CORRELATION BETWEEN EMOTION REGULATION AND SPIRITUALITY WITH STRESS ON THE CAREGIVER OF ELDERLY Dwi Anjaswati Putri Hastari Istar Yuliadi Rini Setyowati Universitas Sebelas Maret Surakarta Keywords: emotion regulation; spirituality; stress in caregiver of the elderly http://ejournal.iainsurakarta.ac.id/al-balagh Correspondence: e-mail: dwi.anjaswati05@gmail.com istar_yuliadi@yahoo.com rini.setyowati87@gmail.com Abstract Stress occurs while caring for the elderly due to several factors, namely the emotion regulation and spirituality. This study aims to examine the correlation between stress with emotion regulation and spirituality in caregivers of the elderly at Karangmojo 1 Health Center, Gunungkidul. The purposive sampling method was used to obtain data from 36 caregivers on the emotion regulation and spirituality as well as stress scale with Alpha Cronbach's reliability coefficient of 0.871, 0.921, and 0.905, respectively. The results showed that r = 0.485 and Sig. 0.012 (p <0.05). Therefore there is a correlation between stress, emotion regulation, and spirituality. This means that the higher the control of emotion and spiritual level, the lower the pressure. Furthermore, this research expects to provide input in the realm of psychology. For example, it can be used as a reference to help caregivers deal with stress by increasing their emotion regulation and spirituality skills. Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) 28 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Abstrak Stres pada pengasuh lanjut usia terjadi disebabkan kombinasi tugas selama merawat lanjut usia. Terdapat beberapa faktor yang mempengaruhi tingkat stres, yaitu regulasi emosi dan spiritualitas. Penelitian ini bertujuan untuk mengetahui hubungan antara stres dengan regulasi emosi dan spiritualitas pada pengasuh lanjut usia di Puskesmas Karangmojo 1, Gunungkidul. Subjek penelitian yaitu caregiver lanjut usia, berjumlah 36 orang, didapatkan dengan purposive sampling. Data diambil menggunakan skala regulasi emosi (koefisien reliabilitas Alpha Cronbach sebesar 0,871), spiritualitas (koefisien reliabilitas Alpha Cronbach sebesar 0,921), dan stres caregiver lansia (koefisien reliabilitas Alpha Cronbach sebesar 0,905). Hasil penelitian menunjukkan bahwa r=0,485 dan Sig. 0,012 (p<0,05), sehingga terdapat hubungan antara stres dengan regulasi emosi dan spiritualitas. Semakin tinggi regulasi emosi dan tingkat spiritualitas, maka semakin rendah stres yang terjadi. Penelitian ini diharapkan memberi masukan untuk ilmu pengetahuan terutama di ranah psikologi, misalkan dapat digunakan sebagai referensi dan membantu para caregiver dalam mengatasi stres dengan meningkatkan keterampilan regulasi emosi dan spiritualitas. Kata kunci: regulasi emosi; spiritualitas; stres pada pengasuh lanjut usia How to cite (APA 7th Edition): Hastari, D. A. P., Yuliadi, I., & Setyowati, R. (2020). Correlation Between Emotion Regulation and Spirituality with Stress on The Caregiver of Elderly. Al-Balagh: Jurnal Dakwah Dan Komunikasi, 5(1), 27-58. https://doi. org/10.22515/al-balagh.v5i1.2269 INTRODUCTION The Indonesian society comprises of numerous ethnicities, linguistics, and age groups, with the elderly classified as those individuals above 60 years (Papalia, Olds, & Feldman, 2008; Santrock, 2011). Some of them reside in orphanages, while others live with their families. The results of the 2017 National Economic Survey (SUSENAS), showed that 62.64% of the elderly lived with their 29Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) extended families or three generations, namely those that reside with their children and grandchildren, or in-laws in a particular household (BPS, 2017). In relation to those residing with their families, several members play a huge role in attending to them. A person or group of individuals that provide direct care for the elderly are usually regarded as elderly caregivers. The tasks of the elderly caregiver are time-consuming because they carry out numerous daily chores. Besides, the behavior of the elderly being attended to is also a source of burden (Peetoom, Lexis, Joore, Dirksen, & De Witte, 2016). The weight of the elderly causes stresses because caregivers usually feel fatigued and in certain instances, this leads to physical pain. In addition, they find it difficult to control their emotions (Putri, 2013). Generally, relatively 65%(81 persons) out of 125 elderly caregivers are reported to experience high-levels of stress (Bobbitt, Baugh, Andrew, Cook, Green, Pei, & Rasmussen, 2016). Stress is commonly elucidated as a non-specific reaction which tends to occur when humans are faced with pressure or stimulation (stimulus stressor). It also includes varying adaptive reactions, which is because people respond differently to stress. This reaction is influenced by educational background, maturity, and the individual’s ability to adapt to the environment (Hartono, 2007). Meanwhile, stress encountered by elderly caregivers is defined as a series of psychological and physiological reactions that arise from the attempts to adapt to this type of task (Llanque, Savage, Rosenburg, BA, & Caserta, 2016, Noonan & Tennstedt, 1997, Deater-Deckard, 2004). In accordance with the prospective problems of these caregiver interviews were conducted on three of them on the 4th of November, 2018, in Gunung Kidul District. It was discovered that they all felt depressed and burdened with this task. However, two of the elderly caregivers reported that these feelings were overwhelmed immediately the understood that 30 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) it was an obligation that needed to be fulfilled by the family members. They also understood that there was a reward for them hereafter. On the contrary, one of them always felt depressed and usually fails to focus when carrying out these chores. The caregivers also stated that they often felt dizzy whenever the thought about the burden. Based on the statements of these three elderly caregivers, it was concluded that they had a variety of feelings. Besides, the duration of their depression also varies, irrespective of the fact that they all felt the same way initially. This type of indicator shows that the caregivers of elderly parents are usually stressed. However, it need not be ignored because it leads to physical and mental pain. Also, stress causes chronic negative emotions, as well as has an impact on depression (Schoenmakers, Buntinx, & Delepeleire, 2010, Wade, Garry, & Tavris, 2013). The results from certain studies showed that it deteriorates the well-being of the caregivers and it also leads to the emergence of neurological problems. Therefore, perceived negative emotions are handled in various ways, which includes copying. Lazarus (1966), stated that there are two types of coping, namely, problem-focused and emotion-focused strategies. The problem- focused strategy is defined as an individual’s efforts to alleviate stressful circumstances, whereas emotion-focused coping is a person’s effort to reduce or regulate emotional consequences of potentially stressful events (Baqutayan, 2015, Lazarus, 1966). Subsequently, both