Syntax Literate: Jurnal Ilmiah Indonesia p�ISSN: 2541-0849

e-ISSN: 2548-1398

Vol. 6, No. 12, Desember 2021

 

SUPPORT OF MENTAL HEALTH AND PSYCHOSOCIAL ON BODY RESISTANCE IN COMORBID PATIENTS IN THE TIME OF COVID-19

 

Wien Soelistyo Adi, Ramelan, Sugih Wijayanti, Sri Endang Windiarti

Politeknik Kesehatan Kemenkes Semarang, Indonesia

Email: [email protected], [email protected], [email protected], [email protected]

 

Abstract

People infected with COVID 19 if there are comorbidities in the patient's body can increase the risk status of these patients, such as hypertension, diabetes, and other diseases. Other lung conditions, such as tuberculosis, pneumonia and others. These diseases are often called comorbid diseases. Patients who are positively infected with Covid-19 can have severe and incriminating symptoms if they have these comorbidities or comorbidities. This study aims to increase the patient's psychological resilience to reduce more severe symptoms and speed up recovery. This research will be conducted with a quasi-experimental design with pretest and posttest designs, conducted in the Banyumanik sub-district in patients with comorbid COVID-19. Comorbid Covid 19 patients in sub- Banyumanik District. Ethical Clearance. The results of the T-test analysis of the effect of mental health support on body resistance before and after the action on comorbid patients during the COVID-19 pandemic showed a significant difference between before and after treatment with a p-value of 0.018, meaning that health support had a significant effect. The application of mental health support is proven to affect body resistance with operational standards of mental health support which include physical relaxation, positive emotions, positive behaviour, positive relationships, positive spirituality. Future research is expected to support mental health effects on body resistance physiologically so that there are better-known benefits.

 

Keywords:�� mental health support; psychosocial; immune; comorbid; covid 19

 

Introduction

Coronaviruses are a large family of viruses that cause disease in humans and animals. It usually causes respiratory tract infections in humans, ranging from the common cold to severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). A new type of Coronavirus found in humans since an extraordinary event appeared in Wuhan, China, in December 2019, was later named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV 2), and caused Coronavirus Disease-2019 (COVID-19).

COVID-19 is caused by SARS-COV 2, which belongs to the same large family of coronaviruses that caused SARS in 2003, only with a different virus type. The symptoms are similar to SARS, but the death rate for SARS (9.6%) is higher than for COVID-19 (less than 5%), although the number of cases of COVID-19 is much higher than that of SARS. COVID-19 also has a broader and faster spread to several countries than SARS.

It should be noted, until now, that there has been no research that specifically describes the steps for treating patients with Covid-19 infection, so the treatment given is more for an effort to relieve symptoms and efforts to boost the patient's immune system. So far, we have only heard the news of positive Covid-19 patients and a significant death toll. It should be remembered that the high risk of death from Covid-19 infection generally affects those who have comorbidities, especially those related to the immune system and respiratory problems.

The body's immunity must be appropriately maintained not to be susceptible to disease. A sound immune system or immune system can protect us from the first time the germs that cause disease enter the body. Therefore, having a solid immune system is very important to prevent us from falling ill, especially during the current outbreak of the Coronavirus.

One way to increase the body's power above is to reduce stress. Stress is a form of normal psychological reaction that occurs when there is an increase in the burden of life, such as workload. In general, stress is a mental disorder faced by a person due to pressure that comes from within himself or from outside or other people. Stress arises to warn ourselves that the brain is experiencing excessive pressure. Due to the COVID-19 pandemic, many people are experiencing stress. The number of people who hear scary news, such as the viciousness of the virus, is highly contagious, the death rate is high, and the period of illness is only about a week, which makes people feel tense. The news that preaches for people who have other or degenerative diseases such as hypertension, DM, Kidney Heart, the elderly and children, etc., will accelerate and worsen the condition. Many people with other illnesses are confused about staying healthy, strong, and happy.

The general purpose of this study was to determine the effect of mental health support on comorbid Covid 19 to increase body resistance.

