Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 59 Psycoeducation of the Resilience of the Family of Patients with Mental Disorders in Overcoming Psychosocial Problems in the Transition of the Covid-19 Pandemic in the Region Buleleng Regency of Bali Eka Lutfiatus Solehah1*, Nyoman Sri Ariantini2 1,2 Department of Nursing, Sekolah Tinggi Ilmu Kesehatan Rana Wijaya Singaraja, Indonesia *Corresponding author: ekasoleha2018@gmail.com ABSTRACT Background: The Covid-19 pandemic affects all aspects of human life, physically, economically and psychosocially. This pandemic situation also affects the mental state of the families of ODGJ patients. This situation not only threatens overall health but also threatens the resilience of the family in dealing with the situation. Purpose: The study was to determine the effect of psychoeducation on the resilience of families of patients with mental disorders in overcoming psychosocial problems during the transition period of the COVID-19 pandemic in the Buleleng-Bali Regency area. Methods: The methods uses a true experiment using a one group pre-posttest approach. This research activity was carried out in two stages, namely field activities and activities to provide counseling and education about ODGJ care during the transition period. Results: This study indicate that before being given psychoeducation to families of ODGJ sufferers, most of the family toughness was in the less category as many as 57 respondents (57%) and after being given psychoeducation the family was mostly in the good toughness category as many as 67 respondents (67%). The results of the paired T test show the value of = 0.000 with = 0.05. The results of this test show that the value of < then H1 is accepted, meaning that there is an influence of psychoeducation on the resilience of the family of ODGJ patients in Overcoming Psychosocial Problems During the Transition Period of the Covid-19 Pandemic in the Buleleng Regency –Bali. Conclusion: Providing psychoeducation can help families become more resilient in dealing with psychosocial problems in treating DOGJ patients during the transition period of the COVID-19 pandemic. Keywords: family, mental disorders, psychoeducation Received August 10, 2022; Revised September 12, 2022; Accepted October 3, 2022 DOI: https://doi.org/10.30994/jnp.v6i1.277 The Journal of Nursing Practice, its website, and the articles published there in are licensed under a Creative Commons Attribution-Non Commercial- ShareAlike 4.0 International License. https://thejnp.org/ mailto:ekasoleha2018@gmail.com https://doi.org/10.30994/jnp.xxxx.xxx Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 60 BACKGROUND The COVID-19 pandemic not only has an impact on the physical and economic aspects, it also raises health problems that can interfere with mental and psychosocial health. This situation certainly requires integrated and comprehensive efforts in the management and handling of mental health and psychosocial cases that occur in the community due to the COVID-19 pandemic (Kementrian Kesehatan, 2014). This situation has changed the order of people's lives to be able to adopt a new habit or rule in their daily activities (Mawaddah et al., 2021). This uncertain and uncertain situation can lead to a psychological response for the individual. Anxiety is a natural response when individuals are faced with psychosocial stressors, such as unpredictable situations, this situation will have more impact on families who have members who have mental disorders or ODGJ (Pertiwi & Syakarofath, 2020). Some psychosocial problems that can arise during a pandemic include fatigue, low self-esteem, disability Coping with family conflict, anxiety, depression and panic disorder. The family has a big role for individuals in conditions of psychological vulnerability because family support is a very powerful source of strength in order to maintain physical and mental health so that individuals can return to power (Marleta et al., 2020). Handling that can be done to improve the family's ability to deal with these psychosocial problems includes growing family resilience in dealing with these situations, including providing psychoeducation to families. Psychoeducation is provided with the aim of increasing positive attitudes towards the various challenges of family life in dealing with these crisis situations so that families can properly handle problems that arise during the COVID-19 transition period towards the care of ODGJ patients. According to the Ministry of Health's 2021 report, data on the increase in the number of people with mental disorders increased by 6.8% during COVID-19. Based on preliminary study data at the Social Service of Buleleng Regency, the number of people with mental disorders or ODGJ in Kab. Buleleng in January - December as many as 45 people who were recorded in 2021, while the total people with mental disorders in Bali amounted to 9000 people. The high number of ODGJs in Buleleng Regency, Bali, attracted the attention of researchers to conduct research on Psychoeducation on the Resilience of Families of Patients