strategies play a role in managing stress although in different ways. Problem-focused coping is usually more effective when the stressor is controlled, while emotion-focused tends to be more efficient when the cause of stress is uncontrollable. Therefore, emotion regulation is considered the most appropriate means of managing stress. Coping strategies are related to emotion regulation (Pascual, Conejero, & Etxebarria, 2016, Ruiz-Robledillo & Moya-Albiol, 2013). It is the process of reassessment, characterized by cognitive evaluation of 31Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) stimuli which is carried out to influence certain experiences and reduce the harmful effects of emotions, both physical, psychological, and social impacts (H. Chen, 2016, Gross, 2002). Furthermore, it does not only serve as a means to change emotions, rather it is an indirect way of reducing stress. Consequently, stress is also reduced and avoided when an individual possesses a high level of spirituality, which is defined as the person’s relationship with God (The Higher Power) (Hendriani, 2018). Additionally, it is deep-rooted in human beings and relates to their belief systems. Spirituality also aids humans to realize the highest awareness of self-transcendence. In addition, it also helps them to achieve the meaning and purpose of life (Saifuddin, 2019). Spirituality is based on expectations, the individual connotation of things, as well as peoples’ relatedness to the highest dimension or transcendence, and belief systems (Dyson, Cobb, & Forman, 1997). Therefore, a high level of spirituality serves as a modality used to reduce stress. It is because individuals foster hope with spirituality, which is the belief that life difficulties are overcome through their connection with the highest dimension. Consequently, for those that often encounter stressful situations, religious and spiritual systems are valuable resources that tend to make their experiences meaningful (Krok, 2015, Monteiro, Santos, Kimura, Baptista, & Dourado, 2018). Therefore, supposing the caregivers are able to understand the entire situation, their duties of attending to the elderly is not considered as a burden, and they are also protected from stress. Based on some of these explanations, this study was carried out because of persistent stress on the caregivers although the duration differs. In accordance with the data obtained before carrying out this research, it was discovered that some caregivers desired to unearth the implication of their roles. On the contrary, the impact of stress on them is considered dangerous because it leads to depression as 32 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) well as the disruption of other activities. Therefore, it is crucial to examine the psychological constructs or variables (emotion regulation and spirituality) relating to stress, including exploring the correlation between them. The purpose of this research was to examine the correlation between emotion regulation, spirituality, and stress encountered by caregivers for the elderly parents at the Gunungkidul Health Center. In addition, three hypotheses were postulated in this study; namely, the correlation between emotion regulation and spirituality, the correlation between emotion regulation and stress, and the correlation between spirituality and stress encountered by the caregivers in the Karangmojo 1 Gunungkidul health center. There are several previous studies relating to stress, spirituality, and emotion regulation experienced by elderly caregivers (Branscum, 2010; Kurasawa et al., 2012; Longacre, Valdmanis, Handorf, & Fang, 2017; Mehta, 2005; Murdiyanto & Gutomo, 2017; Padmiati & Diyanayati, 2015; Shen, Wan, Xie, Chen, & Li, 2019; Tang, 2009; Putri, 2013; Moustafa & Moustafa, 2018; Naing, May, & Aung, 2020; Oliveira, Souza, Luchesi, Inouye, & Pavarini, 2017; Popli & Panday, 2018; Sabzwari, Badini, Fatmi, & Shah, 2016; Tamdee et al., 2019; Widyakusuma, 2013; Yigitalp, Gumus, Surucu, & Evinc, 2017;Ibad, Ahsan, & Lestari, 2015; Missesa & Syam’ani, 2017;Widyastuti, Sahar, & Permatasari, 2011) Conversely, the differences between previous studies and this research occurred in several aspects. The theme of these studies was centered on the dynamics of stress in elderly caregivers. Similarly, this research examined the correlation between emotion regulation and spirituality in accordance with stress faced by the caregivers. Certain previous studies applied qualitative, longitudinal, and cross-sectional methods. In contrast, a quantitative correlational approach was applied in this research and the subject is related to the correlation between spirituality and emotion 33Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) regulation based on stress. Additionally, the measuring instrument utilized is also different from previous studies. Therefore, this study has originality. METHODS This quantitative correlational study measures three variables. They are emotion regulation as well as predictor, and criterion variables which comprise of spirituality and stress respectively. The operational definition of stress encountered by elderly caregivers is a form of response that relates to their mental, physical, emotional, and spiritual inability to cope with the problems associated with the tasks of attending to the elderly. Also, this study applied a psychosocial approach, namely emotional, cognitive, social behavior, and biological aspects (Sarafino & Smith, 2016). A Likert scale model is used to measure the stress variable, subsequently, when a high score is obtained, it simply means that the level of stress experienced by the caregivers is also high, and vice versa. The operational definition of emotion regulation involves the process of reassessment, which is usually carried out by monitoring, evaluating, and modifying sentimental reactions. It is also applied to reduce the negative effects of emotions perceived by humans. Consequently, emotions are either positive or negative. According to Thompson (1991), aspects of emotion regulation include monitoring, evaluating, and modifying. The higher the score, the greater the emotion regulation of the caregiver, and vice versa. Spirituality is operationally defined as a fundamental belief in the care, hope, kindness, love, optimism, and the enormous power that governs the universe. It is also the relationship between an individual and a transcendent being (God). The aspects of spirituality applied in this research are transcendent elements, awareness of suffering, meaning and purpose in life, altruism, the sanctity, material values, 34 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) idealism, personal mission, and outcome (Elkins, Hedstrom, Hughes, Leaf, and Saunders, 1988). The tool for measuring this variable is the Likert scale model, and when the score is high, the caregiver’s spirituality is also high, and vice versa. The research sample used in this study are adults responsible for attending to the elderly in Gunungkidul Community Health Center. The sample was acquired using the purposive sampling method based on several characteristics, such