 

Methode

This research will be conducted with a quasi-experimental approach with treatments, outcome measures, and experimental units but does not use random placement. Quasi-experimental research aims to explain relationships, clarify the causes of an event, or both. Research design with pretest and posttest designs. Of the many actual experimental designs, the pretest-posttest design is the preferred method for comparing groups of participants and measuring the degree of change resulting from the treatment. This research was conducted in the Banyumanik sub-district for patients with comorbid covid 19. The population of this study was patients with comorbid covid 19 in the sub- Banyumanikdistrict.� Samples were taken by sampling with technique, purposive sampling with 30 respondents comorbid patients. The variables in this study consist of the variable independent (independent variable) mental health and psychosocial support (dependent variable) is the immune system of patients with comorbid covid 19. The analysis used is using a different test for independent samples or often referred to as compare mean, pear sample t-test. The difference between the two is in the number of sample groups or sample groups.�

 

Result and Discussions

The results of implementing mental health and psychosocial support for comorbid patients during the COVID-19 pandemic show that several variables have a significant influence. However, some do not, due to different levels of public acceptance. The results of analysis statistics with SPSS show as follows:

A.    Univariate Analysis Results

1.      Characteristics of� Respondents

The analysis results show that the element majority is aged 20-45 years, as much as 60%, the majority of education is high school as much as 73.3%. In contrast, the work majority work by 83.3% and have comorbid hypertension by 40%. The results of the complete analysis can be seen in Table 1 as follows:

Table 1

Percentage Characteristics of Respondents with Comorbidities

in Banyumanik District Semarang

Variable

category

n

%

age

20 - 45 years

8

60.0

46 - 55 years

9

30.0

55 < yr

3

100

education

Junior high school

8

26.7

Senior high school

2

73.3

Work

Work

5

83.3

Not working

5

16.7

Comorbid

DM

6

20

Hypertension

2

40

Kidney

3

10

Heart

2

6.67

Etc.

7

23.33

 

2.      Knowledge, attitude, self-efficacy, family role, assistance Pre and Post Treatment.

Distribution analysis results in Frequency the variables before and after treatment showed that: good knowledge increased from 43.3% to 83.3%, agreed attitudes increased from 40% to 60%, self-efficacy was able from 43.3% to 73.3%, the family role was supportive from 46, 7% to 76.7%, and good body resistance from 60% to 86.7%. The percentage of variables before and after the intervention is in table 2 as follows:

 

 

 

Table 2

The Percentage Of Variables Before And After The Intervention Is Carried Out On Respondents In The Banyumanik District Of Semarang

Variable

Category

Pre

Post

 

%

 

%

Knowledge

less

7

6.7

5

6.7

 

Good

3

3.3

5

3.3

Attitude

Disagree

8

0.0

2

0.0

 

Agree

2

0.0

8

0.0

Self Efficacy

Disadvantaged

7

6.7

8

6.7

 

Able

3

3.3

2

3.3

Role of Families

Do Not Support

6

3.3

7

3.3

 

Support

4

6.7

3

6.7

body resistance

Poor

2

0.0

4

3.3

 

Good

8

0.0

6

6.7

 

B.     Bivariate Analysis Results

The results of the analysis using the paired T-test that shows existence the significance of the difference becomes further increased in some variables, namely the variable knowledge with a significance of p 0.001, the role of the family with a significance of p 0.10 and body resistance with a significance of p 0.018 which means a very significant increase. The complete list of analysis results is in table 5.3 as follows:

 

Table 3

The results of the analysis of the paired T-test before and after treatment

 

Mean

Std. Deviation

Std. Error Mean

95% Confidence Interval of the Difference

t

df

Sig. (2-tiled)

lower

upper

Knowledge Pre - Post

0,563 0,103 -0,610 -0,190 -3,890

 

 

 

 

-0,40

29

0,001

Attitudes Pre - Post

0,664 0,121 -0,448 0,048 -1,649

 

 

 

 

-0,20

9

0.110

Pre-Post Self Efficacy

0.000

0.695

0.127

-0.259

0.259

000

9

1,000

 

Pre-Post Family Role

-0.300

0.596

0.109

-0.523

-0.077

7

9

0.010

 

Pre-Post body resistance

-0.267

0.583

0.106

-0.484

-0.049

504

9

0.018

 

 

C.    Discussion

The Discussion in this study will be adjusted to the results the of implementation of interventions given to respondents, namely comorbid patients during the covid 19 pandemic. Comorbid or comorbid diseases themselves are other health problems that a person had before his body was infected with the Coronavirus. This disease will make the COVID-19 experienced by sufferers worse because of a weak immune system, primarily if professionals do not handle it (Mujiburrahman et al., 2020).