with Mental Disorders in Overcoming Psychosocial Problems During the Transition Period of the COVID-19 Pandemic in the Buleleng Regency, Bali. The purpose of this study was to determine the effect of psychoeducation on the resilience of families of patients with mental disorders in overcoming psychosocial problems during the transition period of the COVID-19 pandemic in the Buleleng-Bali Regency area. This research method uses a true experiment using a one group pre-posttest approach. This research activity was carried out in two stages, namely field activities and activities to provide counseling and education about ODGJ care during the transition period. The results of the study are expected to increase the family's resilience in carrying out and overcoming the psychosocial problems of ODGJ patients during the transition period of the COVID-19 pandemic, so that families are able to recognize mental health problems, are able to overcome family problems independently or come to health workers to obtain appropriate treatment in accordance with health problems experienced by families and patients. OBJECTIVE The purpose of the study was to determine the effect of psychoeducation on the resilience of the family of patients with mental disorders in overcoming psychosocial problems during the transition period of the Covid-19 pandemic in the Buleleng-Bali Regency. https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 61 METHODS This research method uses a true experiment using a one group posttest only design approach. ODGJ population in Kab. Buleleng numbered 45 people, assuming 1 ODGJ was cared for by 2 family members, so the sample in this study amounted to 90 people. The sampling technique in this study will use probability sampling, namely Simple Random Sampling, which is sampling in the population that is carried out randomly without regard to the existing strata in the population. The inclusion criteria in this study were families who had ODGJ, domiciled in Buleleng Regency, Bali, and were willing to be respondents. This research activity was carried out in two stages, namely counseling and education activities about the care of ODGJ in the COVID-19 transition, the second was the evaluation phase of the implementation of psychoeducation for ODGJ families. Data collection used instruments in the form of questionnaires and interview guidelines which were directly given to respondents. Analysis of the data used in this study used the t test to determine the average increase in family resilience before and after psychoeducation. RESULTS A. General Data 1. Family Characteristics Table 1 Frequency Distribution of Family Characteristics in the District of Buleleng – Bali in August 2020 (n=100) Care Giver Characteristics Amount Prosentase Age of Family 26-35 Years 6 6 36-45 Years 64 6 46-55 Years 30 30 Family Education Elementary School 1 1 Junior High School 38 38 Senior High School 49 49 University 12 12 Working Not Work 27 27 Work 73 73 Source : Primyary Data Process, 2022 Based on table 1 above, it is known that the characteristics of respondents based on family age obtained data mostly aged 36-45 years as many as 64 respondents (64%). the educational characteristics of the respondents' families obtained data that almost half of them are high school graduates as many as 49 respondents (49%). The characteristics of the respondents' occupations showed that most of the respondents worked as many as 73 respondents (73%). The results showed that most of the families of ODGJ patients were still in the productive age category even though there were some who entered early elderly age, and had a secondary educational background and many of them still had jobs either as private employees, tradesmen, or entrepreneurs, so that the characteristics The respondent's family affects the respondent's knowledge and skills in caring for family members who suffer from ODGJ but sometimes this can be a psychological burden for the family. The characteristics of https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 62 this respondent indicate that the respondent can be said to be quite able to understand information about the care that must be carried out on family members who experience ODGJ so that families can carry out proper care even in the current pandemic condition, so that family resilience can be further improved and maintained properly. 