as married caregivers attending to elderly parents aged 70 years and above. In addition, 36 research samples were obtained. The measuring instrument used for data collection is a Likert scale model. There are three scales, namely the level of emotion regulation in accordance with the theory formulated by Thompson (1991), spirituality is based on Elkins, L. James Hedstrom, Hughes, Leaf, & Saunders (1988), and the stress relates to the theory reported by Sarafino & Smith (2016) theory. The validity of the measuring instrument is qualitatively assessed by professional judgment, and the difference is calculated using the corrected item-total correlation test. A statement is considered to have good contrast when the correlation value obtained for each of them is above 0.300 (Azwar, 2016; Saifuddin, 2020). The reliability of the measuring instrument was determined using a single presentation method, which was tested on a group of people with characteristics similar to the sample used in this study. The results from this trial were analyzed using the Alpha reliability coefficient formula, and the minimum limit of the measuring instrument is 0,700 (DeVellis, 2016). 35Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Table 1. Aspects and Indicators of Emotion Regulation Scale After Try Out No. Aspect Indicators Total 1 Monitoring emotions Can realize the feelings that arises 3 Understand the background of actions 3 2 Evaluating emotions Able to manage emotions 2 Emotional balance 6 3 Modifying emotions Able to change emotions 4 Able to motivate oneself when experiencing negative emotions 4 Total 22 The results from calculating the Alpha reliability coefficient showed that the scale of emotion regulation was an estimation of α = 0.871. In accordance with the different power items, the measuring instrument for emotion regulation ranges from 0.329 to 0.619. Therefore, it is considered to be reliable with a high power difference. Table 2. Spirituality Scale Aspects and Indicators After Try Out No. Aspect Indicators Total 1. Transcendent Belief in the transcendent dimension 3 Possess transcendent experiences such as being able to envision those not detected with the plain eyes 4 2. Life of purity Believe that there is afterlife and need for holiness 2 Feeling sacred or religious throughout their entire life 1 3. Life mission Have a sense of responsibility towards life 1 Possess the urge to fulfill their life mission 1 4. The meaning and purpose of life Believing that life is meaningful 4 Possess an evident meaning and purpose in life 1 36 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) No. Aspect Indicators Total 5. Material values Realizing the fact that the highest satisfaction in life is not derived from money and position 2 Highest satisfaction is obtained from spirituality 4 6. Idealism Committed to ensuring the world is a better place 3 Actualize potential 4 7. Awareness of suffering Realizing the existence of suffering 2 Realizing the existence of death 2 8. Altruism Being aware of the suffering of others 3 Possessing strong feelings or a sense of social justice 1 9. The result from spirituality Individual relationships with others 3 Relationship with a transcendent being and nature 3 Total 44 The results from calculating the Alpha reliability coefficient showed that the scale of spirituality is approximately α = 0.921. Based on the different power items, the measuring instruments for emotion regulation ranges from 0.307 to 0.694, therefore, it is considered reliable with a high power difference. Table 3. Aspects and Indicators of Elderly Caregiver Stress Scale After Try Out No. Aspect Indicators Total 1. Cognitive Impaired memory 2 Lack of attention and concentration 3 2. Emotion Anxiety and resentful 1 Extremely depressed 1 3. Social Habits Hostile, and insensitive to the needs of others 6 Increase in negative behavior 2 37Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) No. Aspect Indicators Total 4. Biological Physiological reaction 3 Indigestion 5 Total 23 The results from calculating the Alpha reliability coefficient showed that the scale of spirituality is approximately α = 0.905. In addition to the different power items, the measuring instruments for emotion regulation range from 0.345 to 0.757. Therefore, it is reliable and has a high power difference. Multiple linear regression tests in SPSS version 24 is used for data analysis. Consequently, the basic prior test and classical assumptions, which include normality, linearity, heteroscedasticity, and multicollinearity were also carried out. RESULTS AND DISCUSSION Research Results This study applied descriptive analysis to obtain a general picture of the emotion regulation, spirituality, and stress conditions in the sample, namely elderly caregivers. Table 4. Mean and Standard Deviation of Hypothetic and Empirical Data Scale N Hypothetic Data M SD Empirical Data M SD Min Score Max Score Min Score Max Score Emotion Regulation 36 22 88 55 11 63 76 67,72 3,029 Spirituality 36 44 176 110 22 120 152 133,69 7,778 Elderly Stress Caregiver 36 23 92 57,5 11,5 38 51 45,75 2,892 38 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) However, the normality, linearity, heteroscedasticity, and multicollinearity tests were also conducted. Table 5. Normality Test Results Table One-Sample Kolmogorov-Smirnov Test Emotion Regulation Spirituality Stress N 36 36 36 Normal Parameters,b Mean 67,72 133,69 45,75 Std. Deviation 3,029 7,778 2,892 Most Extreme Differences Absolute ,132 ,099 ,146 Positive ,132 ,099 ,083 Negative -,082 -,097 -,146 Test Statistic ,132 ,099 ,146 Asymp. Sig. (2-tailed) ,117c ,200c,d ,052c Based on the results from calculating the normality test using Kolmogorov-Smirnov, it was discovered that the magnitude of the normality coefficient for the emotion regulation variable was 0.132 with Asymp. Sig. (2-tailed) of 0.117 (p> 0.05), while for spirituality it is 0.099 with Asymp. Sig. (2-tailed)of .200 (p> 0.05), and for stress it is 0.146 with Asymp. Sig. (2-tailed) of 0.052 (p> 0.05). Therefore, the data distribution for the three variables is a normal curve. Table 6. Table of Linearity Test Results Between Stress and Emotion Regulation ANOVA Table Sum of Squares Df Mean Square F Sig. Stress * Emotion Regulation Between Groups (Combined) 144,050 10 14,405 2,422 ,035 Linearity 36,648 1 36,648 6,161 ,020 Deviation from Linearity 107,402 9 11,934 2,006 ,082 Within Groups 148,700 25 5,948 Total 292,750 35 39Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) The linearity test is a technique for detecting the presence or absence of a linear relationship between the predictor and the criterion variables. A good correlation occurs when both of them are linear. Based on the results from the linearity test between stress and emotion regulation, an F of 6.161 and Sig. Of 0.020 (p <0.05) was obtained. In conclusion, the data from the two variables are linear. Table 7. Table of Linearity Test Results Between Stress and Spirituality ANOVA Table Sum of Squares df Mean Square F Sig. Stress * Spirituality Between Groups (Combined) 206,500 21 9,833 1,596 ,186 Linearity 57,106 1 57,106 9,269 ,009 