A person with comorbidities or comorbidities may have weaker immunity and other problems depending on their condition. Comorbidities can include high blood pressure, diabetes, heart disease, respiratory disease, autoimmune disorders, and many more. A person with comorbidities has a higher risk of experiencing severe symptoms and complications from Covid-19. When they have been exposed to Covid-19, the cycle of transmission of the virus can develop rapidly and severely. Covid-19 risk factors such as previous lung disease and other comorbidities should be monitored and treated promptly to avoid severe complications in the future. Patients with comorbidities should take precautions because they may have a poor prognosis. It is essential to take proper precautions and be most careful to avoid contracting the virus.

  1. Before and after, mental health support was carried out, including physical relaxation, positive emotions, positive behaviour, and positive relationships and spirituality.�

Knowledge is a result of curiosity through sensory processes, especially in the eyes and ears of particular objects. Knowledge is essential in forming open behavior (Donsu, 2017). Knowledge or knowledge is the result of human sensing or someone knowing about an object through the senses he has. The five human senses for sensing objects are sight, hearing, smell, taste and touch. The time of sensing to produce knowledge is influenced by the intensity of attention and perception of the object. A person's knowledge is mainly obtained through the sense of hearing and the sense of sight (Notoadmodjo, 2014).

Knowledge is influenced by factors of formal education and is very closely related. It is hoped that the knowledge will be more comprehensive with higher education. However, people with low education are not necessarily low-knowledge either. Increased knowledge is not obtained from formal education but can also be obtained from non-formal education. Knowledge of an object contains two aspects, namely, positive aspects and negative aspects. These two aspects will determine a person's attitude. The more positive aspects and objects that are known will lead to a more positive attitude towards particular objects (Notoadmodjo, 2014).

The education level of the respondents is the majority of high school graduates, namely 73.3%, and it should be easier to accept the input obtained, especially if receiving health education. The results showed that assisting for two weeks showed a significant effect with a p-value of 0.001, meaning that the assistance provided was acceptable to the respondent.

Education is the guidance given by someone to develop others towards specific dreams or ideals that determine human beings to act and fill life to achieve safety and happiness. Education is needed to get information to inform them of things that support health to improve the quality of life. According to YB Mantra, quoted by Notoatmodjo, education can affect a person, including behaviour regarding lifestyle, especially in motivating attitudes to participate in development in general. The higher a person's education, the easier it is to receive information.

Attitude is a reaction or response of a person who is still close to a stimulus or object. Newcomb, a social psychologist, stated that attitude is a readiness or willingness to act and is not an implementer of certain motives. The attitude process stages are as follows: accept, which means that people (subjects) want and pay attention to the given stimulus (object). Giving answers when asked, doing and completing the given task indicates attitude. Because with an effort to answer questions or do a given task, whether the job is right or wrong, people accept the idea. Inviting others to work on or discuss with others a problem is an indication of a third-level attitude. Taking responsibility for everything he has chosen with all risks is the highest attitude. The analysis results still do not show a significant effect because the p-value is 0.11. This can happen because it is still too short, so that the process of forming the brush is not perfect.

Self-efficacy is defined as the belief that a person can successfully execute the behaviours necessary to produce results (Glanz et al., 2008). Outcome expectations refer to perceptions of the likely consequences of one's actions, self-efficacy expectations refer to control of personal or agency actions. A person who believes that he can cause an event can also lead a more active life at his beat down (Schwarzer, 2014). Self-confidence is courage in facing challenges, organizing and carrying out actions to deal with certain situations, and individual belief in doing something desired. A person's belief in his ability to complete something successfully. When an individual has high self-efficacy, he believes he can do something. The famous Canadian psychologist named Professor Albert Bandura introduced this concept in 1977.

Healthy self-efficacy beliefs will help a person not easily succumb to negative emotions due to failure or disappointment. On the contrary, people with good self-efficacy can rise from failure. There is a belief that it is time to rise further when you fail. The results of this study indicate that self-efficacy is not significant with a p-value of 1,000, meaning that mental health support has not yet affected self-efficacy in respondents. This happens because, as with attitude, it is not as easy as turning the hand. There needs to be a process to believe that the respondent can act.

Emotions, moods, and physical conditions also influence a person's assessment of his or her self-efficacy. Still, according to Bandura, it is more challenging to feel confident in your abilities if you are in a bad mood or there are things you are worried about. Even if it gets worse, mood bad can hinder the emergence of self-efficacy and the ability to achieve targets. No wonder people with bad moods are more accessible to give up on than achieving their targets and are reluctant to try further. Of course, this is not easy, considering that mood swings can happen at any time. It takes the ability to turn a negative understanding into a positive one. Thus, pessimism about achieving targets can be much reduced (Triviana, 2020).