2. Characteristic Of ODGJ patients Tabel 2 Frequency Distribution based on ODGJ Patient Characteristics in the District of Buleleng –Bali in August 2020 (n=100) ODGJ Patient Characteristics Amount Prosentase Age of patient 26-35 years 62 62 36-45 years 31 31 46-55 years 7 7 Education of patients Elementary School 5 5 Junior High School 35 35 Senior High School 58 58 University 2 2 Source : Primyary Data Process, 2022 Based on table 2 above, it is explained that based on the age of the patients, most of them are 26-35 years old as many as 62 respondents (62%). Based on patient education, most of them have high school education background as many as 58 respondents (58%), The results of this study indicate that most ODGJ patients are still of productive age with patient education background including higher education. B. Special Data 1. Resilience Of The Family Tabel 3 Frequency Distribution based on Resilience Of The Family before and after giving pyschoeducation in the District of Buleleng –Bali in August 2020 (n=100) Resilience of the Family Before After Amount Prosentase Amount Prosentase Less Resilience 57 57 33 33 Good Resilience 43 43 67 67 Amount 100 100 100 100 Source : Primyary Data Process, 2022 Based on the results in table 3, it shows that before being given psychoeducation to families of ODGJ sufferers, most of the family toughness was in the less category as many as 57 respondents (57%) and after being given psychoeducation the family was mostly in the good toughness category as many as 67 respondents (67%). The results of this study indicate that the provision of psychoeducation increases the resilience of the families of ODGJ patients in overcoming psychosocial problems during the Covid-19 pandemic transition period in the Buleleng Regency – Bali. 2. Result Of Statistics Tabel 4 The results of the paired t test Psychoeducation of resilience in families of people with ODGJ in Overcoming Psychosocial Problems During the Pandemic Transition Covid-19 in the District of Buleleng –Bali in August 2020 (n=100). https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 63 Paired Differences t df Sig. (2- tailed) Mean Std. Deviati on Std. Error Mean 95% Confidence Interval of the Difference Lower Upper Pair 1 Resilience of Family Pretest - Resilience of Family Postest .240 .429 .043 .325 .155 5.591 99 .000 Source : Primyary Data Process, 2022 Based on the results in table 4 shows that the value of = 0.000 with = 0.05. The results of this test show that the value of < then H1 is accepted, meaning that there is an influence of psychoeducation on the resilience of the family of ODGJ patients in Overcoming Psychosocial Problems During the Transition Period of the Covid-19 Pandemic in the Buleleng Regency – Bali. DISCUSSION Based on the results in table 3, it shows that before being given psychoeducation to families of ODGJ sufferers, most of the family toughness was in the less category as many as 57 respondents (57%) and after being given psychoeducation the family was mostly in the good toughness category as many as 67 respondents (67%). The results of this study indicate that the provision of psychoeducation increases the resilience of the families of ODGJ patients in overcoming psychosocial problems during the transition period of the Covid-19 pandemic in the Buleleng Regency –Bali. Based on the results in table 4 shows that the value of = 0.000 with = 0.05. The results of this test show that the value of < then H1 is accepted, meaning that there is an influence of psychoeducation on the resilience of the family of ODGJ patients in Overcoming Psychosocial Problems During the Transition Period of the Covid-19 Pandemic in the Buleleng Regency –Bali. Family as caregiver plays a very..important role..in assisting people with mental disorders and living their daily lives. So many problems faced by families in caring for family members who experience mental disorders. Family resilience is the ability of the family to protect themselves from various life threats that come from their own family and from outside the family such as the environment, society and the state; the ability to adapt to conditions that are always changing dynamically and have a positive attitude towards the challenges of family life (Budi Wijoyo et al., 2021). Family psychoeducation program is a family mental health care program with an educational approach. The purpose of this family psychoeducation is to increase family knowledge about health problems, teach techniques that can help families recognize the symptoms of behavioral deviations and increase support for other family members (Cahyaningtyas et al., 2016). The psychoeducation program provided in this community activity is Family Resilience Psychoeducation in overcoming psychosocial problems that occur due to the Covid-19 pandemic. Towards a strong family during this pandemic, it is necessary to start by https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 64 strengthening personal resilience first which can then strengthen other family members. This community service activity aims to increase participants' knowledge about mental health problems or psychosocial problems and increase their ability to face various difficulties during the crisis as a result of the Covid-19 pandemic that occurred. Based on the results of the research above, it shows that before psychoeducation was given, many families felt less capable, less confident and also not ready to face psychosocial problems because of the stigma and public perception of ODGJ patients. The family's lack of resilience creates feelings of tiredness and despair in caring for their family members who have ODGJ. In addition, families feel burdened in caring for their family members with mental disorders. Lack of knowledge and insight possessed by the family in caring