Microsoft Word - HASINUDDIN QC 2 20-12-2021.docx http://e-journal.unair.ac.id/JNERS | 193 Jurnal Ners Vol. 16, No. 2, October 2021 http://dx.doi.org/10.20473/jn.v16i2.30637 This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License Original Research Parents' Psychological Aspect in Caring for the Child During COVID-19 Pandemic M. Hasinuddin1, Rusana Rusana2, Ulva Noviana1, Heni Ekawati1, Nurul Aini3 and Sandeep Poddar4 1STIKES Ngudia Husada Madura, Madura, Indonesia 2STIKES Al-Irsyad Al-Islamiyyah Cilacap, Cilacap Indonesia 3Universitas Muhammadiyah Malang, Malang, Indonesia 4Lincoln University College, Selangor, Malaysia ABSTRACT Introduction: COVID-19 is unprecedented, especially for parents with children aged 2-12 years old who are prone to infection due to their activities. The psychological condition of parents will be affected as they are worried about their children being infected with COVID-19. Methods: This study aims to identify and analyse the psychological aspects of parents who are caring for children during the COVID-19 pandemic. Results: The results showed that as many as 236 parents (80.9%) showed an emotional anxiety response. The social reaction to the COVID-19 situation was more likely to be a positive response (73.8%) rather than a negative response. Conclusion: The reactions that occur in parents who have pre-school and school-aged children regarding the COVID-19 were anxiety and worry. Reactions arise due to the information obtained being less verifiable, namely social media. ARTICLE HISTORY Received: October 12, 2021 Accepted: December 16, 2021 KEYWORDS child; caring; pandemic; psychosocial; parent CONTACT M. Hasinuddin * hasin3333.nhm@gmail.com + STIKES Ngudia Husada Madura, Madura, Indonesia Cite this as: Hasinuddin, M., Rusana, R., Noviana, U., Ekawati, H., Aini, N., & Poddar, S. (2021). Parents' Psychological Aspect in Caring for The Child During Covid-19 Pandemic. Jurnal Ners, 16(2). 193-197. doi:http://dx.doi.org/10.20473/jn.v16i2.30637 INTRODUCTION The World Health Organization (WHO) has reported more than 2 million cases of Corona Virus Disease (COVID-19) in more than 210 countries and regions, resulting in 195,755 people dying and 781,109 people recovering (Bhattacharya et al., 2020; Nakoe et al., 2020). In Indonesia, two cases of confirmed COVID-19 were announced in March 2020, and it increased significantly to reach 1790 confirmed cases, in which there were 113 new cases per day, with 170 deaths, and 112 people recovered (Djalante et al., 2020; Ministry of Health, 2020). The unpredicted COVID-19 situation has created stress, and it is likely to affect people (World Health Organization, 2020), especially parents caring for children in the school-aged group (Brown et al., 2020; Moscardino et al., 2021). A previous study has proven that the COVID-19 emergency resulted in a worrying period for families, increasing difficulties in managing daily activities, especially free time and structured activities (Colizzi et al., 2020). Since the phenomenon of the COVID-19 pandemic affects people's psychological and daily lives (Buzzi et al., 2020), family living conditions suddenly change in the home environment, and, thus, the role of parents' education for children is more important than ever. Children expect parents who can provide support and pay attention to their development and provide new learning experiences, especially for toddlers and pre-schoolers (Jiao et al., 2020). Many parents also have to work from home, so managing time to work and accompanying children becomes very problematic. This situation can significantly increase the risk of experiencing stress and negative emotions in parents, with the effect of decreasing the welfare of children (Sprang & Silman, 2013). M. HASINUDDIN ET AL. 194 | pISSN: 1858-3598 � eISSN: 2502-5791 The psychological wellbeing of parents and children is a major concern with the quarantine regulation due to COVID-19. This creates fear and anxiety in both parents and children (Liu et al., 2020). Most of the studies conducted during the pandemic and since the beginning of the COVID-19 outbreak examined the psychological consequences on the general population, especially on the elderly and children (Brooks et al., 2020). A survey in China found that the psychological effects on children during the COVID-19 pandemic, such as fear, inattention and irritability, were the most severe symptoms (Jiao et al., 2020). Several factors influence the psychological response of parents and children including structural aspects of the home and family as well as the environment. The subjective experience of parents, stress and adjustment to quarantine, affect the welfare of parents and children which can make parents stressed and can interfere with children's wellbeing (Abidin, 1992; Madigan et al., 2018; Wong et al., 2021). The COVID-19 pandemic increases the psychological problems of parents, especially stress at the individual and community level, which has a negative impact on the emotional wellbeing and behavior of children and parents (Dalton et al., 2020). This study aims to identify and analyse the psychological aspects of parents who are caring for children during the COVID-19 pandemic. MATERIALS AND METHODS A cross-sectional approach was used in this study. The samples were taken by purposive sampling technique which consisted of parents or guardian with children aged 2-12 years as many as 325 people, from more than seven provinces in Indonesia. The inclusion criteria of the participants in this study were: (1) parents or guardians who have children in aged 2-12 years old; (2) living together with the children and caring for them; (3) being able to fill in the Google Form; and (4) agreeing with the terms and conditions of this research. Meanwhile, those who were not eligible for the inclusion criteria will be excluded from this study. The dependent variable of this study was parents’ psychological aspects and caring for children in the school age group was the independent variable. The data were collected online in July 2020 by utilising Google Forms as a tool to distribute the questionnaire. We reached the participants through WhatsApp groups by sharing the Google Form link. The questionnaire instrument contains the characteristics, beliefs and sources of information as well as the psychosocial (emotional and social) responses of the respondents. The used instrument in this study was a questionnaire which was developed from the instrument protocol from Health Department ((Kemenkes, 2020). Several questions were directed to measure the socio-demography of participants, in particular: Child’s Age, Child’s Gender, Origin, Parental Status. Specific questions related to the psychological response were (1) the belief of COVID- 19 existence divided into two categories: believe and do not believe; (2) Information Resource consisted two options: social media and health worker; (3) Psychological Response or emotion was measured into unconcern and anxiety; and (4) Social Response included positive and negative. Data were analysed by univariate analysis, bivariate with Chi-square and multivariate using linear regression. All data analysis was performed statistically using SPSS version 26 for Windows (SPSS, Inc, Chicago, Ill) and significance was set at p<0.05. The research has been approved by the research ethics committee of STIKES Ngudia Husada Madura (681/KEPK/STIKES-NHM/EC/VII/2020) on July, 23rd 2020. RESULTS Most of the respondents were mothers (88.0%), from East Java (70.8%), which was classified as the red zone for the spread of COVID-19. The majority of participants believed in the existence of COVID-19 (94.5%), sources of information about COVID-19 were from social media (42.8%). Respondents in this study had children of pre-school age (44.3%) with sex mostly male (53.2%). Most of the respondents were likely to have experienced psychological responses Table 1. Characteristics of respondents (N= 325) Characteristic n % Child’s age: Toddler 202 62.2 School Age 123 37.8 Child’s Gender: Male 173 53.2 Female 152 46.8 Origin: East Java 230 70.8 Central Java 36 11.1 West Java 26 8.0 Jakarta 9 2.8 Bali 9 2.8 DIY 4 1.2 South Sumatera 3 0.9 The other 8 2.4 Parent Status: Parents (Mother or Father) 319 98.2 Another Guardian 6 1.8 The belief of COVID-19 Existence Believe 307 94.5 Do not believe 18 5.5 Information Source: Social Media 249 76.6 Health Worker 76 23.4 Psychological Response/ Emotional: Unconcern 62 19.1 Anxiety 263 80.9 Social Response: Positive 240 73.8 Negative 85 26.2 JURNAL NERS http://e-journal.unair.ac.id/JNERS | 195 (anxiety) (80.9%) rather than unconcern response (19.1%). Social response to the COVID-19 situation was more likely to be positive response (73.8%) than negative response (26.2%). Detailed information about the characteristics of respondents is depicted in Table 1. The analysis of the relationship between parental status and respondent's belief with psychological responses showed that there were 261 (81.8%) and 258 (84%) participants who experienced an anxiety emotional response, worried that a family member had contracted COVID-19. The results of statistical tests showed that there was a significant relationship between parental status and respondents' psychological responses (p-value = 0.014) as depicted in Table 2. In addition, the belief of COVID-19 existence showed a significant value among parents who believe compared to those who do not believe (p- value=0.001). DISCUSSION The COVID-19 situation has been a stressor for families as the disease is creating uncertainty and novelty (Brown et al., 2020; Chung et al., 2020). The life condition of families has been restricted and led to experience some stressors and emotional feelings (Morelli et al., 2020). The stressors come from several factors including managing children for 24 hours, having had to work from home, the reduction of wages and the fear of COVID-19 infection (Morelli et al., 2020; Spinelli et al., 2020). These impacts influence the family system and stimulate parenting stress; even those who are not exposed to the virus can feel the