Deviation from Linearity 149,394 20 7,470 1,212 ,362 Within Groups 86,250 14 6,161 Total 292,750 35 In accordance with the results of the linearity test between the stress and spirituality variables an F of 9.269 and Sig. Of 0.009 (p <0.05) were obtained. Conclusively, the data from the two variables are linear. Figure 1. Heteroscedasticity Test Results With Scatterplot 40 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) The heteroscedasticity test is used to determine the variance in residual values during the observation or measurement period. Homoscedasticity rather than heteroscedasticity tends to occur when the variance is fixed. Data is evaluated by regression analysis when there is a lack of heteroscedasticity. Based on the scatterplot method, it was concluded that heteroscedasticity did not occur. This is because the data points spread above and below the number 0, and they did not only gather at line 0, as well as the patternless distribution. Table 8. Multicollinearity Test Results Table Coefficients Model B Unstandardized Coefficients Standardized Coefficients t Sig. Tolerance Collinearity Statistics Std. Error Beta VIF 1 (Constant) 77,605 10,679 7,267 ,000 Emotion Regulation -,207 ,157 -,217 -1,316 ,197 ,854 1,171 Spirituality -,133 ,061 -,359 -2,179 ,037 ,854 1,171 a. Dependent Variable: Stress In this study, the autocorrelation test was not carried out because the research data was taken at a specific time, and measurements were repeated. The multicollinearity test was subsequently carried out to determine the presence or absence of a strong correlation between the independent variables (predictors). A good regression occurs when there is a lack of multicollinearity, and this simply means that there is no existent correlation between an independent variable and another. Based on calculations, it was discovered that the tolerance value for emotion regulation was 0.854 (p> 0.10), and the VIF value was 1.171 (p <10.00). Likewise, the tolerance value for spirituality was 0.854 (p> 0.10) and the VIF value was 1.171 (p <10.00). In conclusion, there is no existent correlation between emotion regulation and spirituality, or it lacks multicollinearity. 41Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Table 9. Hypothesis Test Results Table or Regression Analysis ANOVAa Model Sum of Squares Df Mean Square F Sig. 1 Regression 68,856 2 34,428 5,074 ,012b Residual 223,894 33 6,785 Total 292,750 35 Subsequently, the hypothesis is evaluated using multiple linear regression tests supported by SPSS (Statistical Product and Service Solution). This testing aims to determine whether the hypothesis is accepted or not and it is based on the correlation between the three variables. The results from the hypothesis testing using multiple regression analysis regarding the correlation between emotion regulation, spirituality, and stress shows a regression coefficient of 5.074 and Sig. amounted to 0.012 (p <0.05). Therefore, the first hypothesis is accepted, or there is a significant correlation between emotion regulation, spirituality, and stress. Table 10. Correlation Test Results Table Model Summaryb Model R R Square Adjusted R Square Std. Error of the Estimate 1 ,485a ,235 ,189 2,605 The correlation coefficient (R) obtained is 0.485, which means that emotion regulation, spirituality, and stress has a moderate level of relationship, which is within the range of 0.400 to 0.599. Discussion The simultaneous results from these tests are consistent with previous studies which stated that emotion regulation causes individuals to feel undisturbed when they are stressed (Deater-Deckard, Li, & Bell 42 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) 2016; Finlay-Jones, Rees, & Kane 2015; Katana, Röcke, Spain, & Allemand 2019; Lewis, Yoon, & Joormann 2017; Wang & Saudino 2011). Emotion regulation reduces the negative effects of stress,this is because itinvolves cognitive activities and strategies (positive reappraisal), considered to be the most appropriate (Folkman & Moskowitz, 2000, Garland, Gaylord, & Fredrickson, 2011). Individuals tend to be understandable when their cognitive emotions are regulated (Doré et al., 2017). This is in accordance with the research which stated that peoplewith positive emotion regulation can use their cognitive abilities in managing emotions, and vice versa. In addition, itis also realized throughseveral other ways, such as suppression whichrestrains emotional impulses and expressions. Although, a comparison between reappraisal and suppression, shows that suppression has a negative impact on emotion regulation (Peters, Overall, & Jamieson, 2014). It is also less effective when managing emotions, therefore it has a lesser impact on stress. Suppression causes lower life satisfaction (Nam, Kim, & Tam, 2018). Figure 2. Emotion Regulatory Process Model (Quoted from Gross, 2002) The application of cognitive reappraisal emotion regulation is 43Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) considered to be more effective than suppression because it makes it possible for individuals to be understood. However, when triggered by the existence of spirituality, the suppression of emotion regulation tends to occur even without cognitive reappraisal. According to several studies, spirituality causes one to be obedient, (Dyson et al. 1997; Koerniawan & Candrawulan 2018; Mok, Wong, & Wong 2010; Newman, 2004). Individuals can decipher the events that occur in their lives thereby making it easier for them to handle stressful situations (Tuck, Alleyne, & Thinganjana, 2006; Yadav & Khanna, 2014). A high level of spirituality enables individuals to develop the most effective coping mechanism to either reduce or prevent stress (Baldacchino & Draper, 2001, Baruah & Pandey, 2016, Krok, 2008). It also causes people to be able to handle difficult circumstances encountered, thereby preventing them from being stressed by these conditions (Ardilla & Wahyuni, 2012). Besides, spirituality creates an acceptance mechanism that causes caregivers not to become stress-prone (Hervey, 2017). Based on some of the studies, it was concluded that elderly caregivers that apply cognitive reappraisal emotion regulation can deal with stress effectively, compared to those that apply suppression. In addition, assuming the caregiver possesses a high level of spirituality, then whatever emotion regulation utilized, causes them to easily deal with stress. This is because spirituality plays a similar role as cognitive reappraisal. The second hypothesis stated that there is an existent correlation between emotion regulation and stress faced by the caregivers of the elderly. However, the results from the partial test show that the significance value of (p) 0.197> 0.05, this simply means that the second hypothesis in this study is rejected, or there is no correlation between emotion regulation and stress. In this study, the second hypothesis was not proven because the average educational background of the caregivers was elementary, and junior high school, therefore the respondents in this study possess 44 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) a lesser tendency