for ODGJ patients, especially in dealing with psychosocial problems, causes the family to feel heavy and uncomfortable in carrying out the treatment. Besides that, with the need for care and daily needs which sometimes become difficult to fulfill because the process of treating patients with mental disorders takes a long time and also because of the impact of the COVID-19 pandemic which destroys the community's economy. Based on the characteristics of the family age of ODGJ patients in table 1, the data obtained are mostly aged 36-45 years as many as 64 respondents (64%). According to Bandura in Solehah, (2021) state one of the factors that affect a person's ability and belief in doing something is age. Abilities and beliefs are formed through a social learning process that can take place throughout life. Older individuals tend to have more time and experience in dealing with things that happen when compared to younger individuals, who may still have less experiences and events in their lives. Older individuals will be more able to overcome obstacles in their lives compared to younger individuals, this is also related to the experiences that individuals have throughout their life span. The results of this study indicate that the respondent's age includes late adulthood where at that age the respondent will find it easier to understand the information received, especially about health education provided by officers regarding the management of ODGJ patient care, especially in dealing with family psychosocial problems in the transition period of the COVID- 19 pandemic. so that many families who before the provision of psychoeducation had less resilience turned into more resilient after being given psychoeducation. Based on family education, the data in table 1 shows that almost half of them are high school graduates as many as 49 respondents (49%). According to Bandura in Kusumawaty et al., (2020) states that abilities and beliefs are formed through a learning process that can be accepted by individuals at the level of formal education. Individuals who have higher levels usually have higher abilities and beliefs, because basically they learn more and receive more formal education, in addition, individuals who have higher levels of education will have more opportunities to learn in overcoming problems. -problems in life. According to the researcher's assumption, the respondent's educational background is secondary education so that they are quite capable of understanding and receiving explanations from officers on how to deal with psychosocial problems that occur during the family's care for ODGJ patients during the transition period of the COVID-19 pandemic. This happens because with an explanation from the respondent's health officer they can explain how to https://thejnp.org/ Journal Of Nursing Practice https://thejnp.org/ ISSN: 2614-3488 (print); 2614-3496 (online) Vol.6 No.1. October 2022. Page.59-66 65 manage the stress they face when caring for ODGJ patients, especially in dealing with psychosocial problems that arise during the transition period of the COVID-19 pandemic, so many respondents have high family resilience after being given psychoeducation. The results of this study indicate that providing psychoeducation can help families become more resilient in dealing with psychosocial problems in treating DOGJ patients during the transition period of the COVID-19 pandemic. With the provision of psychoeducation, the family feels that they can determine appropriate coping strategies to adapt to the current situation, where families usually feel worried and anxious so that they cannot adapt well, but after being given psychoeducation about family stress management, they are able to control the anxiety they experience. so that they can be calmer in taking care of family members who have mental disorders. CONCLUSION 1. Before being given psychoeducation to families of ODGJ sufferers, most of the family's toughness was in the poor category as many as 57 respondents (57%) and after being given psychoeducation, most of the family members were in the good toughness category as many as 67 respondents (67%). 2. The results of this test show that the value of < then H1 is accepted, meaning that there is an influence of psychoeducation on the resilience of the family of ODGJ patients in Overcoming Psychosocial Problems During the Transition Period of the Covid-19 Pandemic in the Buleleng Regency –Bali. REFERENCES Budi Wijoyo, E., Yoyoh, I., Hastuti, H., & Mulyawan, A. (2021). Intervensi Psikoedukasi Keluarga Untuk Merawat Orang Dengan Gangguan Jiwa (ODGJ) : Literature Review. In Edu Masda Journal (Vol. 5). http://openjournal.masda.ac.id/index.php/edumasda. Cahyaningtyas, A., Tenrisana, As. A., Triana, D., Prastiwi, D. A., Nurcahyo, E. H., Jamilah, & Tiwa, V. D. (2016). Pembangunan Ketahanan Keluarga 2016 (Edisi Satu). CV. Lintas Khatulistiwa. Kementrian Kesehatan, I. (2014). Undang-Undang Republik Indonesia Nomor 18 Tahun 2014 Tentang Kesehatan Jiwa. Kusumawaty, I., Yurike, & Pastari, M. (2020). 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