could not follow the activity
until it was finished. After all, there was a sudden need.
The implementation of sustainable community service
activities for the future can be carried out in better coordination with
activity participants so that obstacles can be minimised and the implementation
of activities can occur as expected.
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