to use cognitive-emotion regulation. This is consistent with the results from the research carried out by Ratnasari & Suleeman (2017), which stated that education has an influence on the selection of emotion regulation strategies, therefore the higher the educational qualification, the more the research samples tend to apply cognitive- emotion regulation. These dynamics occur because individuals usually try to regulate their emotions when carrying out and completing tasks in school. Some learning activities carried out in schools or educational institutions involve emotion regulation strategies. According to King & Chen (2019), emotions play an essential role in education. Individuals that develop emotion regulation easily handle problem-solving issues and pressure (Bahrami, 2017). Therefore, it affects the performance of private education in specific contexts (Gumora & Arsenio, 2002), as well as on the individuals’ attitudes towards problems in the general context. Based on these explanations, it was concluded that the emotion regulation in this research is negative or maladaptive. Stress is turned into distress, and the emotion regulation undertaken becomes less influential. Furthermore, the third hypothesis in this study, stated that there is a correlation between spirituality and stress. In other words, the third hypothesis is accepted. This is indicated by the partial test, which shows that the significance value is (p) 0.037 <0.05. The results from this analysis are consistent with the study carried out by Le, Piedmont, & Wilkins (2019), which stated that spirituality has been proven to be a predictor of stress in middle-aged Vietnamese. In addition, other studies include the research carried out by Sharif & Ong (2019), which reported that individuals with high-level spirituality, encounter less stressful experiences. According to some studies, spirituality helps individuals find meaning and purpose in the role they play (Yadav & Khanna 2014, dan Yun, Kim, & Awasu 2019). This leads to an increase in the positive perceptions of life activities. Finally, individuals with a high level of spirituality minimize the 45Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) occurrence of stress. In the context of this study, the research subjects that attend to elderly parents perceived the role as an obligation and responsibility which is rewarded in the afterlife. According to Powers, Cramer, & Grubka (2007), spirituality has little impact on the ability to discover the meaning of life. This research also shows that the stress level experienced by elderly caregivers varies. This is based on the age, sex, occupation, and education of the caregivers, as well as the health of elderly parents. Table 11. Research Respondents Categorization Variable Norma Categorization Total Respondent Frequency Percentage Emotion Regulation X < 65 Rendah 4 11,1% 65 X < 71 Sedang 27 75,0% X 71 Tinggi 5 13,9% Spirituality X < 126 Rendah 5 13,9% 126 X < 141 Sedang 24 66,7% X 141 Tinggi 7 19,4% Stress X < 43 Rendah 5 13,9% 43 X < 49 Sedang 26 72,2% X 49 Tinggi 5 13,9% According to table 11, the level of emotion regulation, spirituality, and stress on the average is moderate furthermore, the number of respondents for emotion regulation is 27 (75.0%), 24 (66.7%) for spirituality, and 26 (72.2%) for stress. Based on this table, it is concluded that the elderly caregivers working in Karangmojo 1 Gunungkidul Public Health Center are among the few that are highly stressed from attending to elderly parents. Also, the majority tend to regulate emotions and possess an adequate level of spirituality. 46 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Table 12. Categories of Research Respondents on the Stress Variable of Caregivers for the Elderly based on the Age of Elderly The Age of caregivers Stress Total Low Average High 28-35 0 6 0 6 36-48 4 16 4 24 49-56 1 4 1 6 Total 5 26 5 36 According to table 12, six of the subjects aged between 28-35 years, experiences moderate stress levels, and none have low or high-stress levels. Furthermore, 4 people within the age range of 36-48 years are faced with low-stress levels, while 16 of them experience moderate stress levels, and as many as four people encounter a high-stress level. Finally, only 1 subject aged 49-56 years, have low-stress level, while 4 of them possess moderate stress level, and 1 person has a high-stress level. Based on the table, it is concluded that irrespective of various age groups, the level of stress encountered by caregivers working in Karangmojo 1 Public health center, Gunungkidul is slightly different, namely at the moderate level. It simply means that age has little or no impact on stress. This is inconsistent with the studies carried out by Aldwin, Sutton, Chiara, & Spiro-III (1996) dan Chen, Peng, Xu, & O’Brien (2018), which stated that age has an impact on coping strategy, therefore, it affects stress levels. 47Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Table 13. Categories of Research Respondents in the Stress Variable of Elderly based on the Gender of The Elderly Gender Stress Total Low Average High Male 1 4 1 6 Female 4 22 4 30 Total 5 26 5 36 According to table 13, only one male subject has a low-stress level, while four persons have moderate stress levels, and one person has a high- stress level. Meanwhile, 4 female subjects have low-stress levels, while 22 people have moderate stress levels, and 4 of them have a high-stress level. Although in this study, the sample of female caregivers was more than their male counterparts, based on the table, there was no difference in stress levels between the sexes of the workers in Karangmojo 1 Public health center, Gunungkidul. The results of this research are inconsistent with the study carried out by Matud’s (2004), which reported that gender affects the coping and stress model. Table 14. Categories of Research Respondents on the Stress Variable of Caregivers for the Elderly based on the Caregivers’ Occupation Occupation Stress Total Low Average High Farmer 2 5 4 11 Housewife 2 10 0 12 Freelance 0 5 0 5 Teacher 0 2 0 2 Entrepreneur 1 3 1 5 Private Employee 0 1 0 1 Total 5 26 5 36 48 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Based on the table, 2 of the farmers have low-stress levels, while 5 are moderate, and 4 are faced with high-stress levels. Conversely, 2 of the housewives have low-stress levels, ten people experience moderate stress level, and none has a high-stress level. It was discovered that five of the laborers, experienced moderate stress levels, and none encountered low or high-stress levels, also 2 teachers were discovered to possess moderate stress levels. Furthermore, one of the privately employed people has a low-stress level, while three of them experience a moderate stress level, and one individual has a high-stress level. Conclusively, only one private employee experienced moderate stress. The table shows that despite the various occupations of elderly caregivers in Karangmojo 1 Public health center, Gunungkidul, they experience a moderate level of stress. Table 15. Categories of Research Respondents in the Variable Stress of