The results of this study indicate that the role of the family in comorbidities during the COVID-19 pandemic has a significant effect after mental health assistance is carried out with a p-value of 0.010. The role of the family This study is in line with the results of research from (Efendi & Larasati, 2017), which emphasizes that the health function of the family has an essential role in managing the health conditions of family members, especially those experiencing health problems. The influence of the family can be summarized in the extent to which it can carry out the primary family support system, financial balance, health control, and wellbeing, which is a subcategory of the influence of the family on the health problems it faces.

Families who are respondents in this study provide a discourse on how maintaining family health has been carried out, especially during the current covid19 pandemic. The family, which is the central and first pillar of health for other family members, determines the level of health quality. During the COVID-19 pandemic, families need to maintain their health and their families, especially members vulnerable to disease conditions, one of which is the elderly. With a family function that runs family health care during a pandemic covid 19 conditions and health status of members will be maintained because the point in health management will be focused and particularly to members of the vulnerable such as the elderly age.

Families must be more optimal in maintaining and maintaining the health of all family members, where all members must be mutually aware and integrated to create a strong family in dealing with all existing health problems. Every family member should have a sense of caring for each other in various ways according to their portion and role, respectively. With this, the balance will be maintained. Because with awareness, every family member is responsible for maintaining their health and other family members comprehensively, including Bio-Psycho-Social-Spiritual (Lubis, 2020).

As is the case with similar research conducted by (Ashidiqie, 2020) explains that families also have roles and functions that can be done to fight and prevent the spread of the Covid-19 outbreak. By carrying out the role and function of the family, which is a national gotong royong movement between the community and the government to eradicate, fight and break the chain of distribution of Covid-19 so that the Indonesian nation can defeat the epidemic and return to normal. In addition, a study from (Abidin, 2019) explained that the health care function has a positive impact/effect on the management of family health. Families have an integrated portion and function capacity to take care of each other's health in their family environment.

The immune system or the immune system has a very central function in the human body's defence. Without an immune system, the body will be vulnerable to attack by germs, parasites, or viruses. The immune system also plays a role in fighting various types of pathogens so that your body remains in a healthy condition. Every individual has a different immune system. However, generally, the immune system will get stronger as humans age. Because the more often your body is exposed to various types of pathogens, the immune system in the body will automatically develop. The immune system itself spreads throughout the body and involves many cells, organs, proteins, and tissues. This system can distinguish the existing tissue in our body and foreign tissue. That way, dead cells or other foreign elements that are not recognized will be automatically cleared from the body (Adi Wikanto, 2020).

Not many people are aware of the signs when the immune system weakens. I realized too late that a weakened immune system can worsen health conditions. Conversely, if you first realize that your immune system is not sound, you can take preventive measures to prevent the threat of disease that may arise. If you experience one or more of the symptoms below, your immune system may be starting to weaken. Start paying attention to health with lots of rest and maintain the nutrients or nutrients that enter the body. According to the American Psychological Association, one of the causes of a weakened immune system. Long-term stress can interfere with a person's immunity. Being easily depressed and gradually in the long term is one sign of weakening a person's immunity (19, 2020).

Stress has a significant effect on the immune system. If a person experiences chronic stress for an extended period, cortisol levels in the body will decrease and decrease the production of 'good' prostaglandins. Prostaglandins are local hormones that carry cellular messages to support immune system function. If the production of this compound is reduced, the immune system will automatically weaken. The results of this study showed that there was a significant effect after mental health support was carried out on increasing body resistance with a p-value of 0.018.

Managing stress is also essential. Because stress affects the body's immunity, the body will release hormones to relieve stress when a person is stressed. However, this condition has the effect of lowering the immune system. Therefore, he appealed to the public not to get stressed quickly in the face of this uncertain situation during the Covid-19 pandemic.

Doing physical activity such as exercising is also essential to maintain immunity. Exercise should be done for 30 minutes at least three times a week with moderate intensity. Exercising will help improve immunity and maintain physical strength.

Adding supplements is also recommended if you feel that your daily diet has not fulfilled your vitamin needs. Meanwhile, the consumption of immunostimulants may be given to those who need to increase their immune system. For example, people with excessive physical activity are forced to work outside the home or people with weak immune systems, such as people with comorbidities.

  1. The application of mental health support affects the body's resistance.

There are various ways to increase endurance during a pandemic. In order for your body's immunity to be vital to fighting germs that cause disease, including the Coronavirus, all these methods need to be done consistently and cannot just rely on one way. The pandemic situation COVID-19 has made many people stressed, panicked, and worried excessively careful. This can affect immunity and make the body more susceptible to disease.