indirect effect of the COVID-19 pandemic (Bavel et al., 2020; Chung et al., 2020). Our study proved that two psychological factors (parental status and the belief of COVID-19 existence) have shown a significant association with the parental condition when caring for their children during the pandemic. The status of parents is highly likely to have an association with the psychological state of parents caring for their children (p=0.014; X2=83) in which most parents felt anxiety about the exposure of children to the COVID-19 virus. This finding has correlation with a previous study that most of parents reported high level of anxiety of COVID-19 infecting their children when they do physical outdoors activities (McCormack et al., 2020). The parents’ anxiety encouraged them to make some restrictions for their children, particularly limited access to the public areas, and this drove the parents to follow the health recommendations, such as physical distancing (Tremblay et al., 2016). Long-term effect of the parents’ anxiety is the child's boredom and the desire to get out of the house, which triggers the parents to be more frustrated in caring for them. Then, this situation will turn into a family stress and harsh parenting. To prevent the forecast stress situation, it is better for the parents to manage their psychological care by balancing the way they handle their anxiety about the situation and their children’s wellbeing. The role of health practitioners is needed to be a consultant for the parents on how to cope with this situation. The second significant factor is the parents’ perception about the existence of COVID-19 itself. In present study, we evaluate that the more parents believe about the COVID-19 pandemic, the more they felt worry about the disease. Generally, the COVID-19 pandemic has a psychological effect and becomes a heavy stressor. A common response in times of crisis is anxiety which arises because of fear or feeling uncomfortable. Anxiety about the spread of COVID-19 can happen to parents as they hear news or information related to the increasingly rapid spread of the Corona virus and the increasing number of Table 2. The Relationship between Respondent Status and the Psychological (Emotional and Social) Response of Parents during the COVID-19 Pandemic (N=325) Variables Psychological Response (Emotional) X2 p-value Unconcern Anxiety n (%) n (%) Child’s Gender: Male Female 35(20.2%) 27(17.8%) 138 (79.8%) 125 (82.2%) 1.174 0.672 Parental Status: Parent Another Guardian 58(18.2%) 4 (66.7%) 261 (81.8%) 2 (33.3%) 0.111 0.014* Child’s Age: Toddlers Pre-School 33 (16.3%) 29 (23.6%) 169 (83.7%) 94 (76.4%) 0.633 0.143 The belief of COVID-19 Existence: Believe Do Not Believe 49 (16%) 13 (72.2%) 258 (84.0%) 5 (27.8%) 0.073 0.001* Information Source Social Media Health Worker 48 (19.3%) 14 (18.4%) 201 (80.7%) 62 (81.6) 1.058 1.000 * Chi-square test, p<0.05 M. HASINUDDIN ET AL. 196 | pISSN: 1858-3598 � eISSN: 2502-5791 patients. A qualitative study stated that participants were afraid of contracting COVID-19 both for themselves and their families (Sumakul & Ruata, 2020). Another study has also proved that the anxiety of COVID-19 tends to make people feel fear and the common concern of the fear is because of the health condition of their loved ones (Mertens et al., 2020). The gender of children has not shown any significant relevance with the psychological parents in caring for their children during the pandemic. Theoretically, the gender of children influences the way parents treat, communicate and behave to the children by which the tendency is to be more protective to a girl than boy (Mascaro et al., 2017). From this phenomenon, we can assume that under some circumstances, such as crisis and pandemic, the psychological effect on parents, specifically the anxiety feeling, will equally appear both for sons and daughters. Aside from gender, the age of children was also not considered as a factor related to the psychological state of parents. The parents showed the same psychological response when caring for toddlers and school age children. The reason for this is because parents and children have a strong inner and emotional connection. Thus, parents will feel more worried if their child is sick or contracted with a disease regardless how old their children are. According to the information source, this study confirmed that there is no relationship between the psychological status of parents with how the get to know the information about COVID-19. In fact, various information about COVID-19 has spread massively from various media rather other sources (Ahmadi et al., 2021; Prasetyawati et al., 2021). Social media through electronic media presents various kinds of news, both actual, trusted and hoax news or information. Fake news or hoax news is news that is spread by certain parties with various interests. There are several factors that make a person or group believe in the spread of hoax news, especially about the trending COVID-19. 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