Caregivers for the Elderly based on Caregivers’ Education Education Stress Total Low Average High S1 0 3 0 3 D3 1 0 0 1 SMA/SMK 0 10 0 10 SMP 2 7 2 11 SD 2 6 3 11 Total 5 26 5 36 In accordance with the data on table 15, it is evident that 3 S1 subjects experience moderate stress levels, while none of them experiences low or high. However, one of the D3 subjects experienced a low-stress level. Approximately 10 subjects from high or vocational schools, experienced moderate stress levels. Furthermore, 2 of the junior high school graduates, experienced low-stress levels, while seven people possess moderate stress levels, while two are high-stress level. Finally, two people from elementary school were discovered to possess low-stress levels, while six of them 49Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) experienced moderate stress levels, and three had high-stress levels. It was therefore concluded that an insignificant difference occurred in the stress level of elderly caregivers in Karangmojo Public Health Center 1, Gunungkidul. Although, it is an obvious fact that most elderly caregivers have elementary and junior high school qualifications, therefore educational factor influences the type of emotion regulation applied. CONCLUSION AND SUGGESTION Conclusion Based on the results from this research, it was concluded that there is a correlation between emotion regulation, spirituality, and stress on the elderly caregivers at the Gunungkidul Public Health Center. Emotion regulation and spirituality both have a significant effect on stress. A significant and negative correlation exists between spirituality. This simply means that the higher the spirituality, the lower the level of stress and vice versa. However, there is an insignificant correlation between emotion regulation and stress. In accordance with the results of this study, it is expected that caregivers need to be able to reduce stress through emotion regulations and spirituality. In addition, the elderly also do not hesitate to ask for help from their families when needed. The results from this study are recommended for the Public Health Center or agency when carrying out a counseling session for the elderly and their companions. It also serves as an additional reference for future studies related to stress experienced by elderly caregivers. Suggestion The results of data analysis found that the average caregiver of the elderly regulates emotions and spirituality at a moderate level. Although they do not experience severe stress, they can improve their emotion 50 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) regulation and spirituality to help the elderly in living a physically and spiritually healthy life. To avoid stress, it is expected that caregivers of elderly parents can improve the ability to regulate emotions, by carrying out activities that can cause positive emotions. For instance, when angry, pray to be calmer, and think positively to avoid being sad when experiencing bad events. In addition, to increase emotion regulation, caregivers are expected to also improve their spirituality, by drawing closer to God and taking meaning from events in life. The elderly caregivers need to only pay attention to them, and those they are meant to take care of by being patient and accommodating. The elderly, themselves, are also expected to work together with the caregivers to enable a good relationship. For example, the elderly need to eat the food provided by the caregivers and seek treatment when sick. The Public Health Center, are expected to conduct counseling on how to care for the elderly, to avoid. Future studies are also expected to avoid the shortcomings that exist in this research by replacing the variables with loneliness, self- acceptance, resilience, etc. REFERENCES Aldwin, C. M., Sutton, K. J., Chiara, G., & Spiro-III, A. (1996). Age Differences in Stress, Coping, and Appraisal: Findings From the Normative Aging Study. Journal of Geronotology: Psychological Sciences, 51B(4), 179–188. Ardilla, D., & Wahyuni, S. E. (2012). Spiritualitas dan Stres Orangtua yang Mempunyai Anak Kelainan Kongenital di RSUP H. Adam Malik Medan. Jurnal Keperawatan Klinis, 1(1), 48–53. Azwar, S. (2016). Reliabilitas dan Validitas (4 Ed). Yogyakarta: Pustaka Pelajar. 51Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Bahrami, F. (2017). The Relationship Between Cognitive Emotion Regulation and Academic Buoyancy with The Role of Mediating Self-Handicapping in Students. Iranian Journal of Educational Sociology, 1(6), 114–124. Baldacchino, D., & Draper, P. (2001). Spiritual Coping Strategies: A Review of the Nursing Research Literature. Journal of Advanced Nursing, 34(6), 833–841. https://doi.org/10.1046/j.1365- 2648.2001.01814.x Baqutayan, S. M. S. (2015). Stress and Coping Mechanisms: A Historical Overview. Mediterranean Journal of Social Sciences, 6(2), 479–488. https://doi.org/10.5901/mjss.2015.v6n2s1p479 Baruah, P., & Pandey, N. (2016). Spirituality as a Coping Strategy among Practitioners and Non Practitioners. The International Journal of Indian Psychology, 3(2), 110–114. Bobbitt, S. A., Baugh, L. A., Andrew, G. H., Cook, J. L., Green, C. R., Pei, J. R., & Rasmussen, C. R. (2016). Caregiver Needs and Stress in Caring for Individuals with Fetal Alcohol Spectrum Disorder. Research in Developmental Disabilities, 55, 100–113. https://doi. org/10.1016/j.ridd.2016.03.002 BPS. (2017). Banyak Lansia Tinggal dengan Anak, Mantu, dan Cucu. Retrieved December 13, 2018, from katadata.co.id website: https://databoks.katadata.co.id/datapublish/2018/04/30/ banyak-lansia-tinggal-dengan-anak-mantu-dan-cucu Branscum, A. Y. (2010). Stress and Coping Model for Family Caregivers of Older Adults. Dissertation Abstracts International Section A: Humanities and Social Sciences, 1–106. Chen, H. (2016). A Theoretic Review of Emotion Regulation. Open Journal of Social Sciences, 04(02), 147–153. https://doi.org/10.4236/ jss.2016.42020 Chen, Y., Peng, Y., Xu, H., & O’Brien, W. H. (2018). Age Differences in Stress and Coping: Problem-Focused Strategies Mediate the Relationship Between Age and Positive Affect. The International Journal of Aging and Human Development, 86(4), 347–363. https:// doi.org/10.1177/0091415017720890 Deater-Deckard, K. D. (2004). Parenting Stress. https://doi.org/10.12987/ yale/9780300103939.001.0001 52 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Deater-Deckard, K., Li, M., & Bell, M. A. (2016). Multifaceted Emotion Regulation, Stress, and Affect in Mothers of Young Children. Cognition and Emotion, 30(3), 444–457. https://doi.org/10.1080/02 699931.2015.1013087 DeVellis, R. F. (2016). Scale Development: Theory and Applications (4th Ed). Thousand Oaks, California, United States: SAGE Publications. Doré, B. P., Boccagno, C., Burr, D., Hubbard, A., Long, K., Weber, J., … Ochsner, K. N. (2017). Finding Positive Meaning in Negative Experiences Engages Ventral Striatal and Ventromedial Prefrontal Regions Associated with Reward Valuation. Journal of Cognitive Neuroscience, 29(2), 235–244. https://doi.org/10.1162/ jocn_a_01041 Dyson, J., Cobb, M., & Forman, D. (1997). The Meaning of Spirituality: A