Moreover, the Coronavirus's development mutates and produces new variants, such as the Alpha, Beta, Gamma, variant delta, Lambda, and Kappa. Some of these variants are more contagious and can cause more severe symptoms. Therefore, the public is advised to be more vigilant. In addition to implementing health protocols, you also need to increase your immune system so you can ward off Coronavirus infection.

DKPS in this study applied several techniques, namely: physical relaxation, positive emotions, positive thoughts, positive behaviour, positive relationships and spirituality.

PHYSICAL RELAXATION EXERCISE: take a comfortable position while sitting or lying down, then take a breath, exhale deep from the nose and hold it for a while, then slowly from the mouth, repeat 4-5 times. The technique next is progressive muscle relaxation (ROP) which is an exercise to tighten and relax muscles while breathing deeply in the muscles from face to toe: eyes and forehead, cheeks, mouth, nape, shoulders, hands, chest, abdomen, back, buttocks, feet and soles of the feet. Evaluate the benefits and exercise regularly 3 to 4 times per day.

EXERCISE POSITIVE EMOTIONS by: doing activities and hobbies that you like, either alone or with families, such as playing music, singing, dancing, talking about fun or funny things. Communication with family and friends, keep things fun through online media. " Happy heart is a medicine".

POSITIVE MIND EXERCISE by: technique focus on five fingers focuses on sight and thoughts five fingers while remembering the conditions. The new body, people who pay attention and care: praise / appreciation / success ever felt, / beautiful place ever visited. Exercises are thinking Positive: useful for increasing endorphins so that immunity increases. Positive thoughts and experiences about self, family, group and society. Write it down, then do the affirmation to yourself so that the mind is filled with pleasant experiences. Make plans and goals that are positive and achievable and say them regularly (affirmations).

EXERCISE STOP NEGATIVE THOUGHTS: by recording negative thoughts, choose one disconcerting thought, take a deep breath, close your eyes and empty your mind until you relax. Think Thoughts negative/disturbing to a count of 3, 5, or 7, say stop on a count of 3, 5, or 7, Take a deep breath and open your eyes. Evaluate the thoughts that arise: positive thoughts should arise. Do it up to 3 times a day, or every thought negative arises.

POSITIVE BEHAVIOR EXERCISE: behaving responsively, being responsive, behaving the best. Behave positively on yourself, behave positively for the family, behave positively for others and behave positively in the environment.

POSITIVE RELATIONSHIP EXERCISE: by greeting, giving praise ( reinforcement), giving hope (hope), helping each other (helping) and sharing positive things (sharing), avoiding sad discussions. Send something positive by sharing fun experiences, sharing funny stories that make you laugh, sharing dance songs that make you happy.

POSITIVE SPIRITUAL EXERCISE by praying for yourself, praying for the community, praying for health workers, praying for the government at home with family members (Ministry of Health RI, 2020b).

The application of exercise in comorbid patients can be applied well, even though it is done online. The SOP is in the pocketbook for comorbid covid 19 sufferers.

  1. The effect of mental health support on body resistance before and after action on comorbid sufferers during the covid 19 pandemic.

The transmission of COVID-19 is no longer an individual health problem but a matter of the survival of a nation. Policies and efforts that encourage the behaviour to comply with health protocols are preventative measures that are supported. Control of COVID-19 also requires health promotion efforts targeting individuals, communities or organizations, so that people can maintain their health and those around them with the support of adequate infrastructure (Covid-19, 2020).

The impact of the COVID-19 pandemic has an economic impact and experiences mental stress and pressure, so it is necessary to improve mental health through mental health support and counselling to suppress and reduce the impact of mental health problems and disorders (Health, 2020).

With this mental health support program innovation, it is hoped that the community will be aware of their mental health problems and want to take advantage of health facilities in handling mental health problems through counselling, especially for comorbid patients (Organization, 2021).

Mental health and psychosocial support for comorbid sufferers during covid 19 were significantly affected with a p-value of 0.018.

 

Conclusions

The results of the T-test analysis of the effect of mental health support on body resistance before and after the action on comorbid patients during the COVID-19 pandemic showed a significant difference between before and after treatment with a p-value of 0.018, meaning that health support had a significant effect.

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Copyright holder:

Wien Soelistyo Adi, Ramelan, Sugih Wijayanti, Sri Endang Windiarti (2021)

 

First publication right:

Syntax Literate: Jurnal Ilmiah Indonesia

 

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