Literature Review. Journal OfAdvanced Nursing, 26, 1183–1188. https://doi.org/10.1046/j.1365-2648.1997.00446.x Elkins, D. N., L. James Hedstrom, Hughes, L. L., Leaf, J. A., & Saunders, C. (1988). Toward a Humanistic-Phenomenological Spirituality. Journal of Humanistic Psychology, 28(4), 5–18. https://doi. org/10.1177/0022167888284002 Finlay-Jones, A. L., Rees, C. S., & Kane, R. T. (2015). Self-Compassion, Emotion Regulation and Stress Among Australian Psychologists: Testing an Emotion Regulation Model of Self-Compassion Using Structural Equation Modeling. PLoS ONE, 10(7), e0133481. https://doi.org/10.1371/journal.pone.0133481 Folkman, S., & Moskowitz, J. T. (2000). Stress, Positive Emotion, and Coping. Current Directions in Psychological Science, 9(4), 115–118. https://doi.org/10.1111/1467-8721.00073 Garland, E. L., Gaylord, S. A., & Fredrickson, B. L. (2011). Positive Reappraisal Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral Process. Mindfulness, 2(1), 59–67. https://doi. org/10.1007/s12671-011-0043-8 Gross, J. J. (2002). Emotion regulation: Affective, Cognitive, and Social Consequences. Psychophysiology, 39, 281–291. https://doi. org/10.1017.S0048577201393198 Gumora, G., & Arsenio, W. F. (2002). Emotionality, Emotion Regulation, and School Performance in Middle School Children. Journal of 53Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) School Psychology, 40(5), 395– 413. https://doi.org/10.1016/S0022- 4405(02)00108-5 Hartono, L. A. (2007). Stres & Stroke. Yogyakarta: Kanisius. Hendriani, W. (2018). Resiliensi Psikologis: Sebuah Pengantar. Jakarta Selatan: Kencana. Hervey, E. (2017). Culture, Spirituality, Self-Acceptance, and Relationships Among Latino Students. Journal of Cross-Cultural Family Studies, 1(1), 1–10. Ibad, M. R., Ahsan, & Lestari, R. (2015). Studi Fenomenologi Pengalaman Keluarga Sebagai Primary Caregiver Dalam Merawat Lansia Dengan Demensia Di Kabupaten Jombang. The Indonesian Journal of Health Science, 6(1), 40–51. https://doi.org/10.32528/the. v6i1.35 Katana, M., Röcke, C., Spain, S. M., & Allemand, M. (2019). Emotion Regulation, Subjective Well-Being, and Perceived Stress in Daily Life of Geriatric Nurses. Frontiers in Psychology, 10(1097), 1–11. https://doi.org/10.3389/fpsyg.2019.01097 King, R. B., & Chen, J. (2019). Emotions in Education: Asian Insights on the Role of Emotions in Learning and Teaching. Asia-Pacific Education Researcher, 28(4), 279–281. https://doi.org/10.1007/ s40299-019-00469-x Knippenberg, R. J. M. van, Vugt, M. E. de, Ponds, R. W., Verhey, F. R. J., & Myin-Germeys, I. (2018). Emotional Reactivity to Daily Life Stress in Spousal Caregivers of People with Dementia: An Experience Sampling Study. PLoS ONE, 13(4), e0194118. https:// doi.org/10.1371/journal.pone.0194118 Koerniawan, D., & Candrawulan, U. (2018). Hubungan Spiritualitas dengan Stres Lansia di Public health center Pakjo Palembang. Elisabeth Health Journal, 3(2), 93–100. Krok, D. (2008). The Role of Spirituality in Coping: Examining the Relationships Between Spiritual Dimensions and Coping Styles. Mental Health, Religion & Culture, 11(7), 643 — 653. https://doi. org/10.1080/13674670801930429 Krok, D. (2015). Religiousness, Spirituality, and Coping with Stress Among Late Adolescents: A Meaning-Making Perspective. Journal of Adolescence, 45, 196–203. https://doi.org/10.1016/j. adolescence.2015.10.004 54 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Kurasawa, S., Yoshimasu, K., Washio, M., Fukumoto, J., Takemura, S., Yokoi, K., … Miyashita, K. (2012). Factors Influencing Caregivers’ Burden Among Family Caregivers and Institutionalization of In- home Elderly People Cared for by Family Caregivers. Environmental Health and Preventive Medicine, 17(6), 474–483. https://doi. org/10.1007/s12199-012-0276-8 Lazarus, R. S. (1966). Psychological Stress and the Coping Process. New York, USA: McGraw-Hill. Le, Y. K., Piedmont, R. L., & Wilkins, T. A. (2019). Spirituality, Religiousness, Personality as Predictors of Stress and Resilience among Middle- Aged Vietnamese-Born American Catholics. Mental Health, Religion & Culture, 1–15. https://doi.org/10.1080/13674676.2019.16462 35 Lewis, E. J., Yoon, K. L., & Joormann, J. (2017). Emotion Regulation and Biological Stress Responding: Associations with Worry, Rumination, and Reappraisal. Cognition and Emotion, 1–13. https:// doi.org/10.1080/02699931.2017.1310088 Llanque, S., Savage, L., Rosenburg, N., BA, H., & Caserta, M. (2016). Concept Analysis: Alzheimer’s Caregiver Stress. Nursing Forum, 51(1), 21–31. https://doi.org/10.1111/nuf.12090 Longacre, M. L., Valdmanis, V. G., Handorf, E. A., & Fang, C. Y. (2017). Work Impact and Emotional Stress Among Informal Caregivers for Older Adults. Journals of Gerontology: Social Sciences, 72(3), 522– 531. https://doi.org/10.1093/geronb/gbw027 Matud, M. P. (2004). Gender Differences in Stress and Coping Styles. Personality and Individual Difference, 37, 1401–1415. https://doi. org/10.1016/j.paid.2004.01.010 Mehta, K. K. (2005). Stress Among Family Caregivers of Older Persons in Singapore. Journal of Cross-Cultural Gerontology, 20(4), 319–334. https://doi.org/10.1007/s10823-006-9009-z Missesa, & Syam’ani. (2017). Pengalaman Keluarga Merawat Lansia Demensia Di Wilayah Kerja Public health center Menteng. Jurnal Forum Kesehatan, 7(2), 65–76. Mok, E., Wong, F., & Wong, D. (2010). The Meaning Of Spirituality and Spiritual Care among the Hong Kong Chinese terminally ill. Journal of Advanced Nursing, 66(2), 360–370. https://doi.org/10.1111/ j.1365-2648.2009.05193.x 55Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Monteiro, A. M. F., Santos, R. L., Kimura, N., Baptista, M. A. T., & Dourado, M. C. N. (2018). Coping Strategies among Caregivers of People with Alzheimer Disease: A Systematic Review. Treands in Psychiatry and Psychotherapy, 40(3), 258–268. https://doi.org/10.1590/2237- 6089-2017-0065 Moustafa, N. S. A., & Moustafa, M. S. A. (2018). Depression, Anxiety, and Stress Among Some Elderly Caregivers in Alexandria City, Egypt. International Journal of Medical Science and Public Health, 7(7), 570–579. https://doi.org/10.5455/ijmsph.2018.0410315042018 Murdiyanto, & Gutomo, R. T. (2017). Peran Keluarga Dalam Mewujudkan Lanjut Usia Sejahtera. Media Informasi Penelitian Kesejahteraan Sosial, 41(1), 1–10. Naing, M. Z., May, S. Y., & Aung, M. H. (2020). Caregiver Burden from Caring for Dependent Elderly in Yangon, the Republic of the Union of Myanmar. Makara Journal of Health Research, 24(1), 13– 20. https://doi.org/10.7454/msk.v24i1.1067 Nam, Y., Kim, Y.-H., & Tam, K. K.-P. (2018). Effects of Emotion Suppression on Life Satisfaction in Americans and Chinese. Journal of Cross-Cultural Psychology, 49(1), 149 –160. https://doi. org/10.1177/0022022117736525 Newman, L. L. (2004). Faith, Spirituality, and Religion: A Model for Understanding the Differences. College Student Affairs Journal, 23(2), 102–110. Noonan, A. E., & Tennstedt, S. L. (1997). Meaning in Caregiving and its Contribution to Caregiver Well-Being. The Gerontologist, 37(6), 785–794. Oliveira, N. A. de, Souza, É. N., Luchesi, B. M., Inouye, K., & Pavarini, S. a C. I. (2017). Stress and Optimism of Elderlies who are Caregivers for Elderlies and Live with Children. Revista Brasileira de Enfermagem, 70(4), 697–703. https://doi.org/10.1590/0034-7167-2017-0088 Özkan Tuncay, F., & Kars Fertelli, T. (2019). Effects of the Caregiver Burden Perceived by Caregivers of Patients with Neurological Disorders on Caregiver Well-being and Caregiver Stress. Perspectives in Psychiatric Care, 55(4), 697–702. https://doi.org/10.1111/ ppc.12405 Padmiati, E., & Diyanayati, K. (2015). Pelayanan Sosial Lanjut Usia dalam Keluarga. Jurnal PKS, 14(3), 329–342. 56 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Papalia, D. E., Olds, S. W., & Feldman, R. D. (2008). Human Development (10th Ed). New York: McGraw-Hill Education (Asia). Pascual, A., Conejero, S., & Etxebarria, I. (2016). Coping Strategies and Emotion Regulation in Adolescents: Adequacy and Gender Differences. Ansiedad y Estrés, 22(1), 1–4. https://doi. org/10.1016/j.anyes.2016.04.002 Peetoom, K. K. B., Lexis, M. A. S., Joore, M., Dirksen, C. D., & De Witte, L. P. (2016). The Perceived Burden of Informal Caregivers of Independently Living Elderly and Their Ideas about Possible Solutions: A Mixed Methods Approach. Technology and Disability, 28(1–2), 19–29. https://doi.org/10.3233/TAD-160441 Peters, B. J., Overall, N. C., & Jamieson, J. P. (2014). Physiological and Cognitive Consequences of Suppressing and Expressing Emotion in Dyadic Interactions. International Journal of Psychophysiology, 94, 100–107. https://doi.org/10.1016/j.ijpsycho.2014.07.015 Pinquart, M., & Sörensen, S. (2004). Associations of Caregiver Stressors and Uplifts with Subjective Well-being and Depressive Mood: A Meta-analytic Comparison. Aging & Mental Health, 8(5), 438–449. https://doi.org/10.1080/13607860410001725036 Popli, U. K., & Panday, R. (2018). Caregivers Burden of Hospitalized Elderly. Journal of Gerontology & Geriatric Research, 07(05), 1000483. https://doi.org/10.4172/2167-7182.1000483 Powers, D. V, Cramer, R. J., & Grubka, J. M. (2007). Spirituality, Life Stress, and Affective Well-Being. Journal of Psychology and Theology, 35(3), 235–243. https://doi.org/10.1177/009164710703500306 Putri, Y. S. E. (2013). Prediktor Beban Merawat Dan Tingkat Depresi Caregiver Dalam Merawat Lanjut Usia Dengan Demensia Di Masyarakat. Jurnal Ners, 8(1), 88–97. https://doi.org/10.20473/ jn.v8i1.3882 Ratnasari, S., & Suleeman, J. (2017). Perbedaan Regulasi Emosi Perempuan dan Laki-Laki di Perguruan Tinggi. Jurnal Psikologi Sosial, 15(1), 35– 46. https://doi.org/10.7454/jps.2017.4 Ruiz-Robledillo, N., & Moya-Albiol, L. (2013). Self-Reported Health and Cortisol Awakening Response in Parents of People with Asperger Syndrome: The Role of Trait Anger and Anxiety, Coping and Burden. Psychology and Health, 28(11), 1246–1264. https://doi.org/ 10.1080/08870446.2013.800517 57Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Sabzwari, S., Badini, A., Fatmi, Z., & Shah, S. (2016). Burden and Associated Factors for Caregivers of the Elderly in a Developing Country. Eastern Mediterranean Health Journal, 22(6), 394–403. https://doi. org/10.26719/2016.22.6.394 Saifuddin, A. (2019). Psikologi Agama: Implementasi Psikologi untuk Memahami Perilaku Beragama. Jakarta: Kencana. Saifuddin, A. (2020). Penyusunan Skala Psikologi. Jakarta: Kencana. Santrock, J. W. (2011). Developmental Psychology. New York: Mc Graw Hill. Sarafino, E. P., & Smith, T. W. (2016). Health Psychology: Biopsychosocial Interactions (9th Ed). New Jersey, United States: John Wiley & Sons, Inc. Schoenmakers, B., Buntinx, F., & Delepeleire, J. (2010). Factors Determining the Impact of Care-giving on Caregivers of Elderly Patients with Dementia: A Systematic Literature Review. Maturitas, 66(2), 191–200. https://doi.org/10.1016/j.maturitas.2010.02.009 Schulz, R., & Sherwood, P. R. (2008). Physical and Mental Health Effects of Family Caregiving. AJN The American Journal of Nursing, 108(9 (Supplement)), 23–27. https://doi.org/10.1097/01. NAJ.0000336406.45248.4c Sharif, S. P., & Ong, F. S. (2019). Education Moderates the Relationship Between Spirituality with Quality of Life and Stress Among Malay Muslim Women with Breast Cancer. Journal of Religion and Health, 58(4), 1060–1071. https://doi.org/10.1007/s10943-018-0587-1 Shen, S., Wan, Y., Xie, Y., Chen, Z., & Li, F. (2019). Care Stress Experienced by Caregivers of Elderly Individuals With Disabilities and the Coping Strategies Utilized: A Survey Study in the City of Nanjing, China. Journal of Family Issues, 40(10), 1396 –1414. https://doi. org/.org/10.1177/0192513X19841659 Tamdee, D., Tamdee, P., Greiner, C., Boonchiang, W., Okamoto, N., & Isowa, T. (2019). Conditions of Caring for the Elderly and Family Caregiver Stress in Chiang Mai, Thailand. Journal of Health Research, 33(2), 138–150. https://doi.org/10.1108/JHR-07-2018-0053 © Tang, Y. (2009). Social Support of Elderly Caregivers. International Journal of Business and Management, 3(8), 81–84. https://doi.org/10.5539/ ijbm.v3n8p81 58 Correlation Between Emotion Regulation and Spirituality with Stress on the Caregiver of Elderly Dwi Anjaswati Putri Hastari, Istar Yuliadi, Rini Setyowati Al-Balagh: Jurnal Dakwah dan Komunikasi, Vol. 5, No. 1, January – June 2020, pp. 27 - 58, DOI: https://doi.org/10.22515/al-balagh.v5i1.2269 ISSN: 2527-5704 (P) ISSN: 2527-5682 (E) Thompson, R. A. (1991). Emotional Regulation and Emotional Development. Educational Psychology Review, 3(4), 269–307. https:// doi.org/10.1007/BF01319934 Tuck, I., Alleyne, R., & Thinganjana, W. (2006). Spirituality and Stress Management in Healthy Adults. Journal of Holistic Nursing, 24(4), 245–253. https://doi.org/10.1177/0898010106289842 Wade, C., Garry, M., & Tavris, C. (2013). Psychology (11th Ed). London, United Kingdom: Pearson. Wang, M., & Saudino, K. J. (2011). Emotion Regulation and Stress. Journal of Adult Development, 18(2), 95–103. https://doi.org/10.1007/ s10804-010-9114-7 Widyakusuma, N. (2013). Peran Pendamping Dalam Program Pendampingan Dan Perawatan Sosial Lanjut Usia Di Lingkungan Keluarga (Home Care). Informasi, 18(02), 211–224. Widyastuti, R. H., Sahar, J., & Permatasari, H. (2011). Pengalaman Keluarga Merawat Lansia dengan Demensia. Jurnal Ners Indonesia, 1(2), 49– 57. https://doi.org/10.31258/jni.1.2.49-57 Yadav, R., & Khanna, A. (2014). Impact of Spirituality on Stress: With the Special Reference of Engineering Students of Indian Institute of Technology Radha. Research on Humanities and Social Sciences, 4(25), 29–35. Yeh, P. M., Wierenga, M. E., & Yuan, S. C. (2009). Influences of Psychological Well-being, Quality of Caregiver-patient Relationship, and Family Support on the Health of Family Caregivers for Cancer Patients in Taiwan. Asian Nursing Research, 3(4), 154–166. https://doi. org/10.1016/S1976-1317(09)60027-X Yigitalp, G., Gumus, F., Surucu, H., & Evinc, E. (2017). Predictors of Caregiver Burden in Primary Caregivers of Chronic Patients. International Journal of Caring, 10(3), 1168–1177. Yun, K., Kim, S., & Awasu, C. R. (2019). Stress and Impact of Spirituality as a Mediator of Coping Methods among Social Work College Students. Journal of Human Behavior in the Social Environment, 29(1), 125–136. https://doi.org/10.1080